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[IP] A1c Measured Monthly In DCCT

Below is a paragraph from the DCCT, which states the
Intensive Therapy Group had, "hemoglobin A1c
(glycosylated hemoglobin), measured monthly, within
the normal range (less than 6.05 percent)." It seems
like in the Kansas City Area this particular aspect of
the treatment has not been adopted as stardard
protocol, even though home testing kits are available.
Is anyone else getting monthly A1c and if so, from
your doctor's office or a home testing kit being sent
to a lab? Do you think it isn't being done because the
ADA has adopted a standard of quarterly A1c for
insulin dependent individuals? If you were a DCCT
participant in the Intensive Therapy Group, did you
find the monthly results useful information for
improving/maintaining control?


The Effect of Intensive Treatment of Diabetes on the
Development and Progression of Long-Term Complications
in Insulin-Dependent Diabetes Mellitus
(The following article was published in The New
England Journal of Medicine,
September 30, 1993, Volume 329, Number 14. 

Treatment and Follow-up:
Intensive therapy included the administration of
insulin three or more times daily by injection or an
external pump.The dosage was adjusted according to the
results of self-monitoring of blood glucose performed
at least four times per day, dietary intake, and
anticipated exercise. The goals of intensive therapy
included preprandial blood glucose concentrations
between 70 and120 mg per deciliter (3.9 and 6.7 mmol
per liter), postprandial concentrations of less than
180 mg per deciliter (10 mmol per liter), a weekly
3-a.m. measurement greater than 65 mg per deciliter
(3.6 mmol per liter), and hemoglobin A1c (glycosylated
hemoglobin), measured monthly, within the normal range
(less than 6.05 percent). The patients initially chose
either multiple injections or pump therapy and could
subsequently change to the other method if their
glycemic goals were not achieved or if such was their
preference. The patients in the intensive-therapy
group visited their study center each month and were
contacted even more frequently by telephone to review
and adjust their regimens. 


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