changing values
DESCRIPTION
Changing Values. When does 6.5 = 48?. Is this a well controlled diabetic?. Before 2009. HbA1C results would have appeared as: Haemoglobin A1c 7.0% total Hb (3.6-6.8) The HbA1c is expressed as a percentage of the Total Haemoblobin relative to a calibrator aligned to the DCCT method. - PowerPoint PPT PresentationTRANSCRIPT
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Changing Values
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• When does 6.5 = 48?
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Is this a well controlled diabetic?
Date HbA1c mmol/mol
23/04/2011 45
01/11/2010 48
12/01/2010 55
15/11/2009 65
01/09/2009 70
03/07/2009 86
03/05/2005 75
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Before 2009
• HbA1C results would have appeared as:
Haemoglobin A1c 7.0% total Hb (3.6-6.8)
The HbA1c is expressed as a percentage of the Total Haemoblobin relative to a calibrator aligned to the DCCT method
![Page 5: Changing Values](https://reader036.vdocuments.mx/reader036/viewer/2022081501/56814d2d550346895dba5d1d/html5/thumbnails/5.jpg)
After June 2009
• HbA1c results have appeared as:
Haemoglobin A1c 7.0% total Hb (3.6-6.8)
HbA1c (IFCC) 53 mmol/mol
The second result has been obtained using the IFCC reference standard
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From June 2011
• HbA1c results will appear as:
HbA1c (IFCC) 53 mmol/mol (<48)
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Relationship between old and new units
• IFCC-HbA1c (mmol/mol) = [DCCT-HbA1c (%) – 2.5] x 10.929
International Federation of Clinical Chemistry
Diabetes Control and Complications Trial
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Following agreement between the various professions a series
of leaflets were produced outlining the changes.
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Standardisation of HbA1c Assays.
HbA1c measured by ion-exchange chromatography as the glucose changes the charge on the haemoglobin molecule.
Originally calculated as a percentage of the HBA peak.
After the DCCT trial and the importance of meeting a set target was established a standardised approach was used to align methods to the DCCT method.
Not a true standard, so a reference standard was produced and a method assigned by isotope dilution mass spectrometry. Enables to report values in molar terms.
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• www.diabetes.org.uk/Guide-to-diabetes/Monitoring/Blood_glucose/Glycated_haemoglobin_HbA1c_and_fructosamine/
• Calculator to convert from old to new units and links to leaflets one of which is for patients.
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Diagnosis of Diabetes• Based exclusively on fasting glucose and
oral Glucose Tolerance Test.
• March 2011 WHO issued a report with the following recommendation
6.5% = 48 mmol/L
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“Use of Glycated Haemoglobin
(HbA1c) in the Diagnosis of Diabetes
Mellitus
Abbreviated Report of a WHO Consultation
March 2011”
Available on the WHO Diabetes website
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Answer
• When does 6.5 = 48?• When they refer to HbA1c measurements• An HbA1c of 6.5% = HbA1c of 48 mmol/mol.
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Is this a well controlled diabetic?
Date HbA1c mmol/mol
HbA1C
%
23/04/2011 45 6.6
01/11/2010 48 6.9
12/01/2010 55 7.5
15/11/2009 65 8.4
01/09/2009 70 8.9
03/07/2009 86 10.4
03/05/2005 75 9.4