Evidence map›Paper›PMID 39757191›Full record

ArticleBMC endocrine disorders2025

Understanding the relationship between the frequency of HbA1c monitoring, HbA1c changes over time, and the achievement of targets: a retrospective cohort study.

Elton Mukonda, Diederick J van der Westhuizen, Joel A Dave, Susan Cleary, Luke Hannan, Jody A Rusch, Maia Lesosky

Abstract read
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In one paragraph

Article in BMC endocrine disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Elton MukondaDivision of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, 7925, South Africa. elton.mukonda@uct.ac.za.
Diederick J van der WesthuizenDivision of Chemical Pathology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Joel A DaveDivision of Endocrinology, Department of Medicine, Groote Schuur Hospitaland the, University of Cape Town , Cape Town, South Africa.
Susan ClearyHealth Economics Unit, School of Public Health, University of Cape Town, Cape Town, South Africa.
Luke HannanDivision of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, 7925, South Africa.
Jody A Rusch *Division of Chemical Pathology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Maia Lesosky *National Heart and Lung Institute, Imperial College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe goal of post-diagnosis diabetes management is the achievement and maintenance of glycaemic control. Most clinical practice guidelines recommend 3-6 monthly HbA1c monitoring. Despite this guidance, there are few data supporting the impact of monitoring frequency on clinical outcomes, particularly from low- and middle-income country settings. This study evaluates the short-term impact of HbA1c monitoring intervals on changes in HbA1c levels, and the impact of adherence to monitoring recommendations on the achievement of HbA1c targets and HbA1c changes over time in a South African cohort. RESEARCH DESIGN AND

methodsThe study utilised routinely collected HbA1c test data on patients with diabetes aged ≥ 18 years in the Western and Northern Cape between 2015 and 2020. Two properties were calculated for each patient: the retest interval (the duration between consecutive HbA1c tests), and the monitoring adherence rate, which represents the proportion of retest intervals that met South Africa's guideline recommendations. Mean changes in HbA1c by the retest interval were used to highlight the short-term impact of monitoring, while multistate modelling and linear mixed-effects modelling were then used to examine the effect of monitoring adherence on the achievement of glycaemic control targets and longitudinal changes in HbA1c.

resultsThe 132,859 diabetes patients with repeat tests had a median of three HbA1c test requests, a median follow-up time of 2.3 years and a median retest interval of 10.3 months. A retest interval 2-4 months maximised the downward trajectory in HbA1c, while individuals with low adherence to the monitoring guidelines were the least likely to achieve glycaemic control in one year. Moreover, patients with low monitoring adherence had higher mean HbA1c levels compared to patients with moderate or high monitoring adherence.

conclusionsThe results from this study illustrate the importance of adherence to monitoring recommendations as adherent patients had better glycaemic control and lower mean HbA1c levels over time.

Indexed as

Glycated HemoglobinAdultAgedBlood GlucoseBlood Glucose Self-MonitoringDiabetes MellitusDiabetes Mellitus, Type 2FemaleFollow-Up StudiesGlycemic ControlHumansMaleMiddle AgedRetrospective StudiesSouth AfricaBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanGlycaemic controlHbA1cLow-and-Middle Income countriesMonitoringType-2 diabetes

Identifiers

PMID39757191
PMCPMC11702234

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.