In Charge Meter
The study took a 25 people with poorly controlled diabetes –
hemoglobin A1c tests above 8% — and randomly divided them into two
groups. They advised all of them how to get better glucose control.
Then they told 14 of them to do blood glucose tests four times a day
and come back to the clinic in three months. They told a group of 11
to test their blood glucose up to 4 times per day in addition to a
weekly fructosamine test and said to call the investigator if their
fructosamine value was above 350 micromolar (equivalent to an H1c of
7.8%), when the doctors then gave them more advice on the phone.
After 3 months all of them came back to the clinic for another H1c
test. Those who were on glucose-only testing averaged a drop in their
H1c tests from 9.4% to 9.1%, which was statistically insignificant.
However, those in the combined glucose plus fructosamine testing group
dropped from an average of 9.2% to 8.0%. That is a significant drop.
My personal experience correlates with this study. Ever since I
started my weekly fructosamine testing almost nine months ago, my H1c
levels have been lower than ever.
June 9th, 2003 at 9:18 am
In response to my message yesterday on the ability of using
fructosamine testing with the new In Charge meter, several people have
written me with a variation of the following question:
How does knowing the fructosamine values promote better control? What
is the correlation?
In my experience the weekly feedback lets me know right away when
something has gone wrong. Unlike hemoglobin A1c tests every three to
six months (the official recommendation), you know every week how you
are doing. And unlike fingerstick tests, which measure just a point in
time heavily dependant on what you have just eaten (or not),
fructosamine testing gives you an average for the week. With that
knowledge comes the power to make corrective action.
Furthermore, as I wrote, in the study the investigators said to call
them if their fructosamine value was above 350 micromolar (equivalent
to an H1c of 7.8%), when the doctors then gave them more advice on the
phone. That’s pulling the doctor into the feedback loop, something
that doesn’t work nearly as well with either hemoglobin A1c or blood
glucose tests.