Authors' response

摘要

We thank the authors for their interest in our article and valuable comments. First, Dr Leach disagrees with the 2-week interval for repeating HbA1c to confirm new diagnosis of diabetes in asymptomatic people with HbA1c >=6.5% (>=48 mmol/ mol). Dr Leach suggests instead a longer interval of 6-8 weeks for the test is more appropriate. However we disagree with Dr Leach's suggestion. First, HbA1c already gives reflection of level of glycaemia over a period of a few weeks compared to glucose test that gives a snapshot of glycaemia at that point in time. Therefore the main idea behind repeating the HbA1c test is to rule out any lab errors in HbA1c measurement. The suggested 2-week interval is arbitrary taking into consideration any logistics of repeating the test after the first test in the primary care setting. Additionally repeating the test within 2 weeks (not after 2 weeks) preclude the possibility of a patient introducing an intervention (for example, increasing physical activity or lowering dietary glucose load) to decrease his/her glucose profile thereby affecting results of the repeat HbA1c test. Fifty per cent of the contribution to HbA1c comes from the preceding 4- weeks and therefore any longer interval would risk a change in the HbA1c result.