Diabetic control--a critical evaluation of current methods of assessment

The value of a number of currently used parameters in the assessment of diabetic control was critically assessed in one hundred and seventy seven diabetics. Each method was compared with the results of 5 blood glucose values taken at selected times during the 24 hours. In all diabetic patients, clinical assessment, semi-quantitative urine tests both at home and in hospital and 24-hour quantitative urinary glucose values can at best indicate only poor diabetic control. They failed to do this in a substantial number of cases. In insulin dependent diabetics, isolated blood glucose readings are of very limited value in predicting good diabetic control. In maturity onset type diabetes, a single blood glucose reading is a reliable index of diabetic control. The implications of these findings in the practical management of diabetes are considered.