Will HbA1c become irrelevant in diabetes management? - Dr. Jothydev Kesavadev, Endocrinology

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One of the goals of therapy in diabetes is to ensure that patients achieve their glycemic targets and maintain it. For this, we have used many monitoring methods, one of which, is the well-known HbA1c (glycated hemoglobin) test.

In this 10Min CME episode, Dr. Jothydev Kesavadev, a diabetologist who is renowned all over India for his contribution to the understanding and awareness of the disease, will explore the reasons that HbA1c is limited in its use in diabetes care. He will also shed some light on the new metric which is taking centre stage in diabetes care - Time-In-Range.

Chapters:
Will HbA1c become irrelevant in the management of diabetes?
0:00 Average HbA1c in India
0:51 Introduction
1:11 Why we can't rely on HbA1c
2:50 Time-in-range & HbA1c
5:00 Normal TIR in DM
6:14 Normal TIR in DM with complications
7:05 Normal TIR in pregnancy
8:02 Why should we use TIR?
8:18 AGP Report
8:33 Continuous glucose monitoring
9:15 Key takeaways
10:14 Thank you!

Dr. Jothydev Kesavadev is chairman of the Jothydev's Diabetes Research Center and he is based out of Trivandrum. He is an avid speaker in diabetes and has contributed much to our understanding of diabetes in the Indian scenario.

Please leave your comments, feedback, doubts, suggestions and/or ideas in the comments section below.

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[akvenkat]

Good day,
I am Dr.A.K.Venkatachalam, an orthopedic surgeon in Chennai. I saw your video with great interest, particularly I was intrigued by the possibility of calculating time in target with a normal glucometer. Can you shed further light on how it can be done with a Abbott Free style libre glucometer?
Thanks in advance.

[SyedShibliAhmed]

In clinics I was taught HbA1c was absolute. Thank you for providing a new perspective and widening the knowledge. 🙂🙌🏻

[nvsmediahouse]

Sir, it is more confusion to normal patients to understand the levels of his/her diabetis

[tonykelpie]

HbA1c is a measure of the percentage of Hb molecules that are permanently glycated. This is probably the mechanism by which elevated glucose causes tissue damage and therefore HbA1c is a very useful prognostic indicator. Time in range is also useful; it depends on having the optimal range settings to work to, and also requires relatively expensive monitoring methods. TIR and HbA1c are both useful. Statins are useful for macro vascular damage reduction

[anjanduttakoirala]

Great education...I believe 95 % of patients will be relieved... great work Doctor... thank you so much.

[AslackSaleem]

Most relevant parameter getting irrelevant,
Medicine keeps growing ❤️

[kotagirivenkataapparao]

Superb analytical scientific explanation very useful for the physician and patients

[rajnikantvyas]

Excellent information and the way you have explained step by step. Blessings

[josephjohn]

Thank u sir..for your fantastic way of explanation

[world-of-susan.]

Thank you. I know people above 80 with diabetic Co morbidities, who try to maintain their HbA1C at 5.5% and are weak and shivering between meals.
Kindly upload a Malayalam video so that I may share with those I know.

[vijayakumarveerappan]

Kudos! Is it possible in our set up to even measure time in range for each and every day?☺️

[drsairaviteja]

This is a very very new initiative 🙏

Keep'em

[aruneeshwarsv]

Such an amazing way of putting forth such topics in a short crisp and clear way .... awaiting more and more videos ❤️❤️❤️

[The_Eye_Doctor]

Nice initiative by daily Thanks sir for adding our knowledge 👍🙏

[kalyansengupta]

Diabetic status changes with change in diet change in physical activity simultaneous consumption of other medicines.CGM can not be done very frequently.
Therefore 7 point glucose monitoring for 3 consecutive days by patient himself and suitable modification of treatment is a better cost effective practical option.
HbA1c is not obsolete.
> 70% of patients are not suffering from any hemoglobinopathies & non pregnant .

[AnilHS]

As a patient, I have been using CGM since about an year, with some gap in between. Unfortunately, even in USA, it still needs prescription and many insurances do not cover the cost. It is such a life saving device! Please influence the big pharma and insurance companies to make these to be available without prescription and with some cost covered.
The new recommendation in USA is not only to stay in the range, but also to keep the blood sugar fluctuations as low as possible (flatter). All these are possible with CGM, since a patient can know exactly what affects him. There are a lot of myths in India about diabetes management; eat chapati, switch to Raagi, upama and poha are OK, fruits are bad, etc.
Try those things with a CGM; eat some dry roasted peanuts immediately after rice or with rice; eat rice and curry with good fat like ghee. See taking some supplements like choline. One aspect of diabetes that is still not being discussed is the health of liver. Heart, kidneys, eyes… all get proper attention in managing diabetes, but liver does not.

Note: CGM can also give false results with high vitamin c (lemon juice), etc.

[shafayatali]

Very much informative,
Clear understanding of concept 😎

[vinodlachake]

Sir I want your consultation. How to get

[mukeshlallu]

Sir, thanks for the information. How the inflammation can be correlate with glucose or say diabetic?

[radhakrishnanpp]

this doctor is in directly promoting continous glucose monitoring and auto injection of insulin