BMJ  2004;329:1196-1197 (20 November), doi:10.1136/bmj.329.7476.1196

Editorial

Standardisation of glycated haemoglobin

Is a scientific advance, but it could worsen overall blood glucose control

The first 150 words of the full text of this article appear below.

The detection of sugars in the urine of people with diabetes usually is attributed to Matthew Dobson. However, first attempts at quantification of urine sugars seem to have been made by Francis Home, an Edinburgh physician. Estimation of urine sugar as a measure of severity of diabetes had two major problems that, until recently, were shared with its contemporary equivalent, estimation of glycated haemoglobin. Firstly, both are surrogate measures of the average concentration of plasma glucose that is responsible for the microvascular and arterial damage that manifests itself in later years. Secondly, both also included in their measurement non-specific (nonglucose) substances when using available assays. Very recently, the glycated haemoglobin assay has been standardised by the scientific community to remove this non-specificity, but switching to this more accurate method for everyday reporting of results could lead to confusion and worsening of the control of diabetes.

Urine glucose remains of . . . [Full text of this article]

School of Medical Sciences, Diabetes, Newcastle upon Tyne, NE2 4HH (philip.home@ncl.ac.uk)

Endocrine Unit, Department of Internal Medicine, University of Yaoundé I, BP 8046, Yaoundé 8, Cameroon

Joslin Diabetes Center, One Joslin Place, Boston, MA 02215, USA

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Rapid Responses:

Read all Rapid Responses

Do not turn HbA1c into something it is not

Eric S Kilpatrick
bmj.com, 19 Nov 2004 [Full text]

Why make HgbA1c more confusing to our patients

Charles H Pointer IV RD LD
bmj.com, 23 Nov 2004 [Full text]

A little "backwardness" sometimes pays off

Peter Boucek
bmj.com, 25 Nov 2004 [Full text]

Re: A little "backwardness" sometimes pays off

Nils Olof Carlin
bmj.com, 26 Nov 2004 [Full text]

Relevant Issue not Addressed

George Phillipov
bmj.com, 6 Dec 2004 [Full text]

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