Discrepancies Between Blood Glucose and Glycosylated Hemoglobin in Intensively Treated Diabetic Patients

Self blood glucose monitoring (SBGM) results in nine insulin- dependent diabetic patients who had elevated levels of glycosylated hemoglobin (HbA 1 9.8% ±0.4%) despite intensive treatment were compared with those of 11 patients who were able to achieve strict diabetes control (HbA 1 8.1% ± 0.2% ; normal 5.6%-8.0%). Surprisingly, both groups reported similar SBGM values and testing frequency, and both groups measured glucose levels accurately when values were checked in the laboratory. On the other hand, laboratory glucose values were lower and correlated with HbA 1 levels only in the group that achieved near normal HbA 1 values. These data suggest that problems with SBGM may impede achievement of strict glycemic control during intensive treatment of insulin-dependent diabetes.