Standard of Care in Diagnosis of Diabetes Mellitus: HbA1c

Shraddha Shaligram¹*, Gayatri V Chandan¹, Abhijit Mondal¹, Himanshu A Sakhare¹, Tanvi V Bahirat¹, Sahil Syed¹ and Shrikant P Pawar²*
¹Hematology and Biochemistry Division, Department of Serology and Microbiome, Mylab Discovery Solutions Pvt. Ltd., Global Innovation Center, 5th Floor, Amar Paradigm, Opposite Croma Showroom, Baner-411045, Maharashtra, India
²Department of Serology and Microbiome, Mylab Discovery Solutions Pvt. Ltd., Global Innovation Center, 5th Floor, Amar Paradigm, Opposite Croma Showroom, Baner-411045, Maharashtra, India
*Corresponding Author: Dr. Shraddha Shaligram, Assistant Manager B, Hematology and Biochemistry Division, Department of Serology and Microbiome, Mylab Discovery Solutions Pvt. Ltd., Global Innovation Center, 5th Floor, Amar Paradigm, Opposite Croma Showroom, Baner-411045, Maharashtra, India.
Dr. Shrikant P Pawar, General Manager (R&D), Department of Serology and Microbiome, Mylab Discovery Solutions Pvt. Ltd., Global Innovation Center, 5th Floor, Amar Paradigm, Opposite Croma Showroom, Baner-411045, Maharashtra, India.

Published: October 20, 2023

DOI: 10.55162/MCMS.05.171

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Abstract  

Objective: The HbA1c concentration is a crucial component of routine diabetes therapy since it serves both as a risk predictor and an indicator of long-term glycemia and represents the average glycemic history of the previous two to three months. The HbA1c assay was approved as the preferred approach for diagnosing diabetes by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation. This article provides an overview of HbA1c to comprehend its importance in the routine monitoring of diabetic patients. Topics discussed include measurement techniques, advantages and disadvantages of different measurement techniques, clinical significance of HbA1c, rapid diagnosis of HbA1c, and alternative means available to assess glycaemic control.

Methods: This review highlights in detail the structure and formation of HbA1c, clinical importance factors influencing HbA1c levels, methods of measurement, the challenges associated with measuring the HbA1c concentration and describes the current state of the art of analytical and clinical aspects of the process.

Results: Recent developments have made HbA1c assays more sensitive, simple to use, and less expensive. In comparison to previous technologies, the point-of-care HbA1c testing devices deliver quantifiable findings while limiting inference of other Hb variations, making diagnosis far more reliable.

Conclusion: A person with diabetes can live a long and high -quality life if regular monitoring and treatment of diabetes should be done properly. This review emphasizes the shortcomings faced by recent diagnostics techniques and the correlation between falsely elevated and lowered HbA1c results with different physical conditions.

Keywords: Glycated Haemoglobin; Blood Glucose; Glycemic Control; Diabetes Mellitus; Reference Standards; Reference Values

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