Association between diabetic complications and frequency of HbA1c checks in the United States – Analysis of the 2015 Behavioral Risk Factors Surveillance System (BRFSS) data.

Purpose: Hemoglobin A1c levels are considered to be the best indicator of good glycemic control. Poor glycemic control leads to diabetic complications. The purpose of this study was to examine the relationship between diabetic complications and the frequency of hemoglobin A1c monitoring. Methods: Behavioral risk factor surveillance system data from 2015 were analyzed to estimate the frequency of hemoglobin A1c monitoring in people with diabetes. Ordinal logistic regression was used to examine the association between frequency of hemoglobin A1c checks and diabetic complications. Results: People with diabetic complications had higher proportional odds (adjusted odds ratio [AOR]=1.27; 95% confidence interval [CI] = [1.08, 1.50]) of checking hemoglobin A1c more frequently when compared to those without diabetic complications. For individual diabetic complications, those who reported having kidney disease (AOR = 1.23; 95% CI = [1.02, 1.50]), eye disease (AOR = 1.34; 95% CI = [1.12, 1.60]), and coronary heart disease (AOR =1.25; 95% CI = [1.03, 1.52]), showed statistically significant association with increased frequency of hemoglobin A1c checks. Conclusion: Our results suggest that people with diabetes do not adhere to recommended care guidelines until complications develop. Interventions should focus on HemoglobinA1c monitoring prior to complications developing to improve diabetic outcomes.