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HbA1c test to be used to diagnose diabetes

Diabetes UK welcomes Monday’s decision by the World Health Organisation (WHO) to accept the use of the HbA1c test in diagnosing diabetes.

The HbA1c test measures the amount of glucose being carried by the red blood cells in the body and indicates a person’s blood glucose levels for the previous two-to-three months. People with diabetes have at least one HbA1c test a year after diagnosis but now, following a review by the WHO, the test has been recommended to also be used for diagnosing diabetes.

A more practical and patient-friendly approach

To date, the most frequently used diagnosis tests typically require taking a blood sample from a patient and measuring the glucose content. In some tests, the patient has to fast and then consume a high glucose drink with blood being taken before and after and the glucose levels compared. Some clinicians already carry out HbA1c tests as a means of diagnosing but it has not yet been widely used.

According to the world health body, the HbA1c test offers a more practical and patient-friendly approach to diagnosing the condition that already affects over 3.5 million people in the UK and over 220 million people worldwide.

Addition of test 'a positive development'

Dr Ala Alwan, Assistant Director General of WHO’s Non-communicable Diseases and Mental Health Cluster, said the addition of this test for diagnosing diabetes is a positive development, provided that stringent quality assurance tests are in place and measurements standardised.

"Unlike other means of diagnosis, it does not require a patient to fast before a blood sample is taken, nor to consume a glucose drink that many people find unpalatable. HbA1c also has the advantage of reflecting the person’s average blood glucose levels over the preceding two-three months," said Dr Alwan.

Other tests will not be shelved

Simon O’Neill, Diabetes UK Director of Care, Information and Advocacy, explained that: "This recommendation does not mean other tests for diagnosing diabetes will be shelved. Doctors will continue to use their clinical judgement about which test is most appropriate for their patients on an individual basis. This advice from the WHO simply provides an assurance that it is acceptable to add HbA1c to the range of options available for testing for diabetes."

In response to questions about the financial implications of introducing the test more widely, O’Neill countered that: "The costs of the HbA1c test are likely to be higher than those for the traditional tests used but the staff time saved in GP surgeries and the convenience for patients is likely to outweigh these."

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