HbA1c is currently used for assessment of glucose control in type 1 and type 2 diabetes patients treated with different therapeutic regiments. Different conditions besides glucose concentration affect its level and, in many cases, HbA1c is insufficient to present glucose control. In our study we compare representativeness of usually used control assessment tools such HbA1c and multiple daily blood glucose measurements 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). Patients were observed for three-month period - they performed eight-point BG measurements at least three time weekly, HbA1c was measured at the end of this period and continuous glucose monitoring with iProTM was performed for seven days. In oral medication treated group a high positive correlation was found between HbA1c (7.13±0.85%) and average blood glucose level during period of CGM (7.15±1.80mmol/l) (p<0.01) with correlation coefficient were (r1=0.742) (p<0.05). In pre-mixed insulin treated group and type 2 with intensified regimen lower positive correlation was found (7.64±1.40% and 7.69±1.23%, respectively 7.64±1.48mmol/l and 7.60±1.30mmol/l), with r2=0.642 (p<0.01) and r3=0.570 (p<0.05). No correlation was found in type 1 diabetes group (r4=0.083). No correlations were found between HbA1c and number of excursions in other groups. Same trend of correlations was found comparing HbA1c and mean BG level in eight-point profile. We conclude that HbA1c is appropriate assessment tool only in oral treated type 2 diabetes patients. In type 1 and insulin treated type 2 patients HbA1c gives relative information about overall control with no precise presenting of glucose fluctuations and out-of-range values of BG.
T. Totomirova: None. M. Arnaudova: None. I. Daskalova: None.