Details

Autor(en) / Beteiligte

• Lundholm, Michelle D.
• Emanuele, Mary Ann
• Ashraf, Alina
• Nadeem, Sarah

Titel

Applications and pitfalls of hemoglobin A1C and alternative methods of glycemic monitoring

Ist Teil von

• Journal of diabetes and its complications, 2020-08, Vol.34 (8), p.107585-107585, Article 107585

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2020

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Intensive glycemic control minimizes the risks of microvascular complications in diabetes. A1C is a convenient estimate of mean blood glucose, but is not the only marker available. The practical use and limitations of alternative markers and continuous glucose monitors are the focus of this review. PubMed and the Cochrane Library were searched for studies concerning applications or limitations of A1C, fructosamine, glycated albumin, 1,5-anhydroglucitol, skin autofluorescence, and continuous glucose monitoring. Papers reporting on strengths, limitations, or comparisons of these methods were reviewed for inclusion. A1C reflects three months of glycemic control and is not an ideal marker in all patient populations. Fructosamine and glycated albumin reflect mean blood glucose over three weeks. 1,5-Anhydroglucitol can measure hyperglycemic excursions in days to weeks. Continuous glucose monitors provide immediate feedback for timely intervention to reduce glycemic excursions and can assess glycemic variability. Current barriers to continuous glucose monitor use include inexperience, cost, discomfort, and medication interference. Many promising alternative glycemic markers exist. The main limitations for all alternative methods of glycemic monitoring are a lack of standardization for clinically useful cut-offs or guidelines, and a lack of long-term data on their association with complications, particularly in varied patient populations. •Hemoglobin A1C is not an ideal glycemic marker in all patient populations.•Fructosamine, glycated albumin, and 1,5-anhydroglucitol can be used adjunctively.•Continuous glucose monitoring gives real-time feedback to prevent excursions.•All alternative markers need further study in varied and diverse populations.