HbA1c is currently the best clinical measure of assessing the degree of glycemic exposure for patients with diabetes. Epidemiologic, observational, and clinical trials have found a consistent relationship between HbA1c, improved glycemic control, and the microvascular risks of diabetes, while there remains an uncertainty about the risk-benefits of aggressive glycemic control and macrovascular events. HbA1c as a measure of glycemic control is an important but not the only therapeutic target in the outpatient management of diabetes. Diabetes management requires the collective attention to other proximate outcomes; biomarkers (e.g., lipids, blood pressure, and weight) and behavioral measures (e.g., knowledge, adherence, trust) that predict patient important outcomes of morbidity, mortality, and quality of life.
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