Escaping the Hemoglobin A1c-Centric World in Evaluating Diabetes Mellitus Interventions

J Diabetes Sci Technol. 2015 Feb 19;9(5):1148-51. doi: 10.1177/1932296815576363.


Any intervention in patients with diabetes must consider its effect on both the incidence of hypoglycemia and hemoglobin A1c. Yet, there is no single metric that expresses these key factors simultaneously. Such a composite metric would permit clinicians, regulators, manufacturers, payers, and researchers to more easily evaluate the merits of an intervention as well as enable the comparison of qualitatively different interventions. This article proposes a composite metric, the hypoglycemia-A1c score (HAS), as the basis for a more comprehensive approach for the stakeholders in diabetes treatment to better understand how an intervention affects diabetes management. The article also demonstrates how additional parameters such as effects on weight, quality of life, and costs could be included in such a scoring system.

Keywords: diabetes mellitus; glycemic control; hemoglobin A1c; hypoglycemia.

MeSH terms

  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Quality of Life*


  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin