【病例学习第5期】Lost in (Glucose) Translation（热衷于血糖转换）

clinphar · 发表于 2010-2-8 17:18:52

From Pharmacy Times(www.pharmacytimes.com)
Thanks to the author Craig I. Coleman, PharmD(Dr. Coleman is an assistant professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy.)

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Lost in (Glucose) Translation

VT is a pharmacy student on experiential rotation in a diabetes specialty clinic. While sitting in on a patient follow-up visit, the student overhears the endocrinologist tell a patient that her sugars are well-controlled, based upon the patient’s laboratory results depicting an estimated average glucose of <154 mg/dL. Later that day, the student meets with her rotation preceptor and asks, “What is an estimated average glucose? I thought we used hemoglobin A1C to monitor patient diabetes control.”

What should the preceptor tell the pharmacy student?

ANSWER

The preceptor should explain to the student that the American Diabetes Association is recommending the use of new terminology when discussing glucose control with patients, called the estimated average glucose (eAG), a measure developed to allow health care providers to translate the results of hemoglobin A1C testing into units (mg/dL) that patients are accustomed to seeing during blood sugar self-monitoring. The relationship between eAG and hemoglobin A1C, validated during the A1C-Derived Average Glucose study, is characterized by the formula: eAG (in mg/dL) = (28.7 x A1C) – 46.7 (so that a goal A1C of <7% is equivalent to an eAG of <154 mg/dL).

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热衷于血糖转换

VT是一位糖尿病专业的临床药学学生。在旁听随访一位病人时，他无意中听到一位内分泌专家告诉病人，他的血糖控制良好。根据病人的实验室数据估算的平均血糖<154mg/dl。那天后，学生遇见了他的轮转指导老师并问：“什么是预计平均血糖？我们习惯于用糖化血红蛋白来监测病人的血糖控制情况。”
指导老师该如何回答学生呢？

答案

指导老师这样解释：美国糖尿病协会推荐在与病人讨论血糖控制的时候用新的术语，叫做估算的平均血糖值（eAG）。一个成熟的测量结果允许医疗服务人员把糖化血红蛋白的结果转化为mg/dl的单位，这样病人习惯于血糖自我监测。预计平均血糖和糖化血红蛋白的关系，源自平均血糖的研究，转换公式是：eAG（mg/dl）=（28.7*A1C）-46.7（这样一个目标糖基化血红蛋白<7%是等同于估计平均血糖<154mg/dl）。