Diabetic tests must be regulated

As a benchmark for diagnosing diabetes, the importance of the A1C test must be reevaluated to improve glycemic numeracy of policy makers, patients and providers – who must make real-world decisions. This is based on a commentary published by Wiley-Blackwell in the Journal of Diabetes.

A1C represents the attachment of glucose to hemoglobin (the oxygen-carrying protein in our red blood cells). Despite being a typical test and a very useful indicator of the average blood sugar level for a person with diabetes, the A1C measure can be misleading as the test only offers a general measurement and does not consider individual factors, such as genetic issues and illnesses – which might lead to lower blood A1C levels. In addition, the laboratory tests are unable to provide a precise measurement.

The commentary entitled, “Know your A1C Number or your A1C Range? The Need to Implement Glycemic Numeracy into Policy and Practice”, examines the clinical implications of A1C variations and proposes guidelines, performance measures and treatment recommendations for physicians and patients.

“A1C is essential to guide therapy and can be used for screening and measurement. However, patients, clinicians and policy makers must understand the limitations of the A1C measurements, so that they can appropriately interpret the results within the context in which they are being used”, said lead author Dr. Leonard Pogach from the DVA New Jersey Veterans Health Care System.

The commentary suggests a scientific review of the adequacy of A1C methodology in clinical practice, a formal program to recommend guidelines to stakeholders.

This article is published in Journal of Diabetes (Published online 15 March 2010). The abstract is available online at: http://www3.interscience.wiley.com/journal/123321252/abstract