糖尿病诊治方式中糖化血红蛋白应用.ppt

A1c-derived average glucose (ADAG) study HbA1c – eAG 关系的个体间差异并无统计学意义 --有无糖尿病 --糖尿病的不同类型 --性别 --不同种族/人种 （亚裔？） Diabetes Care 2008;31:1473--1478 建议 检验部门报告 HbA1c 检测结果时，提供计算得到的 eAG 值 Sacks DB. Clin Chem 2008;54:1756-1758 Kahn R, Fonseca V. Diabetes Care 2008;31:1704-1707 实验以血糖相对稳定者为对象，其他人群？ 是否适合于所有人种？ 儿童？ 妊娠妇女？ 也有报道认为平均血糖(DCCT标本)与 HbA1c 关系并不呈恒定相关 Sacks DB. Clin Chem 2008;54:1756-1758 Kahn R, Fonseca V. Diabetes Care 2008;31:1704-1707 Kilpatrick ES, et al. Clin Chem 2007;53:897-901 Standards of Medical Care in Diabetes—2009 American Diabetes Association Standards of Medical Care in Diabetes—2009 The use of the A1c for the diagnosis of diabetes has previously not been recommended due to lack of global standardization and uncertainty about diagnostic thresholds. However, with a world-wide move toward a standardized assay and with increasing observational evidence about the prognostic significance of A1c, an Expert Committee on the Diagnosis of Diabetes was convened in 2008. Diabetes Care 2009;32(S1):S13-S61 Standards of Medical Care in Diabetes—2009 This joint committee of ADA, the European Association for the Study of Diabetes, and the International Diabetes Federation will likely recommend that the A1c become the preferred diagnostic test for diabetes. Diagnostic cut-points are being discussed at the time of publication of this statement. Updated recommendations will be published in Diabetes Care and will be available at . Diabetes Care 2009;32(S1):S13-S61 Standards of Medical Care in Diabetes—2009 Perform the A1c test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). (E) Perform the A1c test quarterly in patients whose therapy has changed or who are not meeting glycemic goals. (E) Use of point-of-care testing for A1c allows for timely decisions on therapy changes, when needed. (E) Diabetes Care 2009;32(S1):S13-S61 Standards of Medical Care in Diabetes—2009 For patients in whom A