Lim H S, Chew W L, Tan Y T, Tan F B
Ann Acad Med Singap. 1985 Apr;14(2):203-8.
The degree of control of 132 diabetic patients was assessed using historical data, urine glucose and blood glucose measurements. These were then related to HbA1, taken as the final arbiter of glycaemic control. Symptoms of hyperglycaemia and glycosuria were found to be not sensitive or specific indices of control, though symptomatic glycosuric patients tended to have higher HbA1. Fasting blood glucose correlated modestly with HbA1 (r = 0.60, p less than 0.001) but if used alone to determine degree of control, 21% and 9% of patients could be expected to be over or under assessed respectively. The assessment value of timed post-breakfast blood glucose applied only to 120 and 150 minutes post-breakfast blood glucose as they correlated well with HbA1 (r = 0.73, p less than 0.001 and r = 0.96, p less than 0.001 respectively). Clinically impression of degree of control based on a combination of historical data, urine glucose and blood glucose led to "undertreatment" in 41% and "overtreatment" in 27% of patients. The complementary value of a knowledge of HbA1 was thus highlighted.
利用历史数据、尿糖和血糖测量值评估了132例糖尿病患者的控制程度。然后将这些数据与糖化血红蛋白（HbA1）相关联，HbA1被视为血糖控制的最终判定指标。虽然有症状的糖尿患者糖化血红蛋白往往较高，但高血糖和糖尿症状并非控制情况的敏感或特异指标。空腹血糖与糖化血红蛋白有一定相关性（r = 0.60，p < 0.001），但如果单独用于确定控制程度，预计分别有21%和9%的患者会被高估或低估。早餐后定时血糖的评估价值仅适用于早餐后120分钟和150分钟的血糖，因为它们与糖化血红蛋白相关性良好（分别为r = 0.73，p < 0.001和r = 0.96，p < 0.001）。基于历史数据、尿糖和血糖综合判断的控制程度临床印象导致41%的患者“治疗不足”，27%的患者“治疗过度”。因此，突出了了解糖化血红蛋白的补充价值。
