Immediate feedback of HbA1c levels improves glycemic control in type I and insulin-treated type 2 diabetic patients

OBJECTIVE - Accurate and reliable HbA(1c) results can be obtained at the time of the office visit by using benchtop analyzers. We tested the hypothesis that immediately available HbA(1c) result; could improve glycemic control by changing physician or patient behavior or both. RESEARCH DESIGN AND METHODS- A randomized controlled trial was conducted in 201 type 1 and insulin-treated type 2 diabetic patients attending an academic diabetes center. HbA(1c) levels, changes in insulin therapy, and use of health care resources were assessed during a 12-month follow-up period. RESULTS - HbA(1c) levels decreased significantly at 6 and 12 months in the immediate assay group (-0,57 +/- 1.44 and -0.40 +/- 1.65%, respectively; P < 0.01) but did not change in the control group (-0.11 +/- 0.79 and -0.19 +/- 1.16%, respectively; NS). The changes were similar for both type 1 and type 2 diabetic patients. There were no differences in the rates of hypoglycemic events or use of health care resources. CONCLUSIONS - In the setting of a controlled randomized trial, the immediate feedback of HbA(1c) results at the time of patient encounters resulted in a significant improvement of glycemic control at 6-month follow-up and persisted for the 12-month study . The introduction of this assay was positively received by both patients and physicians.