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Related Concept Videos

Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...

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Corrigendum to "Clinical assessment and acceptance criteria for continuous glucose monitoring (CGM) system performance: A proposed guideline by the IFCC working group on CGM" [Clin. Chim. Acta 580 (2026) 120728].

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Updated: Jun 19, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

[HbA1c revisited (again and again ...)].

Peter Diem1

  • 1Universitätspoliklinik für Endokrinologie, Diabetologie und Klinische Ernährung, Inselspital, Universität Bern. peter.diem@insel.ch

Therapeutische Umschau. Revue Therapeutique
|October 16, 2009
PubMed
Summary

The International Federation of Clinical Chemistry (IFCC) standardized HbA1c testing, yielding lower "true" values. Knowing the method and units (IFCC- or DCCT-traceable) is crucial for accurate glycaemic control assessment.

Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Endocrinology

Background:

  • Standardization of HbA1c measurements is vital for accurate diabetes management.
  • The International Federation of Clinical Chemistry (IFCC) developed a new reference measurement system.
  • Traditional HbA1c methods differ from IFCC-referenced methods, potentially causing clinical misinterpretation.

Purpose of the Study:

  • To inform healthcare professionals about the implications of the new IFCC reference measurement system for HbA1c.
  • To highlight the importance of reporting traceable HbA1c values and appropriate units.
  • To prevent clinical misjudgement due to differing HbA1c measurement methods.

Main Methods:

  • Implementation of the IFCC international reference measurement system for HbA1c.

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  • Comparison of IFCC-referenced methods with traditional methods.
  • Development of recommendations for reporting HbA1c results.

    • Main Results:

    • IFCC-referenced methods yield HbA1c values 1-2% lower than traditional methods.
    • Potential for clinical misjudgement exists if the method and units are not clearly stated.
    • The Swiss Society of Endocrinology and Diabetes recommends clear reporting of IFCC- or DCCT-traceable values.

    Conclusions:

    • Clear reporting of HbA1c method traceability (IFCC or DCCT) is essential.
    • IFCC results should ideally be reported in mmol/mol, with the normal range clearly indicated.
    • Accurate interpretation of glycaemic control relies on understanding the HbA1c measurement methodology and units.