Putting this up for argument rather than for agreement. I have read it twice and I am still not certain what it supports.
Quarterly for the first year is convention rather than evidence, and it is defensible for a simple reason: it is roughly the interval over which HbA1c becomes informative again, since it reflects about three months of glycaemia. After the first year, and once doses are stable, annual is reasonable unless something specific is being followed.
Where I think it is weakest: the completion rate deserves as much attention as the headline, because a large effect among those who finished is a different claim from a large effect among those enrolled.
The question I want answered is what actually belongs on a baseline panel, as opposed to the enormous list that gets pasted around here. Not looking for reassurance. Looking for the part I have got wrong.
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
Dr.RheumBOS said:Quarterly for the first year is convention rather than evidence, and it is defensible for a simple reason: it is roughly the interval over which HbA1c…
That is correct as far as it goes, and here is where it stops going. A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin and B12, and a full blood count. That set catches the things that change, the things that explain symptoms, and the things that alter the prescribing decision. Almost everything else on the long circulating lists is either invariant, uninterpretable without a specific question, or an incidental finding waiting to cause an unnecessary workup.
Dr.RheumBOS said:Quarterly for the first year is convention rather than evidence, and it is defensible for a simple reason: it is roughly the interval over which HbA1c…
Pushing back on Dr.RheumBOS here. I would drop the "get everything" instinct further than this thread does. Every extra test is another chance at a false positive, and incidental findings have their own cost in scans, biopsies and worry.
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View ResultsShort answer first, then the reasoning. The single most useful discipline is bringing the whole panel to a clinician rather than one flagged value. One out-of-range result in isolation generates anxiety and unnecessary tests; the same result next to the trend and the rest of the panel usually generates a shrug.
Dr.MetabolicMD said:A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin…
Adding a me-too, because a thread of one person's experience is not much use. I had assumed I was the exception until I read this.