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Experts push to move ‘beyond HbA1c’ as main measure of diabetes outcomes

07:46 EDT 18 Oct 2016 | Healio

For nearly 3 decades, HbA1c has been the accepted gold-standard measurement of diabetes outcomes. Patients, clinicians, regulators and industry have relied on the 3-month average plasma glucose concentration to assess the efficacy of diabetes therapies and inform treatment decisions, and it has become the primary endpoint for most diabetes drug approval studies.But HbA1c alone does not tell the full story of glycemic variability in patients with type 1 and type 2 diabetes. Advances in diabetes technology, including continuous glucose monitoring (CGM), now paint a fuller picture for patients of their daily glucose variability, including time spent in the normal glycemic range for a person with diabetes (70 mg/dL-180 mg/dL) and any episodes of hypoglycemia and hyperglycemia. Experts debate whether the time has come to consider a more comprehensive composite endpoint to determine the adequacy of diabetes therapies, one that may include HbA1c, but also incorporates metrics including time in range, hypoglycemia, change in body weight and patient-reported outcomes, such as health-related quality of life.

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