HbA1c  should replace blood sugar test for diabetes

Monday 8th June 2009: HCFI; A 21-member International Expert Committee (American Diabetic association, the European Association for the Study of Diabetes, and the International Diabetes Federation) has recommended that hemoglobin A1c (HbA1c) should be the mainstay of type 2 diabetes screening and diagnosis, replacing fasting blood glucose level and the oral glucose tolerance test .
This is the first major departure from how we've been diagnosing diabetes in the past 30 years, said Dr KK Aggarwal President Heart Care Foundation of India and Director IMAAKN Sinha Institute.
As per the recommendations
1.      HbA1c of 6.5% should be diagnostic for diabetes.
2.      Patients with HbA1c levels between 6.0 and 6.5% should be cautioned that they are in the highest risk group for developing type 2 diabetes.
3.      The risk for developing diabetes is a continuum. Pre diabetes is not a great term to use.
4.      Diabetic retinopathy is the complication we can measure most readily, and HbA1c correlates very closely with diabetic retinopathy. An HbA1c of 6.5% is the level above which you see eye disease and below which you don't see it.
Although glucose levels have been used to diagnose type 2 diabetes traditionally, using HbA1c has definite advantages. HbA1c reflects the average glucose level over a period of several months, whereas glucose levels only measure one point in time. HbA1c is also a more stable chemical moiety; glucose levels can change with temperature and time. HbA1c testing is also much more convenient for patients and eliminates the need for 8-hour fasting.