OmniBlog

When I was a medical student, the only PDA that I knew was Patent Ductus Arteriosus. Thank God, I didn’t have it. Now I know another PDA and thank God, I have it.

I am talking about Personal Digital Assistants, also called handheld computers or palmtops.

It’s a growing trend. More and more clinicians are using this gadget for accessing information at the point of care. While some well-organized hospitals have even daily patient data available through secure Wi-Fi enabling paperless rounds, I use it as a quick reference tool for conditions that are not routinely seen, to refresh my memory about drugs dosages and interactions and as a medical calculator.


When talking to patients with diabetes and discussing about their diabetes control, I have always had difficulty in explaining the concept of glycated hemoglobin, with most confusing it with hemoglobin itself and wondering why it should be low!


The recent concept of estimated average glucose (eAG) comes in handy now and relieves me of all this discomfort. Instead of telling the patient that her A1c is 10%, I can tell that her average glucose over the last 3 months was 240 mg/dL. It makes a lot of sense to them and they ‘understand’ it, since it is in the same unit as the other glucose values that they are used to.


Last week, I was looking for a converter (HbA1c to eAG) but did not find any that I could use on my PDA. So I made one myself.


eAG Calculator uses Microsoft Excel and can be used on a PDA or PC. The format is adjusted so that it fits the screen of the PDA. The screen is shown on the right side. All you need to do is to enter the patient’s HbA1c value in the orange box. The eAG will instantly be presented in both mg/dL and mmol/L.


In addition, there is also a ready reference list for commonly seen HbA1c values, shown in blue background right under the calculator.


Now, I just flick my PDA open and show the patient her ‘average glucose level in the last 3 months’. Cool, isn’t it?
However, it must be remembered that this concept of eAG is not widely accepted as it is estimated based on HbA1c using a formula derived from the ADAG study, whose validity of data was uncertain. When the ADAG trial results were presented in the EASD September 2007 meeting at Amsterdam, I was also in the audience and was convinced about the need for such a tool to replace the HbA1c, especially from the patients’ point of view.

Download the EAG Calculator