Dear Editor,
For years this writer has been recommending, with supporting evidence, that PPP should focus on getting the basics right, rather than aspiring for the impossible complex. Where as part of the recommendations, this writer proffered the need to invest in Primary Care, with emphasis on diabetes and hypertension, which are our number one causes of mortality.
As a result, it was reassuring to read that Mount Sinai had a two day conference, where the emphasis was on Primary Care and diabetic control. Diabetic control, emphasising on diabetic monitoring, with a blood test known as HBA1C.
The fact is, HBA1C is the process whereby blood sugars become bound to the red cells haemoglobin, to form glycosylated haemoglobin. Generally, when a diabetic prick their finger to check their blood sugars, that represents the blood sugar for that point in time. On the other hand, since the red cells live for 3 months, the sugar attached would be over a 3 months period, hence the HBA1C records the sugar for three months. And it’s for this reason the HBA1C is a superior test to monitor sugar than a one off sugar test.
The fact is, HBA1C has been in clinical use since the 1980s, but only now it’s being introduced to our practice. This evidences how archaic our practice is, and the difficult task Mount Sinai would have in transforming it.
Regards,
Dr. Mark Devonish MBBS MSc
MRCP(UK) FRCP(Edin) FRCP
Consultant Acute Medicine
Nottingham University