Changing from Glucose to HbA1c for Diabetes Diagnosis

Nielsen et al. investigated the change in number of diabetes cases diagnosed by HbA1c versus fasting venous plasma glucose (FPG) in a Danish population. Interestingly, the study revealed that the percentage of undiagnosed patients with diabetes aged 25 - 75 years was reduced from 3.6% based on one FPG measurement (FPG ≥7.0 mmol/L) to only 1.7% based on the criterion of HbA1c >6.5% (DCCT). These findings emphasize the clinical significance of using HbA1c instead of FPG for diabetes diagnosis. (Nielsen et al. 2014: Changing from glucose to HbA1c for diabetes diagnosis: predictive values of one test and importance of analytical bias and imprecision. Clin Chem Lab Med 52:1069-1077.)