SFEBES2021 Poster Presentations Metabolism, Obesity and Diabetes (78 abstracts)
The Variability In Glycosylated Haemoglobin (HbA1c) Testing Interval In People With Diabetes Is Linked To Long-Term Diabetes Control, Independent of HbA1c Test Interval
Adrian Heald 1,2 , David Holland 3 , Michael Stedman 4 , Chirstopher J Duff 5,6 , Lewis Green 7 , Jonathan Scargill 8 , Fahmy WF Hanna 9,10 , Pensee Wu 11,5 & Anthony A Fryer 6,6
1University of Manchester, Manchester, United Kingdom; 2Salford Royal Hospital, Salford, United Kingdom; 3The Benchmarking Partnership, Alsager, United Kingdom; 4RES Consortium, Andover, United Kingdom; 5School of Medicine, Keele University, Keele, United Kingdom; 6Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom; 7St. Helens & Knowsley Teaching Hospitals NHS Trust, Whiston Hospital, Prescot, United
Kingdom; 8Department of Clinical Biochemistry, The Royal Oldham Hospital, The Northern Care Alliance NHS Group, Oldham, United Kingdom; 9Department of Diabetes and Endocrinology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom; 10Centre for Health & Development, Staffordshire University, Stafford, United Kingdom; 11Department of Obstetrics & Gynaecology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
Introduction: Worldwide guidance advocates regular HbA1c testing for people with diabetes mellitus, usually 2-4/yr. We previously showed that HbA1c testing frequency is linked to outcome in terms of HbA1c control. Here we examine the effect of variability (standard deviation = SD) in test interval on change in HbA1c over 7 yrs (Jun 2012-Jul 2019) using laboratory data.
Methods: We focused on people with HbA1c within the first 2 years who also had a HbA1c 5 years± 3 months later and ≥6 tests (total 23582 people). We grouped cases based on the number of tests between t0and t0+5yrsand calculated the SD decile for each group. We examined the link between SD deciles and DHbA1c level,stratifying by starting HbA1c.
Results: We showed that higher variability in testing frequency was linked to worsening HbA1c control. This effect was most evident in those with lower starting HbA1c levels. In those with a starting HbA1c of <59mmol/mol, the lowest SD decile was associated with an increase in mean HbA1c of 3.9mmol/mol while for those with the highest decile, it was more than double this (7.9mmol/mol). In those with an initial HbA1c of 59-75mmol/mol, the lowest SD decile had a mean reduction of 3mmol/mol, while those in the highest decile showed a 4mmol/mol rise. In those with starting values of >75mmol/mol, the same trends were seen, but were less marked. These effects were independent of testing interval. Mean HbA1c level increased with increasing SD decile, irrespective of starting HbA1c (P = 0.009).
Conclusion: These findings indicated that HbA1c testing consistency/regularity, not just numbers of tests/yr, is important in maintaining diabetes control, especially in those with on-target HbA1c levels. This has implications for the management of people who attend sporadically for testing and suggests the need for developing systems to improve regularity of testing.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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