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  Vol. 3 No. 11, November 1994 TABLE OF CONTENTS
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Diabetes Mellitus Management 'PENTAD'

Frank Lawler, MD
The University of Oklahoma Oklahoma City

Arch Fam Med. 1994;3(11):943-944.

Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

While laud the efforts of Lardinois and Lougaris1 to improve diabetes control, I must express strong disagreement of the use of hemoglobin A1c as a quality measure. I have quite a number of diabetics in my patient population; several of them routinely have fasting glucose levels between 13.9 and 16.6 mmol/L (250 and 300 mg/dL) because of a conscious choice of a lifestyle. Others faithfully check and record their glucose levels twice a day.

In both of these groups, the measurement of hemoglobin A1c adds nothing to the management of their disease but another test and bill. Simply ordering a test to be in compliance with poorly conceived guidelines is one of the worst aspects of a bureaucratic approach to medicine. To say that compliance of "less than 100% is unacceptable" is ludicrous. I hope this is not the future of health care system reform. . . . [Full Text PDF of this Article]






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