Despite such frequent monitoring, HbA1c levels remained stable in most patients during the course of the study, with only 4% showing improvement of more than 1 percentage point.
The study was supported by grants from several pharmaceutical and glucose monitoring device manufacturers. Among its limitations were the inclusion of only small numbers from various ethnic minority groups, and the lack of any data on children, pregnant women, or patients with renal impairment, Dr. Kuenen noted.
Independent commentator Dr. Philip Home, professor of diabetes medicine at the University of Newcastle-upon-Tyne (England), cautioned that it will take time to transition to using new numbers that don't correlate with a huge amount of published literature on data using the HbA1c measurement to predict diabetes complications and other important clinical values. “The problem we have as a result of all this is that we have to re-standardize all our guidelines to align with this [ADAG], and that means a bit of re-education.”