You've Been Overtesting for HbA1c, Researchers Assert

By Joe Elia

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Most patients with well-controlled type 2 diabetes have been subject to overtesting, according to a study in The BMJ.

Using U.S. claims data on some 32,000 patients with serial hemoglobin A1c levels indicating stable glycemic control, researchers ascertained how often levels were remeasured during a 24-month follow-up.

Guidelines recommended up to two tests per year, but 55% of the cohort received frequent testing (three or four per year) and 6% received excessive testing (five or more tests). Patients at highest risk for excessive testing were from the Northeast, while those in the Midwest were at lowest risk. The frequency of overtesting dropped after 2009.

An editorialist writes that "we are prone to treating numbers and not individuals." He advises that more attention be paid to absolute risk reductions accruing from testing, and "much less" to single measures (such as HbA1c).