In Reply Drs Munshi and Gabbay suggest that glycated hemoglobin (HbA1c) values may be less important for nursing home residents for several reasons.
First, HbA1c values may not reflect mean glucose levels due to comorbid conditions that decrease red blood cell lifespan. We absolutely agree. Thus, for our study,1 we excluded residents who were receiving hemodialysis. We regret that we were unable to include this in our article due to space constraints.
Lee SJ. Glycemic Control and Functionality in Nursing Homes—More Than HbA1c—Reply. JAMA Intern Med. 2017;177(6):894. doi:10.1001/jamainternmed.2017.1316
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