TEC: Evidence Based Therapeutics
Therapeutics Education Collaboration
Medication Mythbusters – Home of the Best Science (BS) Medicine Podcast

Episode 204: Please stop measuring all those A1c levels

In episode 204, James and Mike get into a discussion about the use of A1c levels for diagnosing and treating type-2 diabetes. We discuss screening recommendations and the impact an elevated A1c has on cardiovascular disease and other outcomes. At the end we realize the key message is that we have to let patients know that having an elevated A1c does not indicate impending doom.

Show notes

1) Impact of screening for type-2 diabetes

Lancet 2012;380:1741-8

2) Recommendations on screening for type 2 diabetes in
adults

CMAJ 2012;184 no.15 doi:10.1503/cmaj.120732

3) Hemoglobin A1c for the diagnosis of Type II Diabetes

Tools for practice

4) Lifetime risk of dialysis and blindness

Estimated benefits of glycemic control in microvascular complications
in type 2 diabetes

Ann Intern Med 1997;127:788-95

5) UKPDS risk engine

For the risks calculated in the podcast we used a version of
the UKPDS risk engine that is not presently publically available – UKPDS risk
engine v3.0b2

6) Risk of dialysis in type 2 diabetes

Diabetes Care 2003;26:2353-8

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