Published 10 November 2009, doi:10.1136/bmj.b4432
Cite this as: BMJ 2009;339:b4432

Analysis

Is haemoglobin A1c a step forward for diagnosing diabetes?

Eric S Kilpatrick, consultant in chemical pathology1, Zachary T Bloomgarden, clinical professor of medicine2, Paul Z Zimmet, director emeritus3

1 Department of Clinical Biochemistry, Hull Royal Infirmary and Hull York Medical School, Hull HU3 2JZ , 2 Department of Medicine, Mount Sinai School of Medicine, New York, USA, 3 Baker IDI Heart and Diabetes Institute, Caulfield South 3162, Australia

Correspondence to: Eric S Kilpatrick eric.kilpatrick@hey.nhs.uk

Eric Kilpatrick, Zachary Bloomgarden, and Paul Zimmet question proposals to diagnose diabetes by raised glycated haemoglobin concentration rather than glucose testing

The first 150 words of the full text of this article appear below.

Currently, diabetes is diagnosed by measuring plasma glucose concentration fasting (threshold ≥7 mmol/l) or after a oral glucose tolerance test (≥11.1 mmol/l). However, an international expert committee comprising members appointed by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation recently recommended replacing these tests with one for glycated haemoglobin A1c (HbA1c).1 The committee stated that type 2 diabetes should be diagnosed in anyone with a confirmed HbA1c value ≥6.5% (48 mmol/mol) without glucose testing, although the glucose criteria will continue to be used in people in whom measurement of HbA1c may be inappropriate. Measurement of HbA1c has several advantages over glucose but its exclusive use could present problems, as we discuss here.

The expert committee document gave no specific reasons for dispensing with glucose criteria in favour of HbA1c, but it did highlight many of the advantages of . . . [Full text of this article]


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Haemoglobin A1c: a false step cystic fibrosis-related diabetes
Federico Marchetti, et al.
bmj.com, 16 Nov 2009 [Full text]
Totally agree
Abdelwahab Y babiker
bmj.com, 19 Nov 2009 [Full text]
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