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Guidance concerning the use of glycated haemoglobin (HbA1c) for the diagnosis of diabetes mellitus

Michael C d’Emden, Jonathan E Shaw, Graham R Jones and N Wah Cheung
Med J Aust 2015; 203 (2): 89-90. || doi: 10.5694/mja15.00041

Summary

  • Glycated haemoglobin (HbA1c) assessment for the diagnosis of diabetes mellitus overcomes many practical problems associated with traditional blood glucose measurements.
  • However, the test is not without limitations of which the medical practitioner needs to be aware.
  • The possibility of an individual having a medical condition that interferes with the test should always be considered, even though these conditions are rare in most Australian communities.
  • Appropriately used, HbA1c assessment should provide a cost-effective, efficient and simple tool for the early diagnosis of type 2 diabetes.

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  • Michael C d’Emden1,2
  • Jonathan E Shaw3
  • Graham R Jones4
  • N Wah Cheung5

  • 1 Royal Brisbane and Women's Hospital, Brisbane, QLD.
  • 2 University of Queensland, Brisbane, QLD.
  • 3 Baker IDI Heart and Diabetes Institute, Melbourne, VIC.
  • 4 St Vincent's Hospital, Sydney, NSW.
  • 5 Westmead Hospital, Sydney, NSW.


Competing interests:

No relevant disclosures.

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  • 2. Department of Health (Australia). MBS online. The November 2014 Medicare Benefits Schedule. http://www.health.gov.au/internet/mbsonline/publishing.nsf/Content/Downloads-2014-11 (accessed Jan 2015).
  • 3. Australian Government Department of Health. Australian type 2 diabetes risk assessment tool (AUSDRISK). 21 June 2013.
  • 4. Colagiuri S, Davies D, Girgis S, Colagiuri R. National evidence based guideline for case detection and diagnosis of type 2 diabetes. Canberra: Diabetes Australia, NHMRC, 2009. http://www.nhmrc.gov.au/guidelines/publications/di17 (accessed May 2015).
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  • 8. Selvin E, Steffes MW, Zhu H, et al. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults N Engl J Med 2010; 362: 800-811.
  • 9. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405-412.
  • 10. Colagiuri S, Lee CM, Wong TY, et al. Glycemic thresholds for diabetes-specific retinopathy: implications for diagnostic criteria for diabetes. Diabetes Care 2011; 34: 145-150.
  • 11. American Diabetes Association. Standards of medical care in diabetes — 2011. Diabetes Care 2011; 34 Suppl 1: S11-S61.
  • 12. Gallagher EJ, Le Roith D, Bloomgarden Z. Review of hemoglobin A1c in the management of diabetes. J Diabetes 2009; 1: 9-17.

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