• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

HbA1c Precision

SamJB

Well-Known Member
Messages
1,857
Location
Chester
Type of diabetes
Type 1
Treatment type
Pump
Anyone know how precise HbA1c results are? I.e. what are the error margins. Do GPs have this information on a particular test? For example, my last result was 6.5%, does my GP know this to be 6.5% +/- 0.2% or something similar?
 
Precision?
I think that all UK labs are part of the NGSP Process for standardisation. The paper shows how it works, no idea how it works at the bottom of the chain .
http://www.clinchem.org/content/57/2/205.full.pdf

So basically what it shows is individual . If your HbA1c goes up or down more than 0.5% then it is probably significant for you but your 6% may not reflect the same average blood glucose levels as someone else's 6%. (depend how average you are :lol: )

That is why the UK authorities don't report the estimated average glucose level.

The Eag study writers said
The results of the A1c-Derived Average Glucose (ADAG) study support the notion of a close relationship between A1C levels and AG for both type 1 and type 2 diabetes. .
http://care.diabetesjournals.org/content/31/8/1473.full

R. David G. Leslie and Eric S. Kilpatrick, (both UK diabetologists/researchers) replied to this paper suggesting

1) that the conversion factor was probably flawed because the study group was non randomly selected and included non diabetics.
2)The formula wasn't validated on specific groups and did not take into account the variations brought about by haemoglobin variants, pregnancy, renal problems, ethnicity etc
3) and probably for most of us the most important given the amount of discussion on what a 'good' Hb1c level is.

 
Thanks for the answers guys, been very useful. Phoenix, I'm always impressed by the papers you dig out for various questions! Do you work in science? Where do you get them all from?

The CVs of 2-3% in that paper mean that the error bars are around +/- 0.1% for 1 standard deviation if your HbA1c is in the 6s, which is good enough for me, an ex-astrophysicist! For 2 standard deviations, your error bars are +/- 0.5%. Doesn't sound very precise!
 
SamJB said:
Anyone know how precise HbA1c results are? I.e. what are the error margins. Do GPs have this information on a particular test? For example, my last result was 6.5%, does my GP know this to be 6.5% +/- 0.2% or something similar?

Labs have different methods of measuring HBA1c and have different equipment. They are supposed to run controls throughout the day and recalibrate at regular intervals. Different methods of measuring HBA1c require some of the data to be converted and some of these have their own error margins. Below is a statement from an article with its link:

"Today, most methods for measuring HbA1c are NGSP-certified. According to the NGSP manufacturer certification criteria, this means that for a panel 40 samples analyzed in duplicate under ideal conditions, the 95% confidence interval of the differences between the method being tested and a NGSP SRL is within +/–0.75% HbA1c."

Your +/- 0.2% is optimistic. Labs rarely achieve the ideal conditions required.

HbA1c
An Overview of Current Analytical Testing Issues
http://www.aacc.org/publications/cln/20 ... bA1c.aspx#
 
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…