Opinions and recommendations of the Argentine Diabetes Society. Hemoglobin A1c

Authors

  • María del Carmen Maselli Faculty of Medicine, University of Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina
  • Isabel Llanos Faculty of Medicine, National University of the Northeast (UNNE), Hospital A.I. de Llano, Corrientes, Argentina
  • Carla Lucarelli Association of High Complexity Laboratories (ALAC), Bahía Blanca, Province of Buenos Aires, Argentina
  • Cecilia Fenili "Norberto Quirno" Medical Education and Clinical Research Center (ProgBA-CEMIC), Autonomous City of Buenos Aires, Argentina
  • Gabriela Ruibal T. Álvarez Hospital, Autonomous City of Buenos Aires, Argentina
  • Silvina Valdez Faculty of Pharmacy and Biochemistry, University of Buenos Aires (UBA), and Institute of Humoral Immunity Studies, Prof. R. Margni (IDEHU), UBA- National Council for Scientific and Technical Research (CONICET), Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v57i1.677

Keywords:

hemoglobin A1c, diagnostic, methods, standardization, recommendations

Abstract

The standardization of hemoglobin A1c (HbA1c) allowed in some countries its use for the diagnosis of diabetes mellitus (DM) and prediabetes, in addition to its use in the follow-up of patients with DM. It is important to highlight that it is an indirect measurement of the glycemic average during the half-life of the erythrocyte, and may be affected by non-glycemic variables, as well as by analytical interferences depending on the methodology used for its determination.

The recommendations and considerations to take into account for the determination of HbA1c when it is used as a diagnostic criterion for diabetes are described below. In addition, it is important to emphasize that it is essential that the HbA1c measurement be performed with certified and standardized methods to the Diabetes Control and Complications Trial (DCCT) results.

Author Biographies

María del Carmen Maselli, Faculty of Medicine, University of Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina

Former Biochemist and Researcher at the Hospital de Clínicas J. F. de San Martín Laboratory, University of Buenos Aires (UBA); Former Faculty of Pharmacy and Biochemistry, Argentine Diabetes Society (SAD)

Isabel Llanos, Faculty of Medicine, National University of the Northeast (UNNE), Hospital A.I. de Llano, Corrientes, Argentina

Chair of Biochemistry, Argentine Diabetes Society (SAD)

Carla Lucarelli, Association of High Complexity Laboratories (ALAC), Bahía Blanca, Province of Buenos Aires, Argentina

Biochemistry

Cecilia Fenili, "Norberto Quirno" Medical Education and Clinical Research Center (ProgBA-CEMIC), Autonomous City of Buenos Aires, Argentina

International Program for External Quality Assurance in Clinical Analysis

Silvina Valdez, Faculty of Pharmacy and Biochemistry, University of Buenos Aires (UBA), and Institute of Humoral Immunity Studies, Prof. R. Margni (IDEHU), UBA- National Council for Scientific and Technical Research (CONICET), Autonomous City of Buenos Aires, Argentina

Chair of Immunology, Argentine Diabetes Society (SAD)

References

I. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33 Suppl 1(Supplement_1):S62-9. doi: 10.2337/dc10-S062.

II. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus: Abbreviated report of a WHO consultation. 2011. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26158184/

III. Guía de Práctica Clínica Nacional sobre prevención, diagnóstico y tratamiento de la diabetes mellitus tipo 2 (DM2) (citado el 28 de diciembre de 2022). Disponible en: https://bancos.salud.gob.ar/sites/default/files/2021-01/guia-nacional-practica-clinica-diabetes-mellitius-tipo2_version-abreviada.pdf.

IV. Hare MJL, Shaw JE, Zimmet PZ. Current controversies in the use of haemoglobin A1c: Review: controversies in the use of HbA1c. J Intern Med 2012;271(3):227-36. doi: 10.1111/j.1365-2796.2012.02513.x.

V. Campbell L, Pepper T, Shipman K. HbA1c: a review of non-glycaemic variables. J Clin Pathol 2019;72(1):12-9. doi: 10.1136/jclinpath-2017-20475.

VI. Fayyaz B, Rehman HJ, Minn H. Interpretation of hemoglobin A1C in primary care setting. J Community Hosp Intern Med Perspect 2019;9(1):18-21. doi: 10.1080/20009666.2018.1559432. eCollection 2019.

VII. Rafat D, Rabbani TK, Ahmad J, Ansari MA. Influence of iron metabolism indices on HbA1c in non-diabetic pregnant women with and without iron-deficiency anemia: effect of iron supplementation. Diabetes Metab Syndr 2012;6(2):102-5. doi: 10.1016/j.dsx.2012.05.011.

VIII. Ford ES, Cowie CC, Li C, Handelsman Y, Bloomgarden ZT. Iron-deficiency anemia, non-iron-deficiency anemia and HbA1c among adults in the US: anemia and HbA1c. J Diabetes 2011;3(1):67-73. doi: 10.1111/j.1753-0407.2010.00100.x.

IX. RR Little, C Rohlfing, D Sacks. The NGSP: over 20 years of improving HbA1c measurement. Clin Chem 2019;65(7): 839-848.

X. Little RR, La’ulu SL, Hanson SE, Rohlfing CL, Schmidt RL. Effects of 49 different rare Hb variants on HbA1c measurement in eight methods. J Diabetes Sci Technol 2015; 9(4):849-56. doi: 10.1177/1932296815572367.

XI. American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: Standards of Medical Care in diabetes-2022. Diabetes Care 2022;45(Suppl 1):S17-38. doi: 10.2337/dc22-S002.

XII. El-Agouza I, Abu Shahla A, Sirdah M. The effect of iron deficiency anaemia on the levels of haemoglobin subtypes: possible consequences for clinical diagnosis. Effect of IDA on haemoglobin subtypes. Clin Lab Haematol 2002;24(5):285-9. doi: 10.1046/j.1365-2257.2002.00464.x.

XIII. Dunaif A, Finegood DT. Beta-cell dysfunction independent of obesity and glucose intolerance in the polycystic ovary syndrome. J Clin Endocrinol Metab 1996;81(3):942-7. doi: 10.1210/jcem.81.3.8772555.

XIV. Unnikrishnan R, Anjana RM, Mohan V. Drugs affecting HbA1c levels. Indian J Endocrinol Metab 2012;16(4):528-31. doi: 10.4103/2230-8210.98004.

XV. Programa de Evaluación Externa de Calidad (PEEC) de la Fundación Bioquímica Argentina (FBA).

XVI. Programa Internacional Buenos Aires de Control de Calidad Externo en Análisis Clínicos. ProgBA.

XVII. Chaila MZ, Viniegra M, Gagliardino JJ, Martínez A, Simesen de Bielke MG, Frusti M, et al. Glycated hemoglobin measurement. Comparison of three methods versus high performance liquid chromatography. J Diabetes Sci Technol 2022;16(3):724-31. doi: 10.1177/1932296821997179

XVIII. Biologicalvariation.eu. Citado: 15/02/23. Disponible en: https://biologicalvariation.eu/search?query=Haemoglobin%20A1c%20(NGSP)

XIX. Westgard S. Consolidated comparison of chemistry performance specifications - Westgard. Disponible en: https://www.westgard.com/consolidated-goals-chemistry.htm

Downloads

Published

2023-04-01

How to Cite

Maselli, M. del C., Llanos, I., Lucarelli, C., Fenili, C., Ruibal, G., & Valdez, S. (2023). Opinions and recommendations of the Argentine Diabetes Society. Hemoglobin A1c. Journal of the Argentine Society of Diabetes, 57(1), 20–23. https://doi.org/10.47196/diab.v57i1.677

Issue

Vol. 57 No. 1 (2023): January/April 2023

Section

Recommendations

License

Copyright (c) 2023 on behalf of the authors. Reproduction rights: Argentine Diabetes Society

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.

La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.

Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.

 

Most read articles by the same author(s)

<< < 1 2