Using glycated hemoglobin hba1c for diagnosis of diabetes mellitus: an indian perspective

Authors:Rajni Dawar Mahajan, Bhawesh Mishra
Int J Biol Med Res. 2011; 2(2): 508 – 512  |  PDF File

Abstract

Glycated Hemoglobin (HbA1c) gives an estimate of long-term average glycemic status. It is used routinely to assess glycemic control in diabetics to attain treatment goals and prevent long term complications. Its recommendation for diagnosis of diabetes mellitus has evoked mixed response worldwide. We reviewed a number of published articles to analyze the pros and cons of using HbA1c for diagnosis of Diabetes mellitus in India. We observed that though HbA1c has some indisputable advantages over fasting plasma glucose estimation for diagnosing diabetes mellitus, a number of biochemical, clinical and economical factors limit its use as single diagnostic agent. Diagnostic methods and laboratories are insufficiently standardized for HbA1c in India. The clinician must consider the overall patient profile in addition to a number of local variations and disorders especially hemoglobinopathies /anemias before accepting an abnormal HbA1c value. Supportive or repeat tests may be required leading to increase in cost and delay in diagnosis. In the present Indian scenario, especially the fragmented unorganized health care sector in suburban areas, HbA1c cannot be accepted as a sole and independent test to diagnose diabetes mellitus.