Accurate glycemic-monitoring and control of the patients with hyperglycemia/diabetes are essential for better patient care management. Hemoglobin A1c (HbA1c) measurements correlate with the average plasma glucose level over the preceding 2-3 months. HbA1c is a stable, glycated hemoglobin formed by non-enzymatic addition of glucose to amino-terminal end of Hb polypeptide chains. HbA1c is stable through the life of red blood cells (RBCs) and can be measured regardless of the time of the day and fasting status. Therefore, HbA1c testing has become the standard of practice for glycemic control assessment. According to the American Diabetes Association (ADA) guidelines, through National Glycohemoglobin Standardization Program (NGSP)-certified Diabetes Control and Complications Trial (DCCT)-standardized assay, an HbA1c level between 5.7% and 6.4% is defined as prediabetes, and a level of 6.5% or more is consistent for diagnosis of diabetes. Many methodologies are available for HbA1c testing. In this session, principles of HbA1c assays such as ion-exchange high-performance liquid chromatography (HPLC), boronate affinity HPLC, capillary electrophoresis, immunoassay and enzymatic assays will be explained. The analytical and biological limitations of these assays-such as hemoglobinopathies (Hb variants) will be discussed and compared. In addition, falsely elevated or decreased HbA1c cases and details surrounding NGSP and CAP related to HbA1c testing will be discussed.
Faculty/Authors
Vishnu Amaran Samara Simha Subhash Chandra, PhD
Physician Competencies: Patient Care, Medical Knowledge, Professionalism, Interpersonal Skills Communication
CME/CMLE Credit: 1.0
Estimated Completion Time: 1 hour
Format: Online Educational Activity
Accreditation Statement: The American Society for Clinical Pathology (ASCP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education (CME) for physicians. This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME).
Credit Designation Statement: The American Society for Clinical Pathology (ASCP) designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Instructions
To claim CME/CMLE credit for the exercise, do the following:
- Review the Technical Considerations.
- Review the Faculty Disclosures.
- Click Go to Course to view an overview of the modules in this course.
- Click Access to begin the course.
- Submit the course Evaluation.
- Enter the maximum number of credits offered and click Claim CME to register credit.
Faculty Disclosure
Technical Considerations
Release Date: 09/05/2024
Review Date:
Expiration Date: 03/06/2025