Recent JAMA Article Asks “Is Hemoglobin A1c the Right Outcome for Studies of Diabetes?"
March 2, 2017
The Journal of the American Medical Association recently published an article that analyzed the effectiveness of hemoglobin A1c (HbA1c) as a measure of diabetes outcomes. Lead researchers Dr. Kasia Lipska, MD and Dr. Harlan Krumholz, MD concluded that “treatment should be selected to target specific complications and inherent risks, not solely glucose levels.” Therefore, the authors suggest an alternative view that recommends identifying drugs for diabetes care based on outcomes such as reduction in heart disease or mortality.
Three clinical trials investigating glycemic control during the use of cardioprotective therapies showed “that lowering HbA1c levels to less than 7% of total hemoglobin was not associated with cardiovascular benefits compared with less intensive glycemic control.” Several other trials also demonstrated that small change in glycemic control levels did not affect outcome significantly. This study suggests that “trials that use outcomes based solely on glycemic parameters are no longer acceptable for clinical decision making, [and] investments in pragmatic studies of existing agents are needed to understand the impact on outcomes of all treatment options.”
Epinex believes that glycated albumin should be evaluated as an alternative measurement tool in addition to such current methods and existing agents.