When Should I Get an HbA1c?

In the current diabetes literature, the average interval for the HbA1c test is variously quoted in the range of four weeks to four months. While I am convinced by the papers published in the 1980s by Henrik Mortensen that the correct answer is four weeks, there clearly is no consensus value among practicing professionals. What do you feel the appropriate interval should be?

Charles Coughran

Currently, the American Diabetes Association and the American Association of Clinical Endocrinology recommend HbA1c tests at least every 120 days. It is my view that HbA1c should be monitored every 60 to 90 days. It is also my view that a fructosomine-hemoglobin A1c ratio may well present its value in coming years.

Currently, in the United States, less than 21 percent of physicians routinely order HbA1c tests on their patients with diabetes. The recent Diabetes Quality Improvement Project guidelines call for action if HbA1c is above 9.5%. This is a high starting point, but at least it is a starting point. It truly reflects the lack of diabetes knowledge in clinical patient care provided in the United States today. On the other hand, this may motivate physicians to activate care intervention for their patients over the 9.5% threshold. Monitoring glycoprotein is an important component of patient care. Whether it be at 30, 60, 90 or 120 days, the important thing is to be consistent so that baseline intervals are meaningful in adjusting optimal therapy. For the long term, I believe, the goal should be every 60 days for HbA1c.

The best we can do is to preach a recommended frequency of having the test done every 90 to 120 days.

Art Williams
President and Chief Scientific Officer
Diabetes Technology, Inc.

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