HbA1c Test to be Used for Diagnosis

When you were diagnosed with diabetes (or prediabetes), did your doctor do a fingerstick blood test in his office, or give you a fasting plasma glucose test? Or did he make the diagnosis based on your HbA1c level? Although some doctors are already using HbA1c test results as a diagnostic tool, you may be surprised to know that there are currently no official guidelines for doing so. However, that may be about to change.

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The HbA1c test — a measure of blood glucose levels over 2–3 months that is usually used to assess how well a person is managing his diabetes — may soon be used officially to diagnose Type 2 diabetes as well. Earlier this month, the American Diabetes Association announced that a group of several leading diabetes organizations will publish guidelines in the next six months on using the HbA1c test as a diagnostic tool. Such a consensus statement is necessary because right now there is no agreement on what HbA1c level would constitute a diagnosis of diabetes.

Most people who don’t have diabetes have an HbA1c level of 6% or less, and those with a higher HbA1c level may have diabetes. In the future, the HbA1c test will probably be used along with other tests to make a diagnosis.

The tests currently in use for diagnosis are the fasting plasma glucose test and the less common oral glucose tolerance test. However, these tests can be inaccurate if a person has eaten recently or is sick. Advantages of the HbA1c test are that it can be given at any time and, because it reflects blood glucose levels over a longer period, it is not unduly influenced by events on the day of the test.

Do you think that using HbA1c as a diagnostic tool is a smart move? Do you remember what your HbA1c was when you were diagnosed? Let us know with a comment here.

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