To anyone who might object to this move, Dr. Nathan reminded the audience that the decision to move to a new standard for HbA1c measurement and its reporting had come from the IFCC and was not going to change. “We were faced with a change in the units and the reporting that was out of our control. [The IFCC's] new standard is a fine thing, but they were going to report it in a way we thought would be confusing.” Indeed, he noted, a study in Sweden had shown that when laboratories there made a change in units, diabetes control among patients suffered (Diabetes Care 2002;25:2110-1).
The timetable for the new reporting standard is not clear. Manufacturers will need to upgrade laboratory machines with new software, which may not necessarily happen all at once, and some upgrades could take a year or two. New point-of-care machines will come with the new standard, but the machines that some physicians already have in their offices will be “more of a challenge” to upgrade, said Dr. Nathan, professor of medicine at Harvard Medical School. In the meantime, the ADA has an online calculator (www.diabetes.org/ag
When asked whether the HbA1c percentage value eventually will be eliminated from the physician-patient conversation in favor of the eAG alone, Dr. Nathan replied, “I think that many of us think [eAG] may ultimately replace [HbA1c]. Why present two numbers when you can present just one?”
Laboratory machines that some physicians have in their offices will be a challenge to upgrade. DR. NATHAN