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
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
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
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