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
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.[
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-HbA1c | DCCT- HbA1c | Mono S- HbA1c |
---|---|---|
(mmol/mol) | (%) | (%) |
10 | 3.1 | 2.0 |
20 | 4.0 | 2.9 |
30 | 4.9 | 3.9 |
40 | 5.8 | 4.8 |
45 | 6.3 | 5.3 |
50 | 6.7 | 5.8 |
55 | 7.2 | 6.3 |
60 | 7.6 | 6.8 |
65 | 8.1 | 7.2 |
70 | 8.6 | 7.7 |
80 | 9.5 | 8.7 |
90 | 10.4 | 9.6 |
100 | 11.3 | 10.6 |
2010 Consensus Statement on the Worldwide Standardization of HbA1c
The recommendations are:
- HbA1c test results should be standardized worldwide, including the reference system and results reporting.
- The IFCC reference system for HbA1c represents the only valid anchor to implement standardisation of the measurement.
- 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).
- HbA1c conversion tables including both SI (IFCC) and NGSP units should be easily accessible to the diabetes community.
- 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.
- The reportable term for glycated hemoglobin is HbA1c, although other abbreviations may be used in guidelines and educational material (A1C).
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