| Status of Hemoglobin A1c Measurement and Goals for Improvement: From Chaos to Order for Improving Diabetes Care. | |
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MedLine Citation:
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PMID: 21148304 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The Diabetes Control and Complications Trial (DCCT) and United Kingdom Prospective Diabetes Study (UKPDS) established the importance of hemoglobin A(1c) (Hb A(1c)) as a predictor of outcome in patients with diabetes mellitus. In 1994, the American Diabetes Association began recommending specific Hb A(1c) targets, but lack of comparability among assays limited the ability of clinicians to use these targets. The National Glycohemoglobin Standardization Program (NGSP) was implemented in 1996 to standardize Hb A(1c) results to those of the DCCT/UKPDS. CONTENT: The NGSP certifies manufacturers of Hb A(1c) methods as traceable to the DCCT. The certification criteria have been tightened over time and the NGSP has worked with the College of American Pathologists in tightening proficiency-testing requirements. As a result, variability of Hb A(1c) results among clinical laboratories has been considerably reduced. The IFCC has developed a reference system for Hb A(1c) that facilitates metrological traceability to a higher order. The NGSP maintains traceability to the IFCC network via ongoing sample comparisons. There has been controversy over whether to report Hb A(1c) results in IFCC or NGSP units, or as estimated average glucose. Individual countries are making this decision. SUMMARY: Variability among Hb A(1c) results has been greatly reduced. Not all countries will report Hb A(1c) in the same units, but there are established equations that enable conversion between different units. Hb A(1c) is now recommended for diagnosing diabetes, further accentuating the need for optimal assay performance. The NGSP will continue efforts to improve Hb A(1c) testing to ensure that clinical needs are met. |
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Authors:
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Randie R Little; Curt L Rohlfing; David B Sacks; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-12-9 |
Journal Detail:
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Title: Clinical chemistry Volume: 57 ISSN: 1530-8561 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-1-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9421549 Medline TA: Clin Chem Country: - |
Other Details:
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Languages: ENG Pagination: 205-214 Citation Subset: - |
Affiliation:
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Departments of Pathology and Anatomical Sciences and Child Health, University of Missouri-Columbia School of Medicine, Columbia, MO; |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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