THU257 Retrospective Analysis Of Hemoglobin A1c Utility At A SafetyNet County Hospital

Abstract

Abstract Disclosure: J. Joseph: None. I.A. Hashim: None. Background: Diabetes remains a prevalent chronic health condition. Measurement of glycated hemoglobin (A1c) is central to both diagnosis and to monitoring response to therapy and hence the extent of diabetes control. Use of A1c continues to increase in compliance with recommendations by the American Diabetes Association. The utility of A1c measurement at a large SafetyNet county hospital was assessed. In this analysis, our goal is to help guide utilization of A1c testing. Method: All A1c values performed over a period of 14 months between January 2021 to March 2022 were retrieved from the electronic health records system (Beaker, EPIC®). Statical analysis of all A1c data were performed using Excel Microsoft® and NCSS statistical software. A1c data were analyzed for prevalence of abnormalities (>6.5%). Results: A total of 28,760 A1c measurements were performed during the study period. Overall values ranged from 0.06% to >17.6% (Median 6.1%). Patients with A1c <5.7% (n=9535) representing 33% of tested patients. Patients with A1c values between 5.7% and 6.5% (n=7619) representing 26% of patients. Patients with A1c values between 6.5% and 11.0% (n = 10,001) representing 35% of patients. Patient in control with A1c values between 6.5% and 7.5% (n=1350) represented 35.8% of the diabetic population. Those poorly controlled A1c >9% (n=734) represented 19.4% of patients. The remaining patients (n=1605) representing 6% of patients had A1c values >11%. Conclusion: A1c testing is widely practiced with 35 % of patients being diabetic. A1c measurement identified 26% of patients in the pre-diabetic stage and that 33% were non-diabetic. The high HbA1c among some patients indicate a need for more proactive approach to their management. The high percentage of the measured population had A1c below 5.7% and thus raises the question of whether routine screening of A1c is cost-effective. Additional analysis for diabetic patients for degree of control and for assessment of urinary albumin levels is required. Presentation: Thursday, June 15, 2023