Does the Relationship Between Hemoglobin A<sub>1c</sub>and Mean Glucose Levels Differ by Race?
Authors: David M. Nathan, Hui Zheng
Journal: Annals of Internal Medicine (2010)

Letters21 December 2010Does the Relationship Between Hemoglobin A1c and Mean Glucose Levels Differ by Race?David M. Nathan, MD and Hui Zheng, PhDDavid M. Nathan, MDFrom Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.Search for more papers by this author and Hui Zheng, PhDFrom Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-12-201012210-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The glycated hemoglobin (HbA1c) assay has been widely accepted as an objective index of chronic glycemia, is universally used for diabetes management (1), and has now been recommended for diagnosis (2). The mathematical relationship between HbA1c and mean glucose levels was established in the 1980s by small studies that compared self-monitored glucose levels over 5 to 8 weeks and HbA1c level measured at the end of that period (1). Recent studies have used more comprehensive measures, such as continuous glucose monitoring, to determine the relationship (3, 4). These studies have demonstrated relatively higher correlation coefficients (R > 0.9) ...References1. Nathan DM, Singer DE, Hurxthal K, Goodson JD. The clinical information value of the glycosylated hemoglobin assay. N Engl J Med. 1984;310:341-6. CrossrefMedlineGoogle Scholar2. International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327-34. CrossrefMedlineGoogle Scholar3. Nathan DM, Turgeon H, Regan S. Relationship between glycated haemoglobin levels and mean glucose levels over time. Diabetologia. 2007;50:2239-44. CrossrefMedlineGoogle Scholar4. Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ; A1c-Derived Average Glucose Study Group. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008;31:1473-8. CrossrefMedlineGoogle Scholar5. Herman WH, Cohen RM. Hemoglobin A1c: teaching a new dog old tricks [Editorial]. Ann Intern Med. 2010;152:815-7. LinkGoogle Scholar6. Ziemer DC, Kolm P, Weintraub WS, Vaccarino V, Rhee MK, Twombly JG, et al. Glucose-independent, black-white differences in hemoglobin A1c levels: a cross-sectional analysis of 2 studies. Ann Intern Med. 2010;152:770-7. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: David M. Nathan, MD; Hui Zheng, PhDAffiliations: From Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGlucose-Independent, Black–White Differences in Hemoglobin A1c Levels David C. Ziemer , Paul Kolm , William S. Weintraub , Viola Vaccarino , Mary K. Rhee , Jennifer G. Twombly , K.M. Venkat Narayan , David D. Koch , and Lawrence S. Phillips Hemoglobin A1c: Teaching a New Dog Old Tricks William H. Herman and Robert M. Cohen Metrics Cited byNo Racial Differences in the Association of Glycated Hemoglobin With Kidney Disease and Cardiovascular Outcomes 21 December 2010Volume 153, Issue 12Page: 847-848KeywordsConflicts of interestGlucoseGlucose tolerance testsHbA1cHemoglobinRacial and ethnic issues ePublished: 21 December 2010 Issue Published: 21 December 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...