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Re: [IP] a1c tests

Richard Haynes <email @ redacted> wrote:

> Do have an up to date review regarding the Hb1ac tests and What it really
> measures.

The "gold standard" hemochromatography has been in use for quite some time.  It measures the rate (expressed as a percent) of glycation of the hemoglobin molecules.  Non-diabetics generally have an HbA1c of around 5%.

> Is there reach regarding the time domain of adsorption, kinetic process
> involved. Is there a time excluded in the process.

I'm not quite sure what you are asking here.  Because HbA1c measurements are rates, and glycation occurs over time, I don't know how one would exclude time from the equation.
> Is it valuable for us to measure 1ac every week or so. I tested two labs for
> 1ac, my doc's and a commercial one(Quest) . Doc"s was higher by 1.0. That
> stopped me from going back to the Doc office.

There are two points here.  First, it really gives no more information to test as frequently as weekly than for every two or three months.  The second point is that it is probably just as inappropriate to compare HbA1c results from different labs unless one can also find out the specific methodology and equipment manufacturer(s) involved.  If the test your physician did was typical of physician office laboratories (which Spot's is *NOT*, BTW), then the test done there was in the waived category, and has a precision of approximately +/- 20%.  I'm not familiar with the precision standards for the Quest test.  The test done by your physician may be fine for screening and/or obtaining a trend, but I'd insist on at least one test per year done by an independent lab using hemochromatography methods.

> By now the tests have been adopted and many studies have used it funding have
> been set up which is based assumed validly. At this point no scientist will
> nor can be objective.
> I have seen this progression form this inside. It is amazing how emotional
> when one's funding and reputation is involved.

Well, when it comes to HbA1c testing, it may not be as good as that.  HbA1c is not specifically mandated for proficiency testing by the Clinical Laboratory Improvement Amendment of 1988 (CLIA 88).  Some labs participate anyway under the assumption that good practice requires outside QA/QC (something that is generally specified by CLIA 88), whereas others do not participate, citing the lack of HbA1c being specifically mandated.

Jim Handsfield
mailto:email @ redacted

The opinions expressed are mine and do not necessarily reflect those of my wife who runs this house and makes more important decisions than I do.
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