[Use HbA1cas a diagnostic test for type 2 diabetes mellitus]

Area of Science:

• Endocrinology
• Clinical Chemistry
• Diagnostic Criteria

Background:

• Current diabetes mellitus diagnosis relies on an 'agreement' based on isolated glucose measurements.
• This diagnostic approach faces challenges and limitations in clinical practice.
• There is ongoing discussion regarding the optimal criteria for diagnosing diabetes.

Purpose of the Study:

• To propose and evaluate a shift in diabetes diagnosis from glucose measurements to hemoglobin A1c (HbA1c) levels.
• To discuss the advantages and disadvantages of an HbA1c-based classification system.
• To encourage a broader discussion for a potential unanimous position on diagnostic criteria.

Main Methods:

• Comparative analysis of diagnostic criteria for diabetes.
• Discussion of the merits and drawbacks of using HbA1c versus glucose measurements.
• Consideration of arguments from clinical chemists and opposing viewpoints.

Main Results:

• The advantages of an HbA1c-based system are considered to outweigh the disadvantages.
• Combining HbA1c and glucose measurements offers minimal added practical value.
• Concerns exist regarding the acceptance of an HbA1c-based system, particularly related to sensitivity and specificity.

Conclusions:

• An HbA1c-based classification system is believed to ultimately benefit patients with diabetes.
• Despite existing doubts and disadvantages, the proposed system holds promise for improved patient outcomes.
• Further discussion is needed to reach a consensus on the adoption of HbA1c for diabetes diagnosis.