HbA1c – uptake of molar units into New Zealand: lessons for Australia?

Abstract

In 2007, it was recommended that HbA1c be reported world-wide in International Federation of Clinical Chemistry (IFCC) units (mmol/mol). So far, uptake around the world has been on a small scale, with some countries including the UK and NZ opting for a period of dual reporting of IFCC and Diabetes Control and Complications Trial (DCCT) aligned (%) units, with a view to reporting exclusively IFCC units. In NZ, the process for change was dependent upon gaining the support of the New Zealand Society for the Study of Diabetes (NZSSD), with publication of a position statement following consultation with the membership. The laboratory community then agreed on a coordinated implementation date (3 August 2009), supported by an education programme addressing general practitioners and also the patient community. The change was received with little controversy, although it was suggested that treatment targets could be better rounded and that various databases and software will need to be appropriately upgraded, as will point of care testing devices. It is expected that educational initiatives will need to be reinforced closer to the time of moving to exclusive reporting of IFCC units. In Australia, it is anticipated that dual reporting will be in place by the time of the RCPA Update Meeting in 2011.