HBA1C: Practical use in primary health care in our set up

Objective: to gather the data from a sample of diabetic population from primary care to see the control of diabetes and to see if really hba1c value is practically imparting some thing to get to a better control and if we need to put in some other factors which may improve the control of glycemia in our primary care set ups check what percentage of pts are on insulin if they are not achieving targets. method and design: a cross sectional randomized observational study done at shalamar hospital to see hba1c levels of control of patients who are coming for the first time in this facility and have been treated by primary care physician. only those patients were included who had there hba1c levels done at least once in last 6 months. results: the results in our sample were very unsatisfactory and the lowest a1c which we saw was 8.1 and max was 16.20 with mean of 10.74 and std 1.658 .in spite of the fact the patients who were on insulin were 35.3% the average hba1c of the patients who were on insulin was 11.16% and average a1c of patients who were on oad was 10.51% conclusion: it seems like asking for hba1c level is just a routine we are not getting any benefit of this expensive investigation by stepping up the treatment to achieve the target .as seen in the study that not a single patient has achieved the target and most of them are still on oad and even if they are shifted on insulin no further intensification has been done. education of patients and doctors dealing with diabetics in primary care needs to be encouraged this will not only give us good targets of control but will reduce the load on tertiary care centers and cost of complication and treatment in this already overburdened health system with scarce resources.