This report is an addendum to the diagnostic criteria published in the 2006
WHO/IDF report Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia” , and addresses the use of HbA1c in diagnosing diabetes mellitus
This report does not invalidate the 2006 recommendations on the use of plasma glucose measurements to diagnose diabetes
A WHO expert consultation was held from 28 to 30 March 2009 . A systematic review was conducted on the use of HbA1c as a diagnostic test for diabetes mellitus.
The evidence was summarized and its quality evaluatedusing the GRADE methodology. The recommendation was formulated and its strength was rated on a two-point scale, based on the quality of evidence and the applicability and performance of the method in different settings
The WHO Consultation concluded that HbA1c can be used as a diagnostic test for diabetes, provided that stringent quality assurance tests are in place and assays are standardised to criteria aligned to the international reference values, and there are no conditions present which preclude its accurate measurement An HbA1c of 6.5% is recommended as the cut point for diagnosing diabetes A value less than 6.5% does not exclude diabetes diagnosed using glucosetests
The expert group concluded that there is currently insufficient evidence to make any formal recommendation on the interpretation of HbA1c levels below 6.5%
© World Health Organization 2011