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HbA1c Testing Can Be Used for Diabetes Diagnosis

Evidence-based recommendations approved for laboratory analysis in patients with diabetes

MONDAY, June 13 (HealthDay News) -- Diabetes can be diagnosed and managed by measuring blood concentrations of hemoglobin A1c (HbA1c), according to evidence-based guidelines approved by the American Diabetes Association (ADA) and published in the June issue of Diabetes Care.

David B. Sacks, M.B., Ch.B., from the National Institutes of Health in Bethesda, Md., and colleagues compiled evidence-based recommendations for diagnosis and management of diabetes by laboratory analysis. Using a new system, the quality of evidence and the strength of recommendations were graded. After posting the draft on the Internet, the guidelines were modified on the basis of comments received, and they were then reviewed by the joint Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry and the National Academy of Clinical Biochemistry. Revisions were made by the Professional Practice Committee and approved by the Executive Committee of the ADA before the guidelines were accepted.

The investigators recommended that, apart from the standard practice of measuring venous plasma glucose, diabetes can be diagnosed by demonstrating increased blood concentrations of HbA1c. Glycemic control can be monitored by laboratory analysis of HbA1c and by patient self-measuring of plasma or blood glucose with meters. Noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes have minimal clinical value at present.

"This guideline focuses on the practical aspects of care in order to assist with decisions related to the use or interpretation of laboratory tests while screening, diagnosing, or monitoring patients with diabetes," the authors write.

Several of the study authors disclosed financial relationships with the pharmaceutical industry.

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