-
Views
-
Cite
Cite
Gary Geffken, William E Winter, Hardware and Software in Diabetes Mellitus: Performance Characteristics of Hand-held Glucose Testing Devices and the Application of Glycemic Testing to Patients’ Daily Diabetes Management, Clinical Chemistry, Volume 47, Issue 1, 1 January 2001, Pages 11–12, https://doi.org/10.1093/clinchem/47.1.11
Close - Share Icon Share
Extract
A current definition of evidence-based medicine is given in the British Medical Journal from 1996: evidence-based medicine is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” (1). Interpretation of laboratory data requires that an appropriate reference interval be defined by studying a healthy population. Subjects with laboratory results that consistently fall outside this interval may not be healthy. This is clearly the case in individuals with diabetes mellitus whose mean blood glucose concentrations in the untreated state are above the reference-population random, fasting, and/or post-glucose challenge blood glucose concentrations (2).
In the 1990s, in the Diabetes Control and Complications Trial (DCCT) (3) and United Kingdom Prospective Diabetes Study (UKPDS) (4), an important question was answered: glycemic control does make a difference in the development of microvascular complications. Healthcare professionals are now focusing their efforts on improving the glycemic control of their patients. Diabetes is likely the best example of a disease whose outcome is predominantly determined by the daily actions of the affected individual. The DCCT and UKPDS results demonstrated that improved glycemic control lowers the frequency of retinopathy, nephropathy, and neuropathy and also likely lowers the long-term risk of developing macrovascular disease. The challenge now is to implement improved diabetic therapy that lowers mean blood glucose into or near to the reference interval reflected in a hemoglobin A1c <7% (5).
