Jump to ContentJump to Main Navigation

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

12 Issues per year


IMPACT FACTOR 2014: 2.707
Rank 6 out of 30 in category Medical Laboratory Technology in the 2014 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2014: 0.741
Source Normalized Impact per Paper (SNIP) 2014: 1.011
Impact per Publication (IPP) 2014: 2.310

VolumeIssuePage

Issues

Haemoglobin A1c – A Marker for Complications of Type 2 Diabetes: The Experience from the UK Prospective Diabetes Study (UKPDS)

Susan Manley

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 41, Issue 9, Pages 1182–1190, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2003.182, June 2005

Publication History

Published Online:
2005-06-01

Abstract

Haemoglobin A1c (HbA1c) is the pre-eminent factor for quantifying the risk of complications in patients with diabetes and for monitoring glycaemia. Intervention to lower blood glucose in the two landmark clinical trials, the UK Prospective Diabetes Study (UKPDS) and the Diabetes Control and Complications Trial (DCCT), led to a reduction in the microvascular complications of diabetes.

Glycaemic status could be compared in the UKPDS and DCCT as the Bio-Rad Diamat HPLC analyser, as used in the DCCT, was introduced in 1989 for measurement of HbA1c in the UKPDS, after liaison with the DCCT. Results from other methods used for measurement of glycated haemoglobin during the UKPDS were aligned to this method. The Bio-Rad Diamat analyser in the central laboratory for the UKPDS, reference range 4.5–6.2% HbA1c, was certified as comparable to the DCCT by the National Glycohemoglobin Standardization Program in 1998.

A median difference in HbA1c of 0.9% was maintained over 10 years between the intensively and conventionally treated groups in the UKPDS (7.0% vs. 7.9% HbA1c) despite HbA1c increasing over time. Clinical care was transferred to general practitioners after the end of the main glucose control study for post-study monitoring. Over the first 3 years of post-study monitoring, HbA1c rose slightly in the previously intensively treated group with no appreciable increase in the conventional group, due to intensification of therapy.

At near-normal HbA1c, <6%, the updated mean value chosen to reflect glycaemic exposure throughout the UKPDS, the incidence of myocardial infarction was 2–3 times that of microvascular disease, with similar incidences for both complications at >10% updated mean HbA1c. Relationships between the risk of complications of type 2 diabetes and updated mean HbA1c had no observable thresholds. The UKPDS risk engine derived from the UKPDS database calculates coronary heart disease risk using HbA1c as a continuous variable and could now replace the Framingham equations for patients with type 2 diabetes.

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
D. Vistisen, S. Colagiuri, and K. Borch-Johnsen
Diabetes Care, 2009, Volume 32, Number 3, Page 397
[2]
M. I. Constantino, L. Molyneaux, F. Limacher-Gisler, A. Al-Saeed, C. Luo, T. Wu, S. M. Twigg, D. K. Yue, and J. Wong
Diabetes Care, 2013, Volume 36, Number 12, Page 3863
[3]
D. Simmons and T. Hlaing
Diabetic Medicine, 2014, Volume 31, Number 11, Page 1387
[4]
Susan E. Manley, Laura J. Hikin, Rachel A. Round, Peter W. Manning, Stephen D. Luzio, Gareth J. Dunseath, Peter G. Nightingale, Irene M. Stratton, Robert Cramb, Kenneth A. Sikaris, Stephen C.L. Gough, and Jonathan Webber
Diabetes Research and Clinical Practice, 2014, Volume 105, Number 3, Page 364
[5]
S. van Dieren, A. P. Kengne, J. Chalmers, J. W. J. Beulens, T. M. E. Davis, G. Fulcher, S. R. Heller, A. Patel, S. Colagiuri, P. Hamet, G. Mancia, M. Marre, B. Neal, B. Williams, L. M. Peelen, Y. T. van der Schouw, M. Woodward, and S. Zoungas
Diabetes, Obesity and Metabolism, 2014, Volume 16, Number 5, Page 426
[6]
Boris P. Kovatchev, Frank Flacke, Jochen Sieber, and Marc D. Breton
Diabetes Technology & Therapeutics, 2014, Volume 16, Number 5, Page 303
[7]
Liyong Yang, Ximei Shen, Sunjie Yan, Xin Yuan, Juanjuan Lu, and Wenfeng Wei
Diabetes Research and Clinical Practice, 2013, Volume 101, Number 1, Page 28
[9]
Barbara Strasser
Annals of the New York Academy of Sciences, 2013, Volume 1281, Number 1, Page 141
[10]
Xiao-Wu Chen, Yuan Ming Di, Jian Zhang, Zhi-Wei Zhou, Chun Guang Li, and Shu-Feng Zhou
The Scientific World Journal, 2012, Volume 2012, Page 1
[11]
E Adamska, M Waszczeniuk, J Gościk, A Golonko, J Wilk, J Pliszka, K Maliszewska, D Lipińska, R Milewski, A Wasilewska, A Citko, A Nikołajuk, L Ostrowska, A Krętowski, and M Górska
Advances in Medical Sciences, 2012, Volume 57, Number 2, Page 296
[12]
M. Rahman, R. K. Simmons, S. H. Hennings, N. J. Wareham, and S. J. Griffin
Diabetologia, 2012, Volume 55, Number 6, Page 1651
[13]
María Salinas, Maite López-Garrigós, Arturo Carratala, Cristina Aguado, Julián Díaz, Mario Ortuño, Enrique Rodriguez-Borja, Martín Yago, Virtudes Chinchilla, Goizane Marcaida, Ángel Esteban, Begoña Laíz, Marcos Guaita, Miguel Ángel Lorente, Francisco Pomares, and Joaquín Uris
Endocrinología y Nutrición, 2011, Volume 58, Number 5, Page 219
[14]
María Salinas, Maite López-Garrigós, Arturo Carratala, Cristina Aguado, Julián Díaz, Mario Ortuño, Enrique Rodriguez-Borja, Martín Yago, Virtudes Chinchilla, Goizane Marcaida, Ángel Esteban, Begoña Laíz, Marcos Guaita, Miguel Ángel Lorente, Francisco Pomares, and Joaquín Uris
Endocrinología y Nutrición (English Edition), 2011, Volume 58, Number 5, Page 219
[16]
Pedro Conthe, Manuel Mata, Domingo Orozco, Francisco Pajuelo, Carmen Sofía Barreto, Silvia Fernández Anaya, and Ramón Gomis
Diabetes Research and Clinical Practice, 2011, Volume 91, Number 1, Page 108
[17]
Erh-Jung Huang, Wei-Wen Kuo, Yuh-Jyuan Chen, Ter-Hsin Chen, Mu-Hsin Chang, Min-Chi Lu, Bor-Show Tzang, Hsi-Hsien Hsu, Chih-Yang Huang, and Shin-Da Lee
Clinica Chimica Acta, 2006, Volume 366, Number 1-2, Page 293
[18]
Hao Zhang, Jing Wei, Rong Xue, Jin-Dan Wu, Wei Zhao, Zi-Zheng Wang, Shu-Kui Wang, Zheng-Xian Zhou, Dan-Qing Song, Yue-Ming Wang, Huai-Ning Pan, Wei-Jia Kong, and Jian-Dong Jiang
Metabolism, 2010, Volume 59, Number 2, Page 285
[19]
E. Salzsieder, L. Vogt, K.-D. Kohnert, P. Heinke, and P. Augstein
Computer Methods and Programs in Biomedicine, 2011, Volume 102, Number 2, Page 206
[20]
Ben F. Hurley, Erik D. Hanson, and Andrew K. Sheaff
Sports Medicine, 2011, Volume 41, Number 4, Page 289
[21]
Allison Hedley Dodd, Margaret S. Colby, Kristina S. Boye, Cheryl Fahlman, Sunny Kim, and Ronette R. Briefel
Current Medical Research and Opinion, 2009, Volume 25, Number 7, Page 1605
[22]
Antje Steveling, Henry Völzke, Matthias Nauck, and Henri Wallaschofski
LaboratoriumsMedizin, 2009, Volume 33, Number 1, Page -
[23]
[24]
Tim Snijders, Lex B. Verdijk, Dominique Hansen, Paul Dendale, and Luc J.C. van Loon
Muscle & Nerve, 2011, Volume 43, Number 3, Page 393
[25]
Muhammad F. Dawwas, James D. Lewsey, Christopher J. Watson, and Alexander E. Gimson
Transplantation, 2009, Volume 88, Number 3, Page 402
[26]
Berhane Seyum, Goitom Mebrahtu, Abdulmumini Usman, Jacob Mufunda, Beyene Tewolde, Solomon Haile, Andrew Kosia, and Ermias Negassi
Acta Diabetologica, 2010, Volume 47, Number 1, Page 23
[27]
D. Hansen, P. Dendale, R. A. M. Jonkers, M. Beelen, R. J. F. Manders, L. Corluy, A. Mullens, J. Berger, R. Meeusen, and L. J. C. van Loon
Diabetologia, 2009, Volume 52, Number 9, Page 1789
[28]
Massimo Chello, Cristiano Spadaccio, Mario Lusini, Elvio Covino, Carla Blarzino, Federico De Marco, Fabio Di Domenico, and Raffaella Coccia
Diabetes/Metabolism Research and Reviews, 2009, Volume 25, Number 5, Page 420
[29]
Speranza Rubattu
High Blood Pressure & Cardiovascular Prevention, 2007, Volume 14, Number 3, Page 119
[30]
P. D. Home
Diabetic Medicine, 2008, Volume 25, Page 2
[31]
Bruce Frier, Pearl Yang, and Albert W. Taylor
European Review of Aging and Physical Activity, 2006, Volume 3, Number 2, Page 63
[32]
Lotte Steuten, Bert Vrijhoef, Hans Severens, Frits van Merode, and Cor Spreeuwenberg
International Journal of Technology Assessment in Health Care, 2006, Volume 22, Number 01
[33]
Michael Maris, Lut Overbergh, Wannes D'Hertog, and Chantal Mathieu
Expert Opinion on Medical Diagnostics, 2008, Volume 2, Number 3, Page 277
[34]
Kathleen H. Berecek and David Calhoun
Current Hypertension Reports, 2005, Volume 7, Number 3, Page 204
[35]
N. Ahmed and P. J. Thornalley
Diabetes, Obesity and Metabolism, 2007, Volume 9, Number 3, Page 233
[36]
Cloud P. Paweletz, Matthew C. Wiener, Jeffrey R. Sachs, Roger Meurer, Margaret S. Wu, Kenney K. Wong, Nathan A. Yates, and Ronald C. Hendrickson
PROTEOMICS, 2006, Volume 6, Number 7, Page 2101
[37]
[38]
N. Ahmed, R. Babaei-Jadidi, S. K. Howell, P. J. Beisswenger, and P. J. Thornalley
Diabetologia, 2005, Volume 48, Number 8, Page 1590

Comments (0)

Please log in or register to comment.