The results of the T1D Exchange Registry are out, and they’re not good.
As reported in Diabetes Technology & Therapeutics (2:2, 2019), data collected from more than 22,000 people with type-1 diabetes shows that only 17% of children and 21% of adults are meeting the A1c targets established by the American Diabetes Association (<7.5 in kids, < 7.0 in adults). Average A1c’s are about the same as they were six years ago, before we had widespread access to CGM and hybrid closed loop technologies. Except in adolescents, where control is actually worse today than it was six years ago.
Forgive my French, but WTF??? There simply is no excuse for this. Anyway can manage their diabetes effectively, given the right tools, proper skills, and a little bit of motivation. I recognize that our patients at Integrated Diabetes Services are a “unique” breed – generally able to access and apply the latest technologies. But the self-management skills and motivation are something that comes from training and elbow grease. Proud to say that, overall, more than 70% of our patients (young, old, and in-the-middle) meet their A1c goals. More importantly, for those who came to us with A1c levels above 8% at the time of initial consultation, 40% were within ADA targets a year later.
We all know that A1c doesn’t tell the whole story. Maintaining stable blood sugars, avoiding hypoglycemia and spending lots of time “in-range” are probably better metrics for quality diabetes management. However, A1c still correlates strongly with risk of long-term complications, so we need to pay attention to it.
If your glucose control isn’t where you want it to be, please reach out. There’s no excuse not to. We work with people remotely via phone/internet, we’re flexible with our fees, and most importantly, we get results.