946-P: HbA1c Is Already Not Enough for Glucose Control Assessment in Type 1 and Type 2 Diabetes

Recommendations for control assessment in diabetes include measurement of glycated hemoglobin (HbA1c) and pre- and postprandial blood glucose (BG). Continuous Glucose Monitoring is a novel method that could be used for insulin dose adjustment but also reveal precise 24-hour glycemic profile through followed days. In our study we compare routine used glycemic control assessment tools with results derived from CGM record. We studied a group of 106 patients (60 men, 46 women; mean age 58.23±10.81 years), 21 patients with type 1 diabetes (on intensified regimen) and 85 patients with type 2 diabetes (33 - on oral medications, 31 - on pre-mixed insulin, 21 - on intensified insulin regimen). Continuous glucose monitoring with iPro^TM was performed for seven days and HbA1c was measured at the end of this period. In oral medication treated and pre-mixed insulin treated group a high positive correlation was found between HbA1c (7.13±0.85% and 7.64±1.40) and average blood glucose level during period of CGM (7.15±1.80mmol/l and 7.64±1.48mmol/l) (p<0.01). Correlation coefficient were (r1=0.742 and r2=0.642) (p<0.05). In group of type 2 patients on intensified regimen correlation was lower (r3=0.507). No correlation was found in type 1 diabetes group (r4=0.083). Only in oral treated type 2 group HbA1c showed correlation with the number of above and below excursion. No correlations were found between HbA1c and number of excursions in other groups. We conclude that HbA1c is appropriate assessment tool only in patients with stable glucose control as in type 2 on oral treatment. In all other cases we need additional method like pre-and postprandial glucose measurement. CGM could be also useful for assessment nevertheless short period of time that it reflects.