Haemoglobin A_(1C) analysis in the management of patients with diabetes: from chaos to harmony

摘要

Effective management of patients with diabetes mellitus requires accurate assessments of blood glucose control. The best characterised marker of long term glycaemic control is whole blood haemoglobin A_(1C) (HbA_(1C)). Published clinical trials have identified quantitative and direct relationships between the HbA_(1C) concentration and risks of diabetic microvascular complications. However, in order to practice evidence-based medicine, assays used to measure patient samples should ideally produce values comparable to the assays used in these trials. Numerous assays using chromatographic and immunological detection methods are used around the world. This paper briefly reviews the scientific evolution of HbA_(1C) and its analysis, discusses the reasons why HbA_(1C) assay standardisation is a challenge, describes the approaches that have been adopted to harmonise HbA_(1C) assays, and addresses the current initiatives to standardise HbA_(1C) globally. These efforts have established HbA_(1C) as an essential component in the management of patients with diabetes mellitus and are likely to lead to the use of HbA_(1C) in the screening/ diagnosis of diabetes.