Interview with a Registered Dietitian and Certified Diabetes Educator

A New Year Message to Clinicians Managing Patients with Diabetes

For patients with diabetes, the holidays were likely filled with tempting sweets and opportunities for heavy feasting. The new year is a perfect time to assess glycemic control and help patients get on a healthy new year course.

Surprisingly, up to 40% of patients with a “good” A1C experience significant postprandial hyperglycemia and glycemic variability.1,2

GlycoMark would like to emphasize the importance of close management of patients with diabetes, throughout the year.

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We recently asked Denise Surman, a Registered Dietitian (RD) and Certified Diabetes Educator (CDE) from GlycoMark, for her perspectives on four questions about managing patients with diabetes after the holidays.

Which patients would you want to more closely assess for glycemic control?

Because of the overwhelming holiday temptations, I encourage clinicians to be vigilant in patients with diabetes that may not be well controlled. To know which patients need closer management, you need a closer assessment of glycemic control.  Having a GlycoMark Test result on patients where control is questionable is important for the glycemic assessment:

  • Not regularly checking blood sugars
  • Poor diet
  • Poor compliance with treatment or lifestyle changes
  • Concerned about chronic complications
  • Experiencing acute symptoms, polyphagia, polydipsia, and polyuria
  • No-shows for scheduled appointments
  • Depressed

 

Is this an all-inclusive list of patients you might more closely assess?

It's a good start because up to 40% of patients with a “good” A1C are not in control. We have to consider glycemic control even when other indicators appear normal.  It’s important to use all available tools to help patients control their blood sugars.

We already know A1C will not detect variability because it is a three-month glucose AVERAGE.  It can also be a lagging indicator of hyperglycemia.3

In addition, self-monitored blood glucose (SMBG) testing compliance can be low as many patients find it a nuisance, painful due to poor technique, or just forget.4,5

The GlycoMark test is a simple non-fasting blood test and indicator of glycemic control during the prior one- to two-weeks. The test detects recent hyperglycemia and postprandial hyperglycemic excursions that traditional tests often miss, and is independently associated with diabetes complications.3,6-10

 

What might clinicians uncover in their patients with diabetes when adding the GlycoMark Test to the lab workup?

The GlycoMark Test can help identify patients with recent hyperglycemia that A1C is not yet detecting.  The test can also reveal postprandial hyperglycemia during the prior one- to two-weeks, which A1C cannot detect when it is offset by hypoglycemia – again, because A1C is a three-month average.

The GlycoMark test also gives clinicians a picture of recent compliance with treatment therapy or recommended lifestyle changes. Multiple studies show the GlycoMark test is a more rapid indicator of changes in glycemic control.11,12

With the GlycoMark test, clinicians have an additional tool to help more closely manage patients and make treatment adjustments, in between checkups, as appropriate.

 

How has GlycoMark helped in improving patient participation in their recommended treatment program?

  • The GlycoMark test gives physicians and patients more timely insight on how well the patient is doing vs. waiting for A1C to change or relying on faulty SMBG numbers. Are they compliant? Have they initiated the recommended therapy?  Did they go carb crazy during the holidays?  Unlike A1C, which at most is tested quarterly, the GlycoMark test has no limits on test frequency.
  • The GlycoMark test helps enhance patient education by allowing a more meaningful and frequent interaction between the patient and physician.
  • Patients also appreciate knowing their physician can make earlier and appropriate adjustments to medications and can use the GlycoMark test as another “number” to monitor their own health.
  • A1C and SMBG have their advantages and drawbacks.  The GlycoMark test is another tool - a timely tool - to help clinicians identify those patients that do need closer management.  So important!

 

Happy New Year!


 

For full GlycoMark prescribing information please see our package insert. 

Denise Surman, RD, CDE is a paid employee of GlycoMark, Inc. For additional clinical perspectives, please visit our website for newsletters, videos, and clinical tools. If you would like to schedule a call with Clinical Affairs, please Contact Us.

References:
1Erlinger TP, Branca FL. Diabetes Care. 2001 Oct;24(10):1734-8.
2Bonora E, et al. Diabetologia. 2006 May;49(5):846-54.
3American Diabetes Association. Diabetes Care 2015 Jan; 38(Supplement 1): S33-S40.
4Erbach M, et al. J Diabetes Sci Technol. 2016;10:1161-1168.
5Klonoff DC, et al. J Diabetes Sci Technol. 2011;5:1529-1548.
6Selvin E, et al. Diabetes 2016;65:201–208.
7Selvin E, et al. Clin Chem. 2014 Nov; 60(11): 1409–1418.
8Lee AK, et al. Diabetes Care 2017 Dec; 40(12): 1661-1667.
9Rawlings AM, et al. Diabetes Care 2017 Jul; 40(7): 879-886.
10Nowak N, et al. Diabetologia 2013 Apr; 56(4): 709–713.
11McGill JB, et al. Diabetes Care 2004 Aug; 27(8): 1859-1865.
12Dungan KM, et al. Diabetes Care 2006 Jun; 29(6): 1214-1219.