Question for poik: what is the latest on intervals for HbA1c. I thought the home testing had been discouraged in favour of HbA1c in the last year or so. But I haven’t really been keeping track. I need information for the weekend. I’m concerned that Mum hasn’t even been having the usual reviews…

I found an RACGP page online, but it’s 2012. So not recent. Have you got the most recent guidelines, or a linky?

buffy said:

Question for poik: what is the latest on intervals for HbA1c. I thought the home testing had been discouraged in favour of HbA1c in the last year or so. But I haven’t really been keeping track. I need information for the weekend. I’m concerned that Mum hasn’t even been having the usual reviews…

I found an RACGP page online, but it’s 2012. So not recent. Have you got the most recent guidelines, or a linky?

Depends…

e.g. if type 2 and not on hypoglycaemia, not point testing Blood Glucose Level at home – just get the 3 or 6 monthly HbA1c to see how they’re going.

If on hypoglycaemics or insulin, need to test BGL.

Geriatric BGL and HbA1c ranges are a bit more relaxed than younger people.

hypoglycaemia = hypoglycaemic

Enjoy

https://static.diabetesaustralia.com.au/s/fileassets/diabetes-australia/5ed214a6-4cff-490f-a283-bc8279fe3b2f.pdf

Thank you, some reading for this evening.

:)

poikilotherm said:

Enjoy

https://static.diabetesaustralia.com.au/s/fileassets/diabetes-australia/5ed214a6-4cff-490f-a283-bc8279fe3b2f.pdf

From that link:

HbA1c = Glycated haemoglobin (mmol/mol; %)

HbA1c has recently been endorsed as a diagnostic test for diabetes by the World Health Organization. The Australian Diabetes Society, the Royal College of Pathologists of Australasia, and the Australasian Association of Clinical Biochemists have reviewed the available evidence and confirmed that HbA1c can be used to establish the diagnosis of diabetes.

At the time of publication, the HbA1c assay was not funded by Medicare as a diagnostic or screening test for diabetes, although approval for this purpose is being sought. Note that HbA1c may be artificially normal in people with haemoglobinopathy or haemolysis, and that it may be artificially high in people with iron deficiency.

HbA1c tests need to be performed in an accredited laboratory.

Needs individualisation according to patient circumstances.
Generally:

• ≤53 mmol/mol (range 48–58)
• ≤7% (range 6.5–7.5).
  Allowing for normal variation in test accuracy, HbA1c results which range between 6.5 and 7.5% would reflect this goal.

Patients for software program can be identified on the basis of the presence of other risk factors such as HbA1c >9%.

Diagnostic criteria for type 2 diabetes

• HbA1c ≥ 6.5% (48 mmol/mol) (on two separate occasions)

Koenig first proposed the measurement of HbA1c in diabetic patients as a marker for evaluating long-term control of diabetes in 1976.72 Over time this has become a gold standard.However, doctors should be aware of the potential pitfalls of HbA1c as a measure of long-term diabetes management.

(see pages 41 to 43 for accuracy and reliability HbA1c tests).