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Assessment and monitoring of metabolic control
Glycated hemoglobin
- Glucose attaches itself to the molecule of hemoglobin (Hb) during the life-cycle of the circulating red cell, forming glycated hemoglobin (HbA1 or HbA1c)
- HbA1c level reflects levels of glycemia over the preceding 6–12 weeks
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HbA1c monitoring has been shown to be the most useful measure
in evaluating metabolic control and is the only measure for which
good data are available in terms of its relationship with later
microvascular complications |
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Recommendation
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Facilities for the measurement of HbA1c should be available to all
centers caring for young people with diabetes
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- Frequency of measurement will depend on local facilities and availability, but good clinical practice would suggest that there should be four to six measurements per year in younger children, three to four measurements per year in older children, and a minimum of one measurement per year in all children
Equipment and facilities
- A normal reference range for non-diabetic children should be available
- There should be regular quality control comparisons with national and DCCT standards
- It is preferable that a capillary method for collecting the child’s blood is available and that the HbA1c result is available at the time of the clinic visit so that adjustments in management may be based on that information
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