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The national glycohemoglobin standardization program: a five-year progress report.

R R Little1, C L Rohlfing, H M Wiedmeyer

  • 1Department of Child Health, University of Missouri School of Medicine, 1 Hospital Dr., Columbia, MO 65212, USA. LittleR@health.missouri.edu

Clinical Chemistry
|October 24, 2001
PubMed
Summary
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Standardizing glycohemoglobin (GHB) testing improved diabetes management. The National Glycohemoglobin Standardization Program (NGSP) has increased comparability of GHB results, aiding adherence to American Diabetes Association (ADA) treatment goals.

Area of Science:

  • Clinical Chemistry
  • Diabetes Mellitus Management
  • Laboratory Standardization

Background:

  • Glycemic control, measured by glycohemoglobin (GHB), is critical for preventing diabetes complications, as shown by the DCCT and UKPDS studies.
  • The American Diabetes Association (ADA) established treatment goals in 1994, but inconsistent GHB testing methods hindered their implementation.
  • A lack of GHB result comparability among laboratories was identified in the 1993 College of American Pathologists (CAP) Survey.

Purpose of the Study:

  • To review the National Glycohemoglobin Standardization Program (NGSP) process.
  • To summarize standardization progress in GHB testing through analysis of CAP data.
  • To assess the impact of NGSP on achieving DCCT-traceable GHB results.

Main Methods:

Related Experiment Videos

  • Review of the NGSP's development and implementation since 1993.
  • Analysis of College of American Pathologists (CAP) GH2-B survey data from 1993 and 2000.
  • Evaluation of laboratory participation and method certification within the NGSP framework.

    • Main Results:

    • Significant improvement in GHB result comparability was observed between 1993 and 2000 CAP surveys.
    • In 2000, 90% of laboratories reported results as hemoglobin A1c (HbA1c) or equivalent, up from 50% in 1993.
    • By 2000, 78% of laboratories reporting HbA1c used NGSP-certified methods, with most showing between-laboratory coefficients of variation (CVs) below 5%.

    Conclusions:

    • The NGSP has successfully enhanced the standardization and comparability of GHB (HbA1c) testing.
    • Increased standardization facilitates meaningful implementation of ADA treatment guidelines for diabetes management.
    • NGSP certification ensures that laboratory results are traceable to the DCCT, improving clinical decision-making.