Hemoglobin AIc: A reliable and accurate test for diabetes care? A prospective  study in Mexico

Abstract

Objective. To compare the concordance correlation coefficient for HbAlc results in an in-field experience. Materials and methods. A prospective study in Monterrey, Mexico from April to August 2012 was conducted to evaluate the day-to-day clinical situation when measuring HbAlc. Blood samples from 38 consecutive patients were sent to seven local laboratories and one international reference laboratory. Results. Poor concordance was found in 4 out of 7 laboratories, moderate in 2 out of 7, and significant in just one. HbAlc values from three laboratories fluctuated more than 1% above or below the reference laboratory in more than 30% of cases, and more than 2% in 10%-20% of subjects. Conclusions. Standardized HbAlc measurement has not occurred worldwide. Physicians should be aware of this issue and be cautious of HbAlc guidelines on diabetes diagnosis or management until proper standardization programs are implemented.

Demographics, A1C Testing, and Medication Use of Mexican Americans and Mexicans With Diabetes

“…The findings showed that out of the 7 laboratories, there was poor A1C level consistency (ie, concordance) in 4, a moderate consistency in 2, and significant consistency in 1. 27 This study shows a lack of A1C level reliability and accuracy in Mexico, which poses a major barrier to providers and for those with diabetes. For providers, this barrier leaves them with the use of a poor measurement method to properly diagnose and monitor their patients, as well as appropriately make medication changes to their patients’ regimen.…”

Hemoglobin A1c and risk of left atrial thrombus and spontaneous echo contrast in non-valvular atrial fibrillation patients

“…This protein can be found in the red blood cell for its entire life span of approximately 120 days [13], so HbA1c levels could reflect the mean glucose range for the previous 2–3 months in patients with or without diabetes mellitus. HbA1c testing does not require patients to fast and its intra individual variability is small, so it is a good value for hyperglycemic and diabetic diagnosis and monitoring.…”