February 2010 Clinical Laboratory News: ADA Endorses HbA1c for Diabetes Diagnosis

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February 2010: Volume 36, Number 2


ADA Endorses HbA1c for Diabetes Diagnosis

In its newly released set of recommendations, “Standards of Medical Care in Diabetes–2010,” the American Diabetes Association (ADA) now officially recommends HbA1c testing for the diagnosis and monitoring of diabetes. This annually released document recommends new standards for the treatment of diabetes based on the latest scientific evidence.

The report proposes a diagnosis of diabetes for HbA1c levels ≥6.5%, when testing is performed by a laboratory method certified by the National Glycohemoglobin Standardization Program and standardized to the Diabetes Control and Complications Trial assay. Other criteria for diagnosis include a fasting plasma glucose level of ≥126 mg/dL, a 2-hour plasma glucose level ≥200 mg/dL during an oral glucose tolerance test, and a random plasma glucose level of ≥200 mg/dL in patients with symptoms of hyperglycemia or a hyperglycemic crisis. The new standards also advise monitoring individuals with pre-diabetes on a yearly basis to prevent progression to full-blown diabetes.

The ADA changed the name of a previous section of the report from “Diagnosis of pre-diabetes” to “Categories of increased risk for diabetes,” with the recommendation that HbA1c levels of 5.7%–6.4% be considered a sign for increased risk for future diabetes. In addition, the report suggests that HbA1c testing be performed at least twice per year in patients meeting treatment goals and quarterly for those who either have not meet their glycemic control goals or have recently changed therapy.

A full copy of the ADA’s recommendations for this year are available online.

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