Wednesday, March 14, 2012

HbA1C - The new way of measuring it - IN future!!

There have been multiple attempts in Global Standarizations and consensus statements have been issued, but very difficult to implement.
In the US we still follow HbA1c in % and eAG ( estimated average glucose) is just catching up.
US guidelines developed based on he National Glycohemoglobin Standardization Program (NGSP)
Two major measurement criteria:  International Federation of Clinical Chemistry (IFCC) units vs NGSP 

IFCC-HbA1cDCCT- HbA1cMono S- HbA1c
(mmol/mol)(%)(%)
103.12.0
204.02.9
304.93.9
405.84.8
456.35.3
506.75.8
557.26.3
607.66.8
658.17.2
708.67.7
809.58.7
9010.49.6
10011.310.6
The International Diabetes Federation and American College of Endocrinology recommend HbA1c values below 48 mmol/mol (6.5%), while American Diabetes Association recommends that the HbA1c be below 53 mmol/mol (7.0%) for most patients.[




2010 Consensus Statement on the Worldwide Standardization of HbA1c







The recommendations are:
  1. HbA1c test results should be standardized worldwide, including the reference system and results reporting.
  2. The IFCC reference system for HbA1c represents the only valid anchor to implement standardisation of the measurement.
  3. HbA1c results are to be reported by clinical laboratories worldwide in SI (Système International) units (mmol/mol – no decimals) and derived NGSP units (% - one decimal), using the IFCC-NGSP master equation (DCCT units).
  4. HbA1c conversion tables including both SI (IFCC) and NGSP units should be easily accessible to the diabetes community.
  5. Editors of journals and other printed material are strongly recommended to require that submitted manuscripts report HbA1c in both SI (IFCC) and NGSP/DCCT units.
  6. The reportable term for glycated hemoglobin is HbA1c, although other abbreviations may be used in guidelines and educational material (A1C).

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