Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: Dr Wagner and colleagues1 use cost data from a health maintenance organization to assess whether enrollees with diabetes who achieve sustained improvement in glycemic control (at least a 1% decrease in hemoglobin A1c [HbA1c] level over 1 year that was maintained for a second year) have lower health care utilization and costs than individuals whose HbA1c improvement was less than 1% or was not sustained. Their results demonstrate that cost savings can be achieved, but only for individuals with the highest baseline HbA1c values (>10%). These results are entirely consistent with the finding of Testa and Simonson2 that improved glycemic control is associated with improved quality of life.
Pogach L. Glycemic Control and Health Care Costs for Patients With Diabetes. JAMA. 2001;285(15):1963-1964. doi:10.1001/jama.285.15.1963