A1C Goals Missed in Most With Type 1 Diabetes: Survey

A disturbing new report on the status of the care of adults with type 1 diabetes (T1D) worldwide was recently released at a major European diabetes meeting. The conclusion, according to one of the presenters, was “a bad result for most people.”

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The report, which was based on information from an initiative called the Study of Adults’ Glycemia in T1D, was presented at the annual meeting of the European Association for the Study of Diabetes, held in 2019 in Barcelona. The study contained data on nearly 4,000 people aged 26 and above who had type 1 diabetes. They were from 17 countries in Europe, Asia, the Middle East and Latin America.

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The basic statistic analyzed was hemoglobin A1C (HbA1c), which measures a person’s average level of blood sugar control over the previous two or three months. The target for people with diabetes is an A1C of less than 7%, but according to the new report, only a quarter to a fifth of the patients were attaining that goal. According to report presenter Eric M. Renard, MD, “It is a bad result for most people…. There is really a need for education.”

Other discouraging results were reported. For example, only one out of five patients used an insulin pump and only about one out of four employed continuous glucose monitoring (CGM). Another issue concerned insulin titration — that is, calculating a patient’s dose of insulin according to blood sugar levels. Diabetes experts advise that patients be educated to do this themselves, but the report found that only 57% of the patients were doing so — the others relied on physician-driven titration. According to Dr. Renard, “It’s a bit surprising to see that 43% of these type 1 diabetes patients are waiting for their physicians to tell them the dose they should use. It’s quite unexpected in type 1 diabetes patients.” About one out of ten patients experienced a severe episode of low blood sugar in the past three months; about one out of twenty had a severe episode of high blood sugar.

Dr. Renard concluded by stressing the importance of patient education: “It’s not only the tools but also the people who live with diabetes understanding the goal of therapy. It’s how you feel with his disease and live with it and being able to see the future. Clinicians should spend more time with their patients explaining why these numbers are important.”

Want to learn more about type 1 diabetes? Read “Type 1 Diabetes Questions and Answers,” “Six Type 1 Diabetes Symptoms You Need to Know” and see our type 1 diabetes videos.

Joseph Gustaitis

A freelance writer and editor based in the Chicago area, Gustaitis has a degree in journalism from Columbia University.

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