OBJECTIVES: The hemoglobin A1c test (HbA1c) is the favored measure of glycemic control for patients with diabetes. Compliance to recommended testing continues to be a challenge. The current analysis evaluates how compliance to HbA1c testing varies based on initial HbA1c results. METHODS: Newly diagnosed patients with Type II diabetes were identified using the Truven Health MarketScan Lab Database (1/1/2010-10/31/2013). Continuous eligibility for the 6 months prior and 12 months following diagnosis were required for study inclusion. Patient cohorts were created based on first HbA1c test value (< 7.0% [controlled], ≥7.0% [uncontrolled]). Presence of a subsequent HbA1c test, including test result and time to test, were evaluated for these cohorts. RESULTS: A total of 133,011 patients met the study inclusion criteria; approximately 40% had evidence of an initial HbA1c test (n=33,616 with HbA1c < 7.0%; n=19,033 with HbA1c ≥7.0%). Approximately 64% (n=21,497) of controlled patients had a subsequent HbA1c test (86% with HbA1c <7.0%, 14% with HbA1c ≥7.0%); 91% (n=17,344) of uncontrolled patients had a subsequent HbA1c test (36% with HbA1c <7.0%, 64% with HbA1c ≥7.0%). Mean times (in days [d]) to subsequent HbA1c test (and result) were as follows: Among initially controlled patients: 231d (controlled) and 370d (uncontrolled); among initially uncontrolled patients: 238d (controlled) and 212d (uncontrolled). Mean time to HbA1c test was significantly longer for controlled patients with HbA1c ≥ 7.0% for subsequent test relative to controlled patients with HbA1c <7.0% and to uncontrolled patients with HbA1c ≥7.0% for subsequent tests. CONCLUSIONS: Compliance to recommended timing for HbA1c testing is suboptimal in the majority of patients regardless of initial glycemic control. Importance of regular HbA1c evaluation should continue to be part of patient education – particular for patients who may initial appear to have favorable glycemic control.