Brick Jessica C, Derr Rachel L, Saudek Christopher D
Johns Hopkins University School of Medicine, Division of Endocrinology, Baltimore, Maryland, USA.
Diabetes Educ. 2009 Jul-Aug;35(4):596-602. doi: 10.1177/0145721709336298.
The purpose of this study was to evaluate the hypothesis that using estimated average glucose (eAG) while instructing patients yields better knowledge retention than using the term hemoglobin A1C (A1C).
Patients with diabetes who had poor baseline understanding of A1C (determined by a 4-question survey) were randomized into 1 of 2 groups: A1C or eAG. Depending on randomization, providers discussed patients' current status and personal targets for glycemic control using either the term A1C or estimated average glucose. Patients had a telephone survey 3-4 weeks later, assessing change in knowledge of glycemic control.
The 80 participants who completed follow-up had similar baseline characteristics, including poor understanding of A1C and poor recall of previous A1C values. At the 3-4 week follow-up, average score for each survey question improved significantly in both groups, with mean composite score increasing in the A1C group by 32% and in the eAG group by 33%. There was no suggestion of a difference in degree of improvement between groups.
Patients previously unfamiliar with the meaning of A1C, using either term (A1C or eAG) resulted in an equal improvement in knowledge. Within this study, eAG was not a more understandable term, or an easier concept for patients to remember. Further research is needed to test whether use of the term A1C should be replaced by eAG.
本研究旨在评估以下假设，即在指导患者时，使用估计平均血糖（eAG）比使用糖化血红蛋白（A1C）术语能产生更好的知识保留效果。
对基线时对A1C理解较差（通过4个问题的调查确定）的糖尿病患者随机分为2组中的1组：A1C组或eAG组。根据随机分组情况，医疗服务提供者使用A1C术语或估计平均血糖来讨论患者的当前状态和血糖控制的个人目标。3至4周后，患者接受电话调查，评估血糖控制知识的变化。
完成随访的80名参与者具有相似的基线特征，包括对A1C理解较差以及对先前A1C值的记忆较差。在3至4周的随访中，两组中每个调查问题的平均得分均显著提高，A1C组的平均综合得分提高了32%，eAG组提高了33%。两组之间改善程度没有差异的迹象。
对于先前不熟悉A1C含义的患者，使用任一术语（A1C或eAG）都会使知识有同等程度的提高。在本研究中，eAG不是一个更易于理解的术语，也不是患者更容易记住的概念。需要进一步研究来测试A1C术语是否应由eAG取代。
