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29-11-2011 | Diabetes | Article

Graphic, numeric tools equal in communicating HbA1c results


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MedWire News: Using a color-coded recording tool to communicate glycated hemoglobin (HbA1c) results to patients with diabetes is no more effective at improving HbA1c levels than using a numeric tool, report researchers.

A graphic record also offers no advantage over a numeric one in improving understanding about HbA1c, they say.

"Published data on graphic presentation for HbA1c results are lacking," write Stalia Wong (University Malaya, Kuala Lumpur, Malaysia) and colleagues.

"Previously, two studies have shown that graphic presentations of HbA1c results were associated with an improvement in HbA1c. However, these two studies focused on the graphic tool and no comparison was made with the numeric tabular recording tools," says the team.

In the current study, the researchers randomly assigned 500 patients with Type 2 diabetes to have their baseline and 3- and 6-month HbA1c results recorded using either a graphic or numeric tool.

In the graphic group, HbA1c ranges were denoted on a graph using "traffic light signal colors." The HbA1c result was plotted on the graph at each follow-up and the trend was demonstrated by a line drawn between the results.

In the tabular group, HbA1c results were recorded in numeric form in rows corresponding with follow-up dates.

At each follow-up visit, patients were shown the results and provided with simple advice about diabetes including complications, treatment, the HbA1c test, diet, and exercise.

Knowledge about HbA1c was assessed at baseline and at 3 months.

As published in the journal Diabetes Research and Clinical Practice, there was no significant difference in the improvement of mean HbA1c between the two groups at 3- or 6-month follow-up.

In the graphic group, the mean HbA1c level at 3 and 6 months was 8.41% and 8.55%, respectively, compared with 8.84% at baseline. The corresponding figures for the tabular group were 8.55% and 8.59% versus 8.95%.

At 3 months the proportion of patients who did not understand HbA1c fell from 89.2% to 67.8%. However, this improvement was unrelated to the recording tool used, with a nonsignificant between-group difference in mean HbA1c knowledge of 0.071.

"The HbA1c tabular record was as good as HbA1c graphic record in improving HbA1c level among patients with diabetes," the researchers conclude.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Sally Robertson

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