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Journal of Clinical Pathology 2008;61:977-982; doi:10.1136/jcp.2007.054304
Copyright © 2008 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.

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Haemoglobin A1c in the diagnosis and monitoring of diabetes mellitus

E S Kilpatrick

Correspondence to:
Professor Eric S Kilpatrick, Department of Clinical Biochemistry, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, UK; Eric.Kilpatrick{at}hey.nhs.uk

Haemoglobin A1c (HbA1c) is due to celebrate its 40th birthday. Many people would argue that the clinical studies relating the test to diabetes complications while in its late 20s are likely to be its finest ever achievement. However, this article looks at how HbA1c has matured since then and discusses in detail how its many strengths and idiosyncrasies as a marker of glycaemic risk have, as a 30-something, become more clearly understood.

As HbA1c approaches middle age, this paper also describes how the test appears to be developing a mid-life crisis, as debate over how its results should be expressed seems likely to divide opinion among clinicians for some time to come.


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Haemoglobin A1c analysis in the management of patients with diabetes: from chaos to harmony
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