Current controversies in the use of haemoglobin A1c

J Intern Med. 2012 Mar;271(3):227-36. doi: 10.1111/j.1365-2796.2012.02513.x. Epub 2012 Feb 14.


Haemoglobin A(1c) (HbA(1c)) has recently been adopted by the World Health Organization into its recommended criteria for diabetes diagnosis. Much debate continues regarding the relative benefits and potential disadvantages surrounding the use of HbA(1c) for this purpose. There is a lack of consensus as to whether this alteration to the definition of diabetes is a step forward or whether it could add further confusion and ambiguity to the debate on the method and criteria for the diagnosis of this globally important disease. This review provides a comprehensive overview of the current issues surrounding how HbA(1c) is measured and reported; and of the evidence for and against its use in diagnosis.

Publication types

  • Review

MeSH terms

  • Biomarkers / analysis
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Glucose Tolerance Test / methods
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Predictive Value of Tests
  • Reference Values
  • Reproducibility of Results


  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human