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Guidance concerning the use of glycated haemoglobin (HbA1c) for the diagnosis of diabetes mellitus

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A position statement of the Australian Diabetes Society

Reimbursement by Medicare of the costs of measuring glycated haemoglobin (HbA1c) for the diagnosis of diabetes mellitus was recently approved. An HbA1c value of 48 mmol/mol (6.5%) or more constitutes a positive result, suggesting the diagnosis of diabetes mellitus. This test provides an alternative to traditional glucose-based methods of diagnosis; it does not replace them. The correct use of the test may facilitate earlier diagnosis of people with elevated mean blood glucose levels who are at increased risk of long-term diabetes-specific microvascular complications. HbA1c assessment will be used predominantly for the diagnosis of type 2 diabetes mellitus.

It is important that medical practitioners who elect to use the test for diagnostic purposes understand its nature, its limitations and its benefits. The latter were outlined in the position paper of the HbA1c Committee of the Australian Diabetes Society published in this Journal in 2012.1 We recommend that medical practitioners read the earlier paper in conjunction with this new implementation document. Assessment of HbA1c levels during pregnancy is not discussed in this article.

This position statement of the Australian Diabetes Society is endorsed…

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