{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:37:48Z","timestamp":1792611468695,"version":"4.5.0"},"reference-count":53,"publisher":"Royal College of General Practitioners","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"accepted":{"date-parts":[[2025,10,1]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The appropriate glycated haemoglobin (HbA1c) monitoring intervals for patients with type 2 diabetes mellitus (T2DM) remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine appropriate HbA1c monitoring intervals for patients with T2DM across different glycaemic control categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design &amp; setting<\/jats:title>\n                    <jats:p>A target trial emulation study using electronic health records obtained from the Hospital Authority of Hong Kong and death records from the Hong Kong Government Death Registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Adult patients who had T2DM between 2009 and 2012 were identified and grouped by baseline HbA1c levels as follows: &lt;7.0% (&lt;53 mmol\/mol), 7.0%\u20137.9% (53\u201363 mmol\/mol), 8.0%\u20138.9% (64\u201374 mmol\/mol), and \u22659.0% (\u226575 mmol\/mol). A pre-specified target trial was emulated for each group to evaluate the impact of various HbA1c monitoring intervals on the risk of all-cause mortality and cardiovascular disease (CVD). For HbA1c &lt;7.0%, the following intervals were compared: every 2\u20134 months, 5\u20138 months, 9\u201315 months, and 16\u201324 months. For HbA1c \u22657.0%, comparisons were made between intervals of 2\u20134 months, 5\u20138 months, and 9\u201324 months. Follow-up continued until the earliest occurrence of the outcome, death, or 31 December 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort comprised 183 078 patients. For those with HbA1c &lt;7.0%, extending the HbA1c monitoring interval to every 16\u201324 months was not associated with higher risks of the assessed outcomes compared with intervals of 2\u20134 months. Among patients with baseline HbA1c 7.0%\u20137.9%, 9\u201324-month monitoring intervals versus 2\u20134-month intervals was associated with higher mortality risk: hazard ratio (HR) 1.10, 95% confidence interval (CI) = 1.05 to 1.15. Moreover, for those with HbA1c \u22658.0%, when compared with monitoring at 2\u20134-month intervals, monitoring every 5\u20138 months was associated with higher risk of mortality (HbA1c 8.0%\u20138.9%: HR 1.10, 95% CI = 1.04 to 1.16; HbA1c \u22659.0%: HR 1.25, 95% CI = 1.18 to 1.33). The corresponding HRs for CVD were 1.04 (95% CI = 0.98 to 1.10) and 1.09 (95% CI = 1.02 to 1.17), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For patients with T2DM and HbA1c &lt;7.0%, monitoring can be extended to 1.5\u20132 years. For those with HbA1c 7.0%\u20137.9% and \u22658.0%, recommended intervals are 6 months and 3 months, respectively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgpo.2025.0020","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T17:25:14Z","timestamp":1762190714000},"page":"BJGPO.2025.0020","source":"Crossref","is-referenced-by-count":0,"title":["Optimising HbA1c monitoring intervals in patients with type 2 diabetes based on glycaemic control status: a target trial emulation study"],"prefix":"10.3399","volume":"10","author":[{"given":"Boyuan","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Tsui Yee","family":"Tse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shugang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9552-3178","authenticated-orcid":false,"given":"Hao","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine Sze Ling","family":"Chui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy Lo Kuen","family":"Lam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6275-1147","authenticated-orcid":false,"given":"Eric Yuk Fai","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"2026102105001015000_10.3.BJGPO.2025.0020.1","doi-asserted-by":"crossref","unstructured":"Weinstock RS Aleppo G Bailey TS et al (2020) The role of blood glucose monitoring in diabetes management (American Diabetes Association, Arlington, VA).","DOI":"10.2337\/db2020-31"},{"key":"2026102105001015000_10.3.BJGPO.2025.0020.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.3"},{"key":"2026102105001015000_10.3.BJGPO.2025.0020.3","unstructured":"National Institute for Health and Care Excellence (NICE) (2026) Type 2 diabetes in adults: management. 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