Reporting HbA1c

LIVINGLIVING

The International Federation of Clinical

Chemistry and Laboratory Medicine

(IFCC) has established a new reference

measurement system for the worldwide

standardisation of HbA1c. It recommends

that HbA1c concentration be reported in

mmol of HbA1c per mol of haemoglobin

(mmol/mol). This will make comparing

HbA1c results from different laboratories

and clinical research trials throughout the

world much easier. These developments

are supported by international diabetes

organisations and came about because

the HbA1c assay systems used in both

the DCCT* and UKPDS** trials were not

specific for HbA1c and were not calibrated

in the manner that is now required.

The unit for reporting HbA1c

concentration is mmol/mol. The range of

HbA1c values for people without diabetes

will be 20 to 42 mmol/mol. For a period

of time, the HbA1c (IFCC, mmol/mol)

result will be accompanied by the familiar,

traditional HbA1c as a percentage (also

known as DCCT %) result, i.e. dual

reporting. For example, a HbA1c report

might read as follows: HbA1c (IFCC) 53

mmol/mol; HbA1c (DCCT) 7.0%.

Standardising ops

The fact that the IFCC number is higher

than the DCCT number does not mean

there has been more glucose in an

individual's blood or that the diabetes was

more poorly controlled. It is just a different

way of expressing the same level of

diabetes control. The IFCC HbA1c values

are very different from blood glucose

concentration values and this should

reduce the risk of people with diabetes

confusing both these results

Małgorzata Koperska, MD, writing for

www.omnicalculator.com explains: "The

international standard way of measuring

blood glucose levels is in terms of

a molar concentration, measured in

mmol/L (millimoles per litre; or millimolar,

mM for short). In the United States, and

continental Europe mass concentration

is predominantly measured in mg/dL

(milligrams per decilitre).

"In contrast, mg/dL gives the

concentration by the ratio of weight

to volume, in this case milligrams per

decilitre. mmol/L is the most common

measurement used in the UK with mg/

dL predominantly used in the USA and

continental Europe. Blood glucose

typically varies from 4 mmol/L to 6 mmol/L

for people without diabetes. There are two

manners of presenting the concentration

of glucose in the blood.

The international standard way of

measuring blood glucose levels is in terms

of a molar concentration, measured in

mmol/L (millimoles per litre; or millimolar,

mM for short). In the United States, and

DOUBLE TROUBLE

Why HbA1c results come in two sizes

continental Europe mass concentration

is predominantly measured in mg/dL

(milligrams per decilitre). The conversion

between the glucose units is on the

fact that 1 mmol/L = 18 mg/dL, but

calculating that in your head can be a

challenge. There are reference tables to

assist with converting one to the other.

Print reference table new measurements

HbA1c reporting always begs the

question, can you put a single valuation

number on a complex variable? The short

answer is 'no', but to date there was only

HbA1c to go on.

*DCCT Diabetes Control and Complications

Trial was conducted by the United States

National Institute of Diabetes and Digestive

and Kidney Diseases (NIDDK) that was

published in the New England Journal of

Medicine in 1993. It was as a landmark

study at the time, and significantly changed

the management of all forms of diabetes.

**The United Kingdom Prospective Diabetes

Study (UKPDS) was a clinical study

published in The Lancet in 1998.

DCCT

7%

IFCC

53 mmol/mol

For a downloadable conversion chart, click HERE.

Index

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  12. Intellin, Chris Genders, diabetes health information app, Type 2 diabetes
  13. Medtronic Minimed 670G hybrid closed loop insulin pump
  14. Medtrum A6 Touchcare patch pump and CGM in harmony
  15. Spirit pharmacy national medicines dispensing service and advice for people with
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  17. Diabetes and coronovirus, diabetes Covid-19
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  21. Diabetes UK helpline
  22. Mike Kendall diabetes every day ups and downs, T1 resources
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  27. Medtrum A6 Touchcare patch pump and CGM in harmony
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  33. Air Liquide Healthcare UK Tandem t:slim insulin pump with Basal IQ
  34. sugarBEAT continuous glucose monitoring from Nemaura Medical for Type 2 diabetes
  35. Page 0035
  36. Reporting HbA1c
  37. Insulet Omnipod DASH insulin pump with insulin pods, podders, Omnipod DASH Personal Diabetes Manager
  38. Desang Diabetes Magazine, free diabetes magazine, living with diabetes
  39. Desang Diabetes Magazine, free diabetes magazine, living with diabetes
  40. Making Carbs Count, Carbohydrate counting for diabetes
  41. Making Carbs Count, Carbohydrate counting for diabetes
  42. Making Carbs Count, Carbohydrate counting for diabetes
  43. : Desang diabetes kitbags, bag for diabetes kit
  44. Free online Desang diabetes magazine diabetes information

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