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• The referral [to NICE from the DoH]……originally set out to address the prevention of ‘pre-diabetes’ among adults.
• However, in January 2011 the WHO recommended that HbA1c could be used as an alternative to standard glucose measures to diagnose type 2 diabetes ….but there is no fixed point to indicate when someone has ‘pre-diabetes’.
• The title of this guidance has been changed since it went out for consultation to reflect this move away from recognising ‘pre-diabetes’ as a separate condition.
'An HbA1c of 6.5% is recommended as the cut point for diagnosing diabetes.
A value less than 6.5% does not exclude diabetes diagnosed using glucose
tests. The expert group concluded that there is currently insufficient evidence
to make any formal recommendation on the interpretation of HbA1c levels
below 6.5%.'
Eric
Professor E S Kilpatrick
Department of Clinical Biochemistry
Hull Royal Infirmary
Anlaby Road
Hull HU3 2JZ
Tel 01482-607708
Fax 01482-607752
From the latest NICE guideline ‘Preventing Type 2 Diabetes’:
“Type 2 diabetes is diagnosed in adults who are not pregnant by a glycated haemoglobin (HbA1c) level of 6.5% (48 mmol/mol) or above.
A type 2 diabetes diagnosis can also be made by:
Does anyone else think that we went very quickly from HbA1c can be used for the diagnosis of DM to it being the first line test?
Regards,
Angela
Angela Kremmyda
Senior Biochemist
Dept of Clinical Biochemistry
Royal Shrewsbury Hospital
Mytton Oak Road
Shrewsbury
SY3 8XQ
Tel: 01743 261158
Fax: 01743 261159
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