A diabetes test that measures a person’s average blood glucose control over the preceding two to three months is being recommended as the new diagnostic tool for the condition.
A committee of international experts recommended the test, called the the A1C assay, at the American Diabetes Association’s 69th Scientific Sessions over the weekend. The report could instigate a change in the way diabetes is diagnosed, the American Diabetes Association said.
The A1C assay, which has been used for nearly 30 years to determine how well a patient controls diabetes, is a more stable, reliable diagnostic tool than the techniques currently in use, the authors of the report said.
“This committee that I chaired is recommending that this be used as widely as possible to diagnose diabetes instead of the blood sugar test,” said Dr. David Nathan, director of the Diabetes Center at Massachusetts General Hospital and chairman of the committee.
The A1C test, which consists of a simple blood test, is also more convenient than the two tests commonly used for diabetes — the fasting plasma glucose and the oral glucose tolerance test — the authors said.
In the fasting test, the patient does not eat for about 12 to 14 hours before a blood test. In the tolerance test, the patient drinks a sweet solution and has blood drawn two hours later.
In addition, Nathan said, “It probably is better related to the development of eye disease with diabetes, and therefore probably serves as a better diagnostic tool.”
The international committee was assembled by the American Diabetes Association, International Diabetes Federation and European Association for the Study of Diabetes, but those organizations have not officially endorsed the report.
“Basically, the American Diabetes Association supports the concept, supports the use of the A1C to diagnose diabetes, and just has to look at the implications of it, and the implementation of it,” said Richard Kahn, Chief Scientific and Medical Officer for the American Diabetes Association, who was part of the committee.
Using A1C in diagnosis would be particularly useful for determining whether patients have type 2 diabetes, which is more difficult to diagnose than type 1, said Dr. William Bornstein, assistant professor of endocrinology at Emory University, who was not part of the committee.
“This will be beneficial to the population in terms of helping us more clearly diagnose folks who are at risks for complications and help them manage that earlier,” Bornstein said.
Still, controversy likely will arise over the use of the A1C in diagnostics because of the long, established track record of using the other two methods, Bornstein said.