Tests of glycemia in diabetes
Open accessAbstract
National Glycohemoglobin Standardization Program; SMBG, self-monitoring of blood glucose; UKPDS, U.K. Prospective Diabetes Study.A table elsewhere in this issue shows conventional and Syste
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Acetoacetate and acetone may increase as beta-hydroxybutyrate falls during successful therapy of diabetic ketoacidosis.
“since AcAc and acetone may increase as bOHB falls during successful therapy (295,298).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
The Urine ketone testing section says the relative proportions of β-hydroxybutyrate, acetoacetate, and acetone vary, and that urine ketones can persist during recovery from ketoacidosis after blood ketones fall. It does not say that acetoacetate and acetone may increase specifically as β-hydroxybutyrate falls during successful therapy; no page number is available in our copy. (LLM, conf=0.77)
Experimental — accuracy not yet measuredConcentrations of fructosamine and glycated albumin reflect mean glycemia over a shorter time (15 to 30 days) than glycated hemoglobin (60 to 90 days).
“Concentrations of these glycated proteins also reflect mean glycemia but over a much shorter time (15 to 30 days, reflecting the turnover of albumin) than GHb ( 60 to 90 days) (295,(311)(312)(313)(314)(315)(316).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
The “Glycated serum proteins” section says that albumin’s shorter turnover makes glycated serum proteins an index of glycemia over a shorter period than glycated hemoglobin. It does not give the claimed 15–30-day and 60–90-day windows; the “Glycated hemoglobin testing” section instead describes GHb as providing a glycemic history of the previous 120 days. (LLM, conf=0.86)
Experimental — accuracy not yet measuredGlycosylated hemoglobin reflects long-term glycemic control and is a more accurate and stable measure than fasting plasma glucose.
“Glycosylated hemoglobin reflects long-term glycemic control and is a more accurate and stable measure than FPG levels [13,14].”
From A Novel Testing Model for Opportunistic Screening of Pre-Diabetes and Diabetes among U.S. Adults (2015) · cites this paper as [13]
The ‘Glycated hemoglobin testing’ and ‘Standardization of GHb’ sections describe glycosylated hemoglobin as a measure of glycemia over preceding weeks and months, supporting the long-term-control claim. The copy does not establish that it is more accurate or a more stable measure than fasting plasma glucose; its description of stable hemoglobin components does not make that comparison. (LLM, conf=0.86)
Experimental — accuracy not yet measuredGlycosuria is normally evidenced when the renal reabsorption threshold is exceeded (>180 mg/dL), even if there is individual variability.
“Glycosuria is normally evidenced when the renal reabsorption threshold is exceeded (>180 mg/dL), even if there is individual variability 171,172.”
From Glucose biosensors in clinical practice: principles, limits and perspectives of currently used devices (2022) · cites this paper as [172]
The lack of precision and sensitivity of urine glucose test limits its use.
“However, the lack of precision and sensitivity of this test limits its use 172”
From Glucose biosensors in clinical practice: principles, limits and perspectives of currently used devices (2022) · cites this paper as [172]
Semiquantitative urine glucose monitoring does not accurately reflect plasma glucose concentration.
“Semiquantitative urine glucose monitoring does not accurately reflect plasma glucose concentration (295).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
Assay methods for ketones that do not include measurement of βOHB may provide misleading clinical information by underestimating total ketone body concentration.
“Thus, assay methods for ketones that do not include measurement of bOHB may provide misleading clinical information by underestimating total ketone body concentration (295,299).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
The nitroprusside reagent does not measure beta-hydroxybutyrate.
“Importantly, this reagent does not measure bOHB (295,304).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
Beta-hydroxybutyrate is the predominant ketone body in diabetic ketoacidosis.
“bOHB, the predominant ketone body in DKA, is not detected.”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
HbA1c is used as an index of mean glycemia, as a measure of risk for the development of diabetes complications, and to set goals of therapy for people with diabetes.
“HbA 1c is used as an index of mean glycemia, as a measure of risk for the development of diabetes complications, and, most importantly, to set goals of therapy for people with diabetes (295,318,327).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
Any condition that shortens red blood cell survival or decreases mean red blood cell age falsely lowers HbA1c test results, compared with mean glycemia, regardless of the assay method.
“Any condition that shortens RBC survival or decreases mean RBC age (e.g., recovery from acute blood loss, hemolytic anemia) falsely lowers HbA 1c test results, compared with mean glycemia, regardless of the assay method (295).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
Most HbA1c methods can be classified into groups based on assay principle.
“Most methods can be classified into groups based on assay principle (66,295,312).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [295]
Urine glucose concentration does not accurately reflect plasma glucose concentration.
“because the urine glucose concentration does not accurately reflect the plasma glucose concentration (147,180).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
The rationale for standardizing glycated hemoglobin results to DCCT values was that the DCCT had determined the relationship between a specific glycated hemoglobin test, HbA1c, and long-term complications in type 1 diabetes.
“The rationale for standardizing GHb test results to DCCT values was that the DCCT had determined the relationship between the results obtained for a specific GHb test (HbA 1c ) and long-term complications in patients with type 1 diabetes (44,147,187).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
The clinical utility of glycated proteins other than hemoglobin has not been clearly established, and there is no convincing evidence linking their concentrations to chronic diabetes complications.
“The clinical utility of glycated proteins other than Hb has not been clearly established, however, and there is no convincing evidence that relates their concentrations to the chronic complications of diabetes (147,187).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
During successful diabetic ketoacidosis therapy, acetoacetate and acetone may increase while beta-hydroxybutyrate decreases.
“The test should not be used to monitor the course of therapy, because AcAc and acetone may increase as bHBA decreases during successful therapy (147,183-187).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
Any condition that shortens erythrocyte survival or decreases mean erythrocyte age, such as recovery from acute blood loss or hemolytic anemia, falsely lowers HbA1c results regardless of assay method.
“Any condition that shortens erythrocyte survival or decreases mean erythrocyte age (e.g., recovery from acute blood loss, hemolytic anemia) falsely lowers HbA 1c test results, regardless of the assay method (147).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
Most glycated hemoglobin methods can be classified into one of two groups according to assay principle.
“Most methods can be classified into one of two groups according to assay principle (147,181, 204).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
Glycated hemoglobin results for the same blood sample could differ considerably among methods unless the methods have been standardized to a common reference.
“The GHb results reported for the same blood sample could differ considerably among methods, however, unless they have been standardized to a common reference [e.g., without standardization, the same blood sample could be read as 7% (42 mmol/mol) in one laboratory and 9% (75 mmol/mol) in another] (53,147,204,(212)(213)(214)(215).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
Glycated hemoglobin is a clinically useful index of mean glycemia over the preceding 120 days, the average erythrocyte lifespan.
“GHb is a clinically useful index of mean glycemia during the preceding 120 days, the average life span of erythrocytes (147,(203)(204)(205)(206).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
HbA1c is used both as an index of mean glycemia and as a measure of risk for diabetes complications.
“HbA 1c is used both as an index of mean glycemia and as a measure of risk for the development of diabetes complications (147,197).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
Concentrations of glycated proteins other than hemoglobin also reflect mean glycemia, but over a much shorter period of 15 to 30 days than glycated hemoglobin's 60 to 120 days.
“The concentrations of these glycated proteins also reflect mean glycemia, but over a much shorter time (15-30 days) than GHb (60-120 days) (147,(203)(204)(205)(206)210,211).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [147]
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Self-citation
- Authors
- Goldstein, D. E., Little, R. R., Lorenz, R. A., Malone, J. I., Nathan, D., Peterson, C. M., & Sacks, D. B.
- Affiliations
- University of Missouri (US)
- Peoria campus of the University of Illinois System (US)
- University of South Florida (US)
- Massachusetts General Hospital (US)
- National Heart, Lung, and Blood Institute (US)
- Brigham and Women's Hospital (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2004-07-01
- Volume
- 27
- Issue
- 7
- Pages
- 1761-1773
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W4295849207
- Semantic Scholar
- a53b4db26b063f6e727377ccd7333171e236771b
- Cited by
- 625
- References
- 155
- Citations by year
- 2026: 18 · 2025: 17 · 2024: 22 · 2023: 25 · 2022: 37 · 2021: 27 · 2020: 25 · 2019: 32 · 2018: 40 · 2017: 30 · 2016: 37 · 2015: 29 · 2014: 24 · 2013: 20 · 2012: 45
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- glycemia, diabetes mellitus, HbA1c, HbA1c standardization, self-monitoring of blood glucose, glycemic control, UKPDS
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Glycosuria, Humans, Ketones
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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