Glycated Haemoglobin A1c in Contrast to Conventional and Novel Biomarkers in the Diagnosis of Diabetes and Monitoring of Glycemic Control: A Review

Diabetes mellitus is an etiologically complex metabolic defect, characterized basically by an elevated blood glucose concentration. At present all countries across the globe, regardless of their developmental stages, face an increasing burden of diabetes mellitus. Diagnosis and monitoring of diabetes are done by many laboratory investigations. This review article discusses the potential of HbA1c in the diagnosis of diabetes and monitoring of glycemic control while looking into the characteristics of alternative novel markers of glycaemic control.
Available literature emphasized that HbA1c is the more accepted, accurate, easy-to-administer, confirmatory and reference test. The prognostic potential of HbA1c lies in its unique capability of assessing the retrospective glycemic control and predicting diabetic complications. However, the cut-off points of HbA1c, its sensitivity, some testing strategies, interferences and costs are heavily debated. Findings of the review conclude that the appropriate combinations of FBG, OGTT, HbA1c and novel alternative biomarkers of glycemic control, significantly enhances the diagnostic accuracy of these individual tests and such combination provide concrete information for more comprehensive diagnoses and effective treatment plans