2.0.0.0 A1C Testing
2.1.0.0 Recommendations
Recommendations
6.1 Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). E
6.2 Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals. E
6.3 Point-of-care testing for A1C provides the opportunity for more timely treatment changes. E
A1C reflects average glycemia over approximately 3 months. The performance of the test is generally excellent for NGSP-certified assays (www.ngsp.org). The test is the major tool for assessing glycemic control and has strong predictive value for diabetes complications (1-3). Thus, A1C testing should be performed routinely in all patients with diabetes-at initial assessment and as part of continuing care. Measurement approximately every 3 months determines whether patients’ glycemic targets have been reached and maintained. The frequency of A1C testing should depend on the clinical situation, the treatment regimen, and the clinician’s judgment. The use of point-of-care A1C testing may provide an opportunity for more timely treatment changes during encounters between patients and providers. Patients with type 2 diabetes with stable glycemia well within target may do well with A1C testing only twice per year. Unstable or intensively managed patients (e.g., pregnant women with type 1 diabetes) may require testing more frequently than every 3 months (4).