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ISPAD Clinical Practice Consensus Guidelines, Compendium. Assessment and monitoring of glycemic control in children and adolescents with diabetes

Barbara Davis Center, University of Colorado Denver, Aurora, CO 80045-6511, USA.
Pediatric Diabetes (Impact Factor: 2.13). 09/2009; 10 Suppl 12(6):71-81. DOI: 10.1111/j.1399-5448.2009.00582.x
Source: PubMed

ABSTRACT In addition to the IFCC Working Group, an IFFC/ ADA/EASD/IDF Working Group was formed, now with representation from Juvenile Diabetes Research Foundation International. This group has been focused on implementing an international study to document what the clinical world has always thought to be true but never proven: that the A1c assay does indeed reflect an average BG over many months. If the direct relationship can be documented, then the reporting of the assay would include an ’estimated average blood glucose’, or 'A1c-derived average glucose (ADAG)’, and the units would be in mmol/L (or mg/dL) (93, 94). IFFC/ADA/EASD/IDF has issued a Consensus statement (91), with which the Guideline editors agree, stating (i) A1c test results should be standardized worldwide, including the reference system and results reporting; (ii) the new IFCC reference system for A1c represents the only valid anchor to implement standardization of the measurement; (iii) A1c results are to be reported worldwide in derived National Glycohemoglobin Standardization Program (NGSP) units (%) using the NGSP-IFCC master equation and IFCC units (mmol/mol) (Note: this transaction will most likely occur over several years.); (iv) if the ongoing ’average plasma glucose study’ fulfills it's a priori specified criteria, an ADAG value calculated from the A1c result will also be reported as an interpretation of the A1c results; and (v) glycemic goals appearing in clinical guidelines should be expressed in IFCC units, derived NGSP units, and ADAG.

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