How would confounders and effect modifiers of HbA1c affect results?
Will changes in the reference anchor for HbA1c affect its use in screening for and diagnosing diabetes? Should HbA1c be accepted as a diagnostic criterion for diabetes? What evidence supports the specific HbA1c diagnostic recommendation? Should criteria be established for screening for diabetes, and if so, should they include HbA1c? Finally, should a random, or casual, plasma glucose be used in screening for diabetes? What practical issues surround the use of HbA1c in the screening and diagnosis of diabetes? A series of practical considerations favor the use of HbA1c in screening for and diagnosing diabetes. First, both the OGTT and FPG require that the patient fast for at least 8 h, but the measurement of HbA1c does not. Unless the patient is severely hyperglycemic and overtly symptomatic, the diagnosis cannot be made in most patients coming for afternoon appointments or if they ate before a morning appointment. This need for a fasting sample cuts into the opportunity to diagnose diab
