Ordering Instructions

Hemoglobin A1c (HbA1c) measurements are used for monitoring the long-term blood glucose control in diabetic patients, and as an aid in the diagnosis of diabetes, and in identifying patients who may be at risk for developing diabetes mellitus (prediabetes).

The American Diabetes Association (ADA) recommends measurement of HbA1c at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control) and quarterly in patients whose therapy has changed or who are not meeting glycemic goals.

In conditions associated with increased red blood cell turnover, such as sickle cell disease, pregnancy (second and third trimesters), glucose-6-phosphate dehydrogenase deficiency, hemodialysis, recent blood loss or transfusion, or erythropoietin therapy, only plasma blood glucose criteria should be used to diagnose diabetes. A1C is less reliable than blood glucose measurement in other conditions such as the postpartum state, HIV treated with certain drugs, and iron deficient anemia.

For patients with hemoglobin variants without hemoglobin A or rare hemoglobin variants that show interference with this method suggest monitoring long term glycemic control with serum fructosamine, LAB782 (Mayo Test ID- FRUCT).

Ref: Classification and diagnosis of diabetes: Standards of medical care in diabetes-2020. Diabetes Care 2020;43:S14-S31.