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- W7098209 abstract "markers and briefly enumerated their respective advantages and limitations. We believe that some clinical value derives from a variety of these markers, including fructosamine, glycated albumin, and 1,5-anhydroglucitol. We had incorrectly noted that glycated albumin was not approved in the United States, but in fact it actually is available (http: //www.exocell.com). All of these secondary markers are helpful as alternative indices in patients for whom HbA1c findings are consistently unreliable. As Chalew et al note, the use of alternative indices, for example, can protect patients from hypoglycemia when glucose-lowering therapy is titrated solely on the basis of HbA1c value. However, we do not advocate the use of any alternative metric in broad substitution for HbA1c value. As we stated previously, HbA1c remains the only biomarker for which compelling clinical data consistently demonstrate its merit in predicting microvascular risk. Our central argument is that HbA1c level nonetheless reflects only a small fraction of total risk and proves unreliable among subsets of patients commonly seen in primary care practices. We believe that the use of any metric requires thoughtful interpretation because of the complexities involved with each test. Additional clinical data may establish the predictive utility of alternative biomarkers, but we believe that none is likely to supplant HbA1c. Instead, integrated use of several markers used in combination, in conjunction with traditional glucose monitoring (including continuous glucose monitoring), may prove the most effective strategy for monitoring glycemic control and assessing microvascular risk." @default.
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- W7098209 date "2007-01-01" @default.
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- W7098209 title "Pregnancy, Addiction, and Incarceration" @default.
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