Failure to Achieve HbA1c Target Tied to Patient Race
HealthDay News — Factors associated with failure to achieve a glycated hemoglobin (HbA1c) target in the standard therapy arm of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) glycemia trial have been identified, according to research published in the January issue of Diabetes, Obesity and Metabolism.
Tyler C. Drake, MD, from the University of Minnesota in Minneapolis, and colleagues examined the clinical features of participants in the standard therapy arm of the ACCORD glycemia trial who did not reach the HbA1c target. The authors evaluated baseline and 12-month clinical characteristics for the 4685 participants from the standard therapy arm, comparing those who reached the HbA1c target of <8.0% (3194 participants) with those whose HbA1c was ≥8.0% (1491 participants) at 12 months after randomization.
The researchers found that in the adjusted model, black race, severe hypoglycemia, and insulin use correlated with failure to reach the HbA1c goal at 12 months (odds ratios, 0.74, 0.57, and 0.51, respectively). More than 30% of participants had an HbA1c ≥8.0% at one year even with free medications, free clinic visits, and aggressive titration of medications.
"Participants who were black, had severe hypoglycemia, and were on insulin were more likely to have an above-target HbA1c concentration after 12 months on the standard protocol," the authors write.
Several pharmaceutical companies provided study medications, equipment, or supplies.