Dan Med Bull
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With the introduction of measurements of glycated haemoglobin in a single blood sample as an index of long-term blood glucose control, the clinically usefulness of these measurements was questioned. The aim of this study was to evaluate measurements of glycated haemoglobin as a new test for metabolic regulation in diabetes management by use of a medical technology assessment strategy. Technology assessment in medicine has been defined as "the art and science of evaluating medical practices", but the strategy has to be adjusted to the medical technology in question always including the following three stages: (a) problem definition and identification of medical technology, (b) analysis by testing the technology with consideration to its benefit and harm, its costs, and its social consequences, and (c) synthesis of the accumulated knowledge about the technology. ⋯ In patients with IDDM our studies demonstrated the limitations of traditional clinical judgement and the laboratory procedures in providing an accurate assessment of blood glucose control and that knowledge of HbA1c values allowed the clinician to identify patients in poor glycemic control and lead to improvement in glycemic control. In patients with NIDDM our study showed that measurements of HbA1c provided information that was otherwise not obtainable in the usual clinical setting in primary health care. Measurements of glycated haemoglobin were easily accepted by patients with diabetes. (ABSTRACT TRUNCA