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Updated: Jul 11, 2026
Biochemical Titration of Glycogen In vitro
Published on: November 24, 2013
Global standardization of glycated hemoglobin measurement: the position of the IFCC Working Group
1Centre for Metrological Traceability in Laboratory Medicine (CIRME), Dept. Science and Biomedical Technology, University of Milano, Italy.
Insights
International standardization of glycated hemoglobin (HbA1c) measurement is crucial for diabetes monitoring. The IFCC established a reference system, including procedures, calibrators, and a lab network, to ensure accurate and traceable HbA1c results globally.
Area of Science:
- Clinical Chemistry
- Laboratory Medicine
- Endocrinology
Background:
- Glycated hemoglobin (HbA1c) measurement is vital for diabetes glycemic control monitoring.
- Numerous laboratory assays exist, leading to variability in results.
- International standardization efforts were initiated to address this variability.
Purpose of the Study:
- To establish an international standard for HbA1c measurement.
- To ensure accurate and comparable HbA1c results across different laboratories worldwide.
- To implement traceability to a common reference system.
Main Methods:
- Development of a reference measurement procedure using purified primary calibrators.
- Establishment of a global network of reference laboratories.
- Initiation of traceability implementation to the IFCC reference system.
Main Results:
- A reference measurement procedure for HbA1c has been successfully established.
- A worldwide network of reference laboratories is operational.
- Progress has been made in implementing traceability to the IFCC reference system.
Conclusions:
- The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group on HbA1c has made significant progress in standardizing HbA1c measurement.
- The analyte is now defined as betaN1-deoxyfructosyl-hemoglobin with units of mmol/mol.
- The name HbA1c is recommended for continued use in clinical practice for clarity.
Abstract:
The measurement of glycated hemoglobin is central in the monitoring of glycemic control in patients with diabetes. There are at least 30 different laboratory assays commercially available to measure the proportion of HbA1c in blood. In 1995 the IFCC established a Working Group (IFCC WG-HbA1c) to achieve international standardization of HbA1c measurement. The main achievements can be summarized as follows: a) a reference measurement procedure has been established with purified primary calibrators; b) a network of reference laboratories has been developed worldwide; and c) work has begun on implementation of traceability to the IFCC reference system. The IFCC WG-HbA1c recognizes the recommendation of the IFCC-IUPAC Committee on Nomenclature, Properties and Units that the analyte measured by the IFCC reference measurement procedure has been defined as betaN1-deoxyfructosyl-hemoglobin and that the recommended measurement units are mmol/mol. The IFCC WG-HbA1c recommends maintaining the use of the name HbA1c in clinical practice.
