HbA1c and the estimated A1c of MyStar Extra
®
HbA1c values can only be obtained from a laboratory and are the major marker of success for all diabetes therapies, including insulin. Under current guidelines patients only have their HbA1c measured every 3 to 6 months. 47–77% of patients with either type 1 or type 2 diabetes do not recall their most recent HbA1c value and more than half do not know their HbA1c targets. Rapid feedback on HbA1c can motivate patients to take a more active role in managing their diabetes. Providing patients with real-time estimates of A1c can therefore increase patient motivation and may result in improved glycaemic control.
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Real-time estimates of A1c
The estimated A1c provided by the MyStar Extra
®
blood glucose meter is a real-time estimation of average glycaemia from self-monitoring blood glucose data, expressed in units of HbA1c. MyStar Extra
®
is the first blood glucose meter that delivers accurate and robust estimates of A1c and trending information based on blood glucose readings stored in the device.
Long-term blood glucose control
The access to an estimated A1c value on MyStar Extra
®
enables patients to see how lifestyle and therapy changes affect their glucose control in real time. This can increase their motivation to better manage their daily treatment regime in between doctor visits which may ultimately lead to improved diabetes control.
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Dr. William H. Polonsky shares his insights on the impact of blood glucose monitoring in the motivation of diabetes patients
Dr. Boris Kovatchev presents the technology behind MyStar Extra’s innovative estimated A1c feature
Frequently asked questions about MyStar Extra’s estimated A1c
What is the (Hb)A1c?
Hemoglobin A1c (HbA1c) is formed when haemoglobin, a protein within red blood cells that carries oxygen throughout the body, joins with glucose in the blood, resulting in a glycosylated haemoglobin molecule. The glucose remains attached to the haemoglobin for the life of the red blood cell. As red blood cells survive for 8-12 weeks before renewal, HbA1c reflects the average blood glucose levels over the past three months. Higher blood glucose concentrations lead to a greater percentage of HbA1c. An increase of the HbA1c value leads to a greater risk of developing diabetes-related complications. HbA1c has become the established standard clinical measurement used as a marker for glycaemic control.
Find out more
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What is the difference between HbA1c and the estimated A1c of MyStar Extra
®
?
The HbA1c value is determined in a clinical laboratory from a capillary or venous blood sample. A HbA1c test is typically done every three months during a doctor visit.
The estimated A1c of MyStar Extra® is an estimate of this long-term blood glucose value based on readings stored in the blood glucose meter. It is updated constantly as long as the user performs blood glucose tests frequently enough.
Which values of HbA1c are considered as target range for patients with diabetes mellitus?
The International Diabetes Federation recommends HbA1c values below 6.5% in most people with type 2 diabetes but individual targets are set in some groups, for example the elderly.
For people with type 1 diabetes – especially children – targets are individualized and range between 7.0% and 7.5%, depending on circumstances. Lowering HbA1c to below or around 7.0% has been shown to reduce microvascular and neuropathic complications of type 1 and type 2 diabetes. Therefore, the HbA1c goal for non-pregnant adults in general is 7.0% or lower.
What does the trend arrow illustrate that is shown together with the estimated A1c values of MyStar Extra
®
?
A simple arrow shown as going up, down or stable indicates the trend direction of the recent estimated A1c value independent from a laboratory HbA1c value. Through the clear and easy-to-understand glucose trend arrows provided by MyStar Extra®, peope with diabetes may more easily track the success of their insulin therapy even in between doctor visits.
References
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American Diabetes Association. ADA Standards of Medical Care in Diabetes 2014. Diabetes Care 2014;37(1):S14-S80. Available at: http://care.diabetesjournals.org/content/37/Supplement_1/S14.full.pdf+html. Accessed: August 2014.
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Cagliero E, et al. Immediate feedback of HbA1c levels improves glycemic control in type 1 and insulin-treated type 2 diabetic patients. Diabetes Care 1999;22:1785–1789
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Chapin RB, et al. Diabetes control improved when inner-city patients received graphic feedback about glycosylated hemoglobin levels. J Gen Intern Med 2003;18:120–124.
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Heisler M, et al. The relationship between knowledge of recent HbA1c values and diabetes care understanding and self-management. Diabetes Care 2005;28:816–822.
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International Diabetes Federation. IDF Guideline on Self – Monitoring of Blood Glucose in Non –Insulin Treated Type 2 Diabetes. 2009. Available at:http://www.idf.org/webdata/docs/SMBG_EN2.pdf. Accessed: August 2014.
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Kovatchev et al. Effect of automated bio-behavioral feedback on the control of type 1 diabetes. Diabetes Care 2011;34(2):302.
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National Institute for Health and Clinical Excellence. Type 2 diabetes: the management of type 2 diabetes (update), Clinical Guideline. May 2008; p 50 (R17)
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Schillinger D, et al. Association of health literacy with diabetes outcomes. JAMA 2002;288:475–482.
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The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus. N Engl J Med 1993;329:977–986.
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UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837–853
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Willaing, I., et al. "Recall of HbA1c and self-management behaviours, patient activation, perception of care and diabetes distress in Type 2 diabetes." Diabetic Medicine 30.4 (2013): e139-e142
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