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Change of HbA1c reporting to the new SI units
Author(s) -
Craig Maria E,
Donaghue Kim C,
Cameron Fergus J,
Silink Martin
Publication year - 2011
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja11.11018
Subject(s) - diabetes mellitus , medicine , family medicine , type 2 diabetes , executive summary , endocrine system , library science , endocrinology , microbiology and biotechnology , hormone , computer science , biology
TO THE EDITOR: The position statement by Jones and colleagues regarding the change of HbA 1c reporting to the new Système International (SI) units — which has been recommended by the Australasian Association of Clinical Biochemists, the Australian Diabetes Educators Association, the Australian Diabetes Society and the Royal College of Pathologists of Australasia — provides a comprehensive summary of the rationale behind the proposed change and suggests a 2-year period of dual reporting. 1 However, Jones et al did not specify targets for children and adolescents, and we believe that it is important to do so. The incidence of type 1 diabetes in Australian children and adolescents is among the highest in the world 2 and, in New South Wales, type 2 diabetes represents at least 10% of cases of new-onset diabetes in adolescents. 3 National evidence-based clinical care guidelines for type 1 diabetes in children, adolescents and adults 4 include age-specific targets for HbA 1c , while recognising that such targets are predominantly consensus based. HbA 1c targets for young people with type 1 diabetes are higher, with a level of < 7.5% recommended for children and adolescents in the Australian guidelines 4 and in those produced by the International Society for Pediatric and Adolescent Diabetes (ISPAD). 5 Jones et al note that " Achievement of HbA 1c targets must be balanced against risk of severe hypoglycaemia, especially among older people " ; 1 this is also the case for young people. For children and adolescents with type 2 diabetes, the ISPAD guidelines recommend an HbA 1c target of < 7%. 5 The move to SI units represents a major change in the established, widely recognised outcome measure of glycaemia; during the transition period, the specific needs of young people with diabetes must not be forgotten. National evidence-based clinical care guidelines for type 1 diabetes in children, adolescents and adults.ment and monitoring of glycemic control in children and adolescents with diabetes.