Problems in the assessment of glycaemic control in diabetes mellitus

The measurement of glycated haemoglobin and serum fructosamine to assess the recent glycaemic control of diabetic patients has become well established. Likewise, the monitoring of blood glucose using glucose test strips and meters has become popular in both the community and in the hospital inpatient environment. However, despite improvements in the methods of analysis, clinically inaccurate assessments of glycaemia can still occur. Specific problems such as the lack of standardization in assays are in the process of being resolved, but inherent difficulties associated with these measures remain. Clinicians should be aware that these tests still need to be interpreted in conjunction with clinical prudence.