LS,
Although HbA1C in the Netherlands is tightly standardized and controlled by
an extensive external quality assessment scheme, any therapy or disease that
affects the erythrocyte "lifespan" directly affects HbA1C!
So, 'HbA1c measurement cannot be used for the diagnosis of diabetes because
of biological variables other than blood glucose that affect HbA1C levels in
vivo'
Bart Ballieux
Dr. Ir. B.E.P.B. Ballieux
Clinical Biochemist
Leiden University Medical Centre
P.O. box 9600
2300 RC Leiden
The Netherlands
t: +3171-5262165
f: +3171-5266753
e: [log in to unmask]
-----Original Message-----
From: Robin Marks [mailto:[log in to unmask]]
Sent: donderdag 30 oktober 2003 16:52
To: [log in to unmask]
Subject: HbA1c in diagnosis of diabetes (was: 5.6 mmol/L is new cutoff
for IFG)
Hello everybody !
To quote from the article in the November 2003 issue of Diabetes Care posted
by Mohammed:
"...
A1C for the diagnosis of diabetes still has disadvantages.
1) A profusion of assay methods has led to different nondiabetic reference
ranges because different glycated hemoglobin fractions have been measured
(30)....
2) A chemical preparation to create uniform calibration standards has only
recently been established (30). This preparation however has not yet been
widely adopted.
3) A1C values may be affected by other conditions (e.g., hemoglobinopathy,
pregnancy, uremia, blood transfusion, and hemolytic anemia), and depending
on the laboratory method used, this may confound the diagnosis of diabetes."
In summary 'HbA1c measurement cannot be used for the diagnosis of diabetes
because of analytical or standardisation problems in the assay'.
Do we agree ?
Dr Robin Marks
Consultant Chemical Pathologist
Calderdale Royal Hospital
Halifax
HX3 0PW
UK
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