Devon Local Medical Committee

DH - Change in measurement of HBA1C for people with diabetes - 1 Jun 09

Source
From 1 June 2009, HbA1c (long term blood glucose levels) in all people with diabetes will be measured in millimoles per mol as well as by percentage, the Department of Health said today.

The UK is responding to the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) call for all countries to adopt the same measurement to make it easier to compare HbA1c results between laboratories throughout the UK and worldwide.

Both the old and the new measurements will be given for the first two years of the change, until 31 May 2011 when people with diabetes will receive their HbA1c measurement only in millimoles per mol.

Dr. Rowan Hillson MBE, National Clinical Director for Diabetes, said,

  • "It is really important that people with diabetes keep their blood glucose levels under good control. Controlling the glucose in a way that is safe and appropriate for each person reduces the risk of diabetic tissue damage. People with diabetes need HbA1c blood tests to check their glucose is under good control. This necessary change in the way that HbA1c is reported is being introduced in a way that allows plenty of time for us all to get used to it."

Simon O'Neill Director of Care and Policy at Diabetes UK said:

  • "Diabetes UK welcomes this change to the way HbA1c results are reported and we believe that this will have the additional benefit of making comparing results from international laboratories and research trials easier, as the new system will be adopted worldwide.
  • "For a period of 2 years people with diabetes will get their results in both percentage and millimoles per mol which will help them get used to the new system. In addition, Diabetes UK has designed a convenient online HbA1c converter tool for people with diabetes to help them through the transition. To use the calculator and for more general

information on the changes and what they mean, people can visit http://www.diabetes.org.uk/HbA1c."

Notes:

1. HbA1c conversion table

Current HbA1c measure(%)   New HbA1c measure (mmol/mol)
6.0  42
 6.5   48
7.0      53
7.5   59
 8.0  64
9.0  75

2. People with diabetes have higher blood glucose levels than normal. This can cause thirst, frequent urination, tiredness and weight loss. Over a long term, high glucose levels can cause complications such as kidney damage.

3. Glucose lowering measures form an important part of the treatment of diabetes. They include healthy eating, regular exercise and tablets and/or insulin treatment. This treatment must be tailored to the needs of each individual person with diabetes so it is safe and appropriate for him or her.

4. The effects of treatment on long term glucose control are monitored by the HbA1c blood test. HbA1c gives a measure of how high or low the blood glucose has been over the previous 2-3 months. Reducing blood glucose levels safely towards the levels found in people without diabetes can reduce the risk of diabetic complications. Each person with diabetes must agree their own target HbA1c with their doctor.

5. The National Diabetes Audit indicates that HbA1c levels in England have improved over the past three years as shown by the table below:

Treatment Targets Percentage Achieved

National 
Values

Number of 
Registrations
 NICE
HbA1c
<6.5%
 NICE
  HbA1c
<=7.5%

 NICE
Cholesterol
<5.0 mmol/l 

 NICE  
Diastolic <=75 and
Systolic <=135 mm Hg
2003-2004 195,001  21.25  53.28  64.62  21.93
2004-2005  417,175 21.08 56.16 71.49 24.93
2005-2006 559,215  22.54 58.37  76.2   27.35
2006-2007 1,181,431 25.47  62.58  79.71 29.33

                      
                                       


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