Diabetes Webinars

Glycated Hemoglobin

Glycated Hemoglobin (HbA1c) for Diagnosis and Monitoring of Diabetes: Current Practice


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Diabetes represents a serious global epidemic.  Diabetes causes its own direct adverse effects but also predisposes patients to the development of both cardiovascular disease (CVD) and chronic kidney disease (CKD).  Identifying individuals at risk of developing diabetes and monitoring glycemic control of patients with the disease are medical imperatives. Glycated Hemoglobin (HbA1c) is a marker well established and routinely used for the monitoring of long term glycemia. Improvements in the analytical performance of HbA1c assays now allow the test to be effectively used for risk assessment in order to prevent individuals from developing the disease. Traditional methods such as fasting blood glucose, two-hour postprandial glucose, and the glucose tolerance test continue to be used for diagnosis but HbA1c offers unique advantages (e.g., no need for a fasting sample, reflect the average blood glucose of a three month period, etc.)
Since the late 1970’s large numbers of HbA1c methods have been introduced into clinical practice, but there was obviously a significant difference in the results produced by different laboratories. Lack of standardization resulted in several countries developing National Standardization Programs including US (NGSP; National Glycohemoglobin Standardization Program), Japan and Sweden. The IFCC (International Federation of Clinical Chemistry and Laboratory Medicine) implemented the international standardization for HbA1c. Significant work has been done by each of these standardization programs and there remains a need to implement a harmonized procedure for reporting HbA1c measurements.
During this webcast we will learn about the nature of HbA1c formation, the outcomes of standardization efforts, and the quality of its measurements which are key to its use in clinical practice for either monitoring or diagnosis.


Cas Weykamp is a clinical chemist and director of the MCA laboratory of the Queen Beatrix hospital in the city of Winterswijk, the Netherlands. A major activity is the standardization of HbA1c. He is network coordinator of the worldwide network of 16 reference laboratories operating the IFCC reference method for HbA1c and secretary of the IFCC Task Force for education on HbA1c.He is also advisor of the NGSP. He organizes the EQA/PT program for HbA1c in the Netherlands. In general he is active in the field of EQA/PT, Standardization and Harmonization as a member of the IFCC Task Force for Proficiency Testing and the IFCC Working Groups on Commutability and CDT. In the AACC he served as chair of the task force to develop tools for the AACC Harmonization Initiative. He is speaker at many international scientific meetings. For a review of his publications please see www.pubmed.com under Weykamp C.


Garry John is a Consultant Clinical Biochemist and Head of Clinical Biochemistry and Immunology at the Norfolk and Norwich University Hospital, and Honorary Professor at The Norwich Medical School, University of East Anglia, Norwich (UK). In addition to teaching on the Norwich Medical degree course he is a visiting lecturer to: Barts and The London School of Medicine and Dentistry, University of Surrey, University of London and the University of Milan. Garry is Fellow of the Royal College of Pathologists (FRCPath), a member of Association for Clinical Biochemistry and Laboratory Medicine, American Association for Clinical Chemistry, Diabetes UK, European Association for the Study of Diabetes, Heart UK.
Garry served as Chairman of the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Working Group (WG) on HbA1c Standardization until the WG was closed following successfully completing all its tasks. Garry now serves as Chairman of the IFCC Task Force on HbA1c standardization implementation. He is a member of the steering committee of the NGSP. In addition, Garry has worked closely with a number of National and International organizations, including the European Association for the Study of Diabetes, the International Diabetes Federation and the World Health Organization.
Garry has published more than 100 papers in refereed journals, authored six book chapters, edited two books and presented over 30 posters at international meetings. He is an Associate Editor for Diabetic Medicine and acts as a reviewer of several renowned journals including Clinical Chemistry, Annals of Clinical Biochemistry, Clinica ChimiActa and Diabetologia.

Learning Objectives

  • Understand how and why glycated hemoglobin (HbA1c) is formed.
  • Explain how the concentration of HbA1c corresponds to a patient’s glycemic control (average blood glucose concentration).
  • Identify the adverse effects of diabetes.
  • Compare and contrast the traditional means of diagnosing diabetes (fasting blood glucose, two hour postprandial glucose, and glucose tolerance test) with HbA1c.
  • Describe the international reference measurement system (RMS) for HbA1c.

Who Should Attend

  • Laboratorians
  • Endocrinologists
  • Clinicians
  • Metabolic Specialists


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