Average glucose, A1c discordance is common, highlights ADAG equation concerns

Also, fingersticks inflate discordance.

“A better assessment of ADAG would be to measure only CGM averages in comorbities, though this may need to be a prospective trial as only 17% of our patients who have identified comorbidities use CGM,” she said.

Dr. Perlman concluded that fingersticks and CGM can provide important confirmation of A1c, but said this applies only at the population level and not to individual patients.

“For individual patients, any level of A1c can translate to a large range of average glucoses. We see this even in our concordant patients,” she said.

Further, while discordance is increased by some comorbidities, it also occurs absent of comorbidities at a rate of 28.7%.

“So here’s the bottom line: We need a professional consensus to help define acceptable discordance before clinical use of the ADAG equation can be safely broadened,” she said.

Dr. Perlman reported having no disclosures. Senior author Irl B. Hirsch, MD, professor of medicine at the University of Washington, Seattle, disclosed financial relationships diabetes drug and device manufacturers Abbot, ADOCIA, Bigfoot Biomedical, Roche, and Medtronic MiniMed.

sworcester@mdedge.com

SOURCE: Perlman J et al., ADA 2018 Abstract 12-OR.