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Practitioner Direct

A1C and Complications

The DCCT was the pivotal trial that provided the link between A1C levels and the risk of diabetes-associated complications. The results of the Diabetes Control and Complications Trial (DCCT) shown below are considered definitive for patients with type 1 diabetes. Relative risk increased with A1C for retinopathy, nephropathy, and microalbuminuria, and the risk of retinopathy and nephropathy accelerated at the highest levels of A1C. In this study, improved glycemic control following intensive diabetes therapy delayed the onset and slowed the progression of diabetic retinopathy, nephropathy and neuropathy in patients with type 1 diabetes. [5]

 

DCCT A1C levels and the risk of complications in type 1 diabetes

 

Chart
Patients with type 1 diabetes (n=1,441)
Adapted from DCCT. Diabetes 1995;44:968-43.

 

The United Kingdom Prospective Diabetes Study (UKPDS) was a large-scale trial that investigated the effect of intensive blood glucose control versus conventional treatment in patients with type 2 diabetes, with a median follow-up of 10 years. This observational analysis of data from the UKPDS demonstrated a direct relationship between the risk of diabetic complications and glycemia over time. Each 1% absolute reduction in mean A1C levels was associated with a 37% decrease in the risk of microvascular complications and a 21% reduction in the risk of any diabetes-related complication or death.

 

Therefore, any improvement in A1C levels is likely to reduce the risk of diabetic complications. [6]


Lowering A1C levels reduces the risk of diabetes complications in people with type 2 diabetes

UKPDS: 21% risk reduction per 1% absolute decrease in A1C levels (p<0.0001)


UKPDS 35 BMJ 2000; 321:405-12
Slide from: http://www.dtu.ox.ac.uk/index.php?maindoo=/ukpds/

 

 

 

Real-time results. Better outcomes.

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  1. Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2002. Atlanta, GA:
    U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2003.
  2. Standards of Medical Care in Diabetes - 2008. Diabetes Care, Volume 31, Supplement 1, January 2008.
  3. Daniels, E. et al, Point of Care Testing to Improve Glycemic Control.Intl J or Health Care Quality Assurance 2008; 21 (3): pp. 325-335.
  4. Data on file; Evaluation of the A1CNow SELFCHECK with lay-users. August 2008.
    * Study results with healthcare professionals showed that the accuracy of A1CNow+ with fingerstick samples was, on average, 99%. This means that, on average, a true 7.0% A1C could read approximately 6.9%A1C. An individual A1CNow+ result may differ by as much as -1.0% A1C to +0.8% A1C from the true result. This represents the 95% confidence limits of a Bland-Altman plot.
  5. DCCT. Diabetes 1995;44:968–83.
  6. UKPDS 35. BMJ 2000;321:405–12.