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Standardization of HbA(1c): good or bad?

Lookup NU author(s): Emerita Professor Sally Marshall

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Abstract

The development of a true reference measurement system by the International Federation for Clinical Chemistry (IFCC) for the first time allows reporting of true HbA(1c) results, standardized to an absolute value, worldwide. Regression equations between the IFCC assay and current harmonization assays, including the Diabetes Control and Complications Trial (DCCT) assay, are linear, tight, and stable over time. National and international setting of targets, audit and benchmarking of services will be easier than before, as will translation of research into clinical practice. Nevertheless, the main disadvantage of the IFCC assay is that the numbers and units reported (mmol/mol) are very different from the DCCT value (percentage). An extensive education program for patients and health-care professionals is, therefore, needed to prevent confusion and consequent deterioration in glycemic control. Furthermore, the IFCC system does not overcome difficulties inherent in the measurement and interpretation of HbA(1c), such as in the presence of abnormal turnover of red blood cells and hemoglobinopathies.

Publication metadata

Author(s): Marshall SM

Publication type: Article

Publication status: Published

Journal: Nature Reviews Endocrinology

Year: 2010

Volume: 6

Issue: 7

Pages: 408-411

Print publication date: 01/07/2010

ISSN (print): 1759-5029

ISSN (electronic): 1759-5037

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/nrendo.2010.66

DOI: 10.1038/nrendo.2010.66

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