Brief report Glycated haemoglobin or mean blood glucose as indicators of metabolic control in Type 2 diabetes? Mario Pupillo a , Giorgia De Berardis b , Daniela Antenucci a , Anita Minnucci a , Antonio Nicolucci b, * a Metabolism and Diabetes Unit, Ospedale Renzetti, Lanciano, Italy b Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/a, 66030 S. Maria Imbaro (CH), Italy 1. Introduction The importance of HbA 1c as a marker of metabolic control was emphasized by the results of the DCCT and UKPDS trials [1,2] and is acknowledged by existing guidelines [3]. Self-monitor- ing of blood glucose (SMBG) is an important component of diabetes care, and mean blood glucose (MBG) and HbA 1c are considered interchangeable estimates of glycemic control. In particular, the DCCT allowed to correlate HbA 1c levels to MBG to enable patients and physicians to set glucose targets to achieve HbA 1c goals [4]. However, several studies have reported that these two parameters are not necessarily identical estimates of glycemic control [4,5], suggesting that haemoglobin glycation phenotype may explain the observed individual differences in the relationship between MBG and HbA 1c [5]. Given the uncertainty about these aspects, and since all the available data refer to Type 1 diabetes, we assessed whether HbA 1c levels reflected MBG levels in Type 2 diabetes mellitus (DM). 2. Materials and methods Study population was represented by Type 2 DM patients attending the Diabetes Outpatient Clinic in Lanciano (Italy) and performing SMBG. All participants used a home glucose monitor produced by one manufacturer (Lifescan), allowing the upload of glucose records from the patient’s glucose monitor to the computerized clinical database (Euro Touch 1 8.0.17 Lifescan). We utilized the last HbA 1c measurement and the corresponding capillary glucose values obtained in the diabetes research and clinical practice 80 (2008) e 1– e 3 article info Article history: Received 20 December 2007 Accepted 2 January 2008 Published on line 6 February 2008 Keywords: Type 2 diabetes HbA 1c Glycation Glycaemic control abstract The aim of the study was to assess whether HbA 1c levels reflected mean blood glucose (MBG) levels in Type 2 diabetes. Despite the good correlation between HbA 1c and MBG, one-third of the patients had consistently higher HbA 1c or lower HbA 1c levels than that expected under the hypothesis that HbA 1c is solely determined by MBG, suggesting the existence of different haemoglobin glycation phenotypes. The use of HbA 1c alone for glycemic control monitoring in these patients could be insufficient to clearly trace their risk of complications. # 2008 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Tel.: +39 0872 570260; fax: +39 0872 570263. E-mail address: nicolucci@negrisud.it (A. Nicolucci). available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/diabres 0168-8227/$ – see front matter # 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.diabres.2008.01.001