apfcbAPFCB eNewscoAPFCB News Volume 5, Issue 2MultidisciplinaryEnglishJuly-Dec, 2026NNY2026099ArticlesThe gold standard under the microscope: navigating HbA1c standardisation and discrepanciesEnglishY5357Dr ErnaLentersEnglishN10.62772/APFCB-News.2026.5204Englishhttps://www.apfcb.org/APFCB_News/abstract?id=52References16191. Hossain MJ, Al-Mamun M, Islam MR. Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Sci Rep. 2024;7(3):e2004. doi:10.1002/hsr2.2004.2. International Diabetes Federation. Facts and;amp; figures [Internet]. Brussels: International Diabetes Federation; [cited 2025 Nov 27]. Available from: https://idf.org/about-diabetes/diabetes-factsfigures/3. World Health Organization. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus: abbreviated report of a WHO consultation [Internet]. Geneva: World Health Organization; 2011 [cited 2025 Nov 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK304271/4. DCCT Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-86.5. United Kingdom Prospective Diabetes Study (UKPDS). Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet 1998;352:837-53.6. Weykamp C, Siebelder C, Lenters E, Slingerland R, English E. The risk of clinical misinterpretation of HbA1c: modelling the impact of biological variation and analytical performance on HbA1c used for diagnosis and monitoring of diabetes. Clin Chim Acta. 2023;548:117495. doi:10.1016/j.cca.2023.117495.7. Jeppsson JO, Kobold U, Barr J, Finke A, Hoelzel W, Hoshino T, et al. Approved IFCC reference method for the measurement of HbA(1c) in human blood. Clin Chem Lab Med. 2002;40(1):78-898. Hoelzel W, Weykamp C, Jeppsson JO, Miedema K, Barr JR, Goodall I, et al. IFCC reference system for measurement of hemoglobin A1c in human blood and the national standardization schemes in the United States, Japan, and Sweden: a method-comparison study. Clin Chem. 2004;50(1):166-74.9. Traceability Chain for HbA1c standardization. Available from: https://www.ifcchba1c.org/GeneralInformation.aspx?I=210. Little RR, Rohlfing C, Sacks DB. The National Glycohemoglobin Standardization Program: over 20 years of improving hemoglobin A1c measurement. Clin Chem. 2019;65(7):839-48.doi:10.1373/clinchem.2018.296962.11. Suparak S, Pratumvinit B, Ngueanchanthong K, Unpol P, Thanomsakyuth A, Setthaudom C, Kunakorn M, Rojanawiwat A, Uppapong B. External quality assessment scheme for HbA1c assays in Thailand: a 5-year experience. Pract Lab Med. 2022;31:e00288. doi:10.1016/j.plabm.2022.e00288.12. Jancev M, Vissers TACM, Visseren FLJ, van Bon AC, Sernand;eacute; EH, DeVries JH, de Valk HW, van Sloten TT. Continuous glucose monitoring in adults with type 2 diabetes: a systematic review and meta-analysis. Diabetologia. 2024;67(5):798-810. doi:10.1007/s00125-024-06107-6.13. Bergenstal RM, Beck RW, Close KL, Grunberger G, Sacks DB, Kowalski A, Brown AS, Heinemann L, Aleppo G, Ryan DB, Riddlesworth TD, Cefalu WT. Glucose Management Indicator (GMI): a new term for estimating A1C from continuous glucose monitoring. Diabetes Care. 2018;41(11):2275-80. doi:10.2337/dc18-1581.14. Lenters-Westra E, Fokkert M, Kilpatrick ES, Schleicher E, Pilla S, English E, van Dijk P. Managing discordance between HbA1c and glucose management indicator. Diabet Med. 2025;42(6):e70023. doi:10.1111/dme.70023.15. Lenters-Westra E, Schouten I, Van Vlodrop I, English E. Confirmation of the value of the labile HbA1c/HbA1c-ration in the presence of a Hb J-Baltimore variant: a clinical case. Clin Chem Lab Med 2025;64(2):e31-e33. doi:10.1515/cclm-2025-1044.