Translating hemoglobin A1c into average blood glucose: implications for clinical chemistry.

Measurement of hemoglobin A1c (Hb A1c) 2 is a fundamental component of the management of patients with diabetes mellitus. Hb A1c measurement provides an indication of chronic exposure to glucose and is extensively used for both monitoring long-term glycemic status and evaluating whether an individual patient has attained adequate metabolic control. The patient’s Hb A1c value is used by clinicians to determine whether glucose-lowering therapy is adequate. A recent report (1 ) establishes a mathematical relationship between Hb A1c and the average glucose (AG) concentration in blood. The findings presented are likely to have considerable impact on the way Hb A1c is reported by clinical laboratories and used by healthcare providers (and patients). The importance and potential consequences of the study are the focus of this Perspective.