5. What is HbA1c HbA1c is simply haemoglobin to which circulating glucose has bound Glucose + haemoglobin Red blood cell Glycohaemoglobin
6. HbA1c is Glycosylated Haemoglobin 14% 7% 9% The HbA1c test reports the amount of HbA1c as a proportion of the total haemoglobin Glucose + haemoglobin Red blood cell Glycohaemoglobin
8. March February May April May 6.25% April March Feb March April April May 8.33% May 12.5% May 25.0% May 52% April 27% March 14.5% Feb 6.5% Test at end May What period is measured ? Month red blood cell produced Total influence of monthly blood glucose on HbA1c
10. Why is HbA1c so important? Microvascular complications 37% 14% Deaths related to diabetes Microvascular complications HbA 1c 37% 14% Deaths related to diabetes Microvascular complications HbA 1c 37% 14% Deaths related to diabetes Microvascular complications HbA 1c 37% 14% Deaths related to diabetes 21% Microvascular complications HbA 1c 37% 14% Deaths related to diabetes 21% Microvascular complications HbA 1c 37% 14% Deaths related to diabetes 21% 1% Myocardial infarction DCCT showed that HbA1c is the best long-term marker of diabetes control Better control of HbA1c leads to better outcomes in people with diabetes Stratton IM, et al . BMJ 2000; 321:405–412.
32. Reporting Formats HbA1c level = 8.0% (DCCT aligned) HbA1c level = 64 mmol/mol (IFCC aligned) This is the format which will appear in primary care reporting systems Internal hospital reports and results printed directly from HbA1c analysers may appear in a slightly different format
From June 2009 there is to be a change to the way that HbA1c measurement test results are reported. This change could lead to potential confusion amongst diabetes nurses in secondary and primary care, and their patients. There could be a real risk that patient control could deteriorate due to potential lack of understanding of the new units by patients and healthcare professionals, leading to complications. The good news is that for a while to come the reports you see will still show the ‘old’ numbers alongside the new, giving you the chance to get used to the new numbers. The good news is that this presentation, which you can have a copy of, explains everything so you can be comfortable with what’s happening.
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