Optimal diabetes care is predicated on balancing the immediate and long-term sequelae of the disease and its therapies, improving patient health and well-being, and mindfully stewarding health care resources for both the patient and society. Professional societies, public health organizations, regulatory agencies, patients, and clinicians have focused on hemoglobin A1c (HbA1c) levels to gauge the quality of diabetes care.1 Over time, HbA1c level has supplanted other indicators of the quality of diabetes care, such as blood glucose levels and symptoms of hyperglycemia, despite being a surrogate rather than a direct marker of glycemic control, and reflecting average levels of glycemia during the preceding 3 months. Although potentially more challenging to measure or difficult to change, other measures of the quality of diabetes care may better represent the outcomes that are truly meaningful to people living with diabetes, including immediate symptoms of hypoglycemia or hyperglycemia, burden of treatment,2 quality of life, and long-term sequelae of inadequately controlled diabetes.
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Rodriguez-Gutierrez R, McCoy RG. Measuring What Matters in Diabetes. JAMA. Published online April 15, 2019321(19):1865–1866. doi:10.1001/jama.2019.4310
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