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Abstract

In recent years there have been several major changes to the diagnosis and management of diabetes mellitus. The World Health Organisation (WHO) recommended the use of haemoglobin A_1C as a diagnostic marker of diabetes in 2011. HbA_1C measurement has been standardised to International Federation of Clinical Chemistry (IFCC) methods and is now being reported in IFCC units. This recommended change was implemented in the UK from 1 June 2009, but is yet to be embraced internationally. We assessed the impact of these changes on the use of HbA_1C and oral glucose tolerance tests (OGTT) in the primary care population. We found a decrease in OGTT tests requested/performed with a concurrent increase in the number of samples with HbA_1C < 48 mmol/mol (< 6.5%) received in the laboratory. This changing practice of diabetes testing in our primary care antedates the WHO recommendation.

Keywords

diabetes oral glucose tolerance test screening standardisation

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References

The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977-86.

UK Prospective Diabetes Study (UKPDS) Group. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837-53.

World Health Organization. Use of Glycated Haemoglobin (HbA_1C) in the Diagnosis of Diabetes Mellitus. Abbreviated Report of a WHO Consultation. Geneva: WHO, 2011. www.who.int/diabetes/publications/report-hba1c_2011.pdf (Accessed April 2013).

World Health Organization. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia. Report of a WHO/IDF consultation. Geneva: WHO, 2006. whqlibdoc.who.int/publications/2006/9241594934_eng.pdf (Accessed April 2013).

Diabetes

. HbA_1C standardisation for clinical healthcare professionals. London: Diabetes UK, 2011. www.acb.org.uk/docs/HbA1cHealthcareProfessionalOct2011.pdf (Accessed April 2013).

Day

Bailey

. HbA_1C: changing units. Br J Diabetes Vasc Dis 2009; 9: 134-6.

Barth

Marshall

Watson

. Consensus meeting on reporting glycated haemoglobin (HbA_1C) and estimated average glucose (eAG) in the UK: report to the National Director for Diabetes, Department of Health. Ann Clin Biochem 2008; 45: 343-4.

Hanas

. Psychological impact of changing the scale of reported HbA_1C results affects metabolic control. Diab Care 2002; 25: 2110-11.

Changing practice of diabetes testing by primary care in West Yorkshire

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