BMJ 1994;309:1511 (3 December)

Letters

Methodological discrepancies are not important

EDITOR,--The article on glycated haemoglobin values by Eric S Kilpatrick and colleagues fails to add anything to diabetic care and misses the most important point.1 It is well known that there is no standardisation in increasing glycated haemoglobin concentration; primary standards do not exist, secondary reference standards are not applicable to different methods, and there is no agreement about which method most accurately mirrors diabetic control.2 3 4 The most important clinical factor is the trend of glycated haemoglobin concentration with treatment and the approximate relation of trend in glycated haemoglobin concentration and the results recorded on a patient's diabetic control card. This gives clinicians information on whether patients are compliant and well trained in monitoring glucose concentrations in their own blood or urine and gives some indication of the previous three months' trend in control.

The discrepancies between methods are well characterised through the different quality control and external quality assurance . . . [Full text of this article]


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Relevant Article

Glycated haemoglobin values: problems in assessing blood glucose control in diabetes mellitus
E S Kilpatrick, A G Rumley, M H Dominiczak, and M Small
BMJ 1994 309: 983-986. [Abstract] [Full Text]

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