The World Health Organisation (WHO) has published a report recommending the use of glycated haemoglobin (HbA1c) testing for type 2 diabetes, with a cut-off of 6.5 per cent, rather than the traditional oral glucose tolerance testing, as long as there are no conditions precluding its accurate measurement.
However, there are also concerns that the move could have a big impact on GP diagnostic practice, guidance by National Institute for Health and Clinical Excellence (NICE), as well as the programme for vascular screening, and could even increase workloads and costs for the NHS, as HbA1c testing is more expensive than conventional testing.
The report found that the 6.5 per cent cut-off for diagnosis was the most effective level, as a value of less than 6.5 per cent does not exclude diabetes diagnosed using glucose tests. The American Diabetes Association changed over at the beginning of the year, and the European authorities are also considering switching the diagnostic criteria for diabetes.
The WHO report states that “Policymakers are advised to ensure accurate blood glucose measurement be generally available at the primary health care level, before introducing HbA1c measurement as a diagnostic test.”
The WHO study also found that there was not enough evidence to offer a formal recommendation concerning the interpretation of HbA1c levels below 6.5 per cent.

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