Change in HbA1c concentration as decision parameter for frequency of HbA1c measurement

Hemoglobin A(1c) (HbA(1c)) is a long-term measure for glucose concentration in plasma. Since its introduction as a diabetes monitoring tool, and its more recent application as a diagnostic tool, the number of measurements of HbA(1c) have risen dramatically. However, HbA(1c) change is slow, so repeating measurements should not be done too often. We use a large, unfiltered dataset from 52,017 patients to determine the possible rate of change in HbA(1c) concentration. In our laboratory, the critical difference between HbA(1c) measurements is 8.5%. Our data show that a 1-unit HbA(1c) rise takes 4 weeks to occur, hence, at a HbA(1c) concentration around 50 mmol/mol Hgb, a critically increased HbA(1c) concentration cannot be determined until after 16 weeks. Conversely a critically lower HbA1c can manifest itself after 2 weeks, but after 7 weeks the dropping tendency stops. The amount of measurements that can be cancelled because they were taken sooner than 16 weeks is 23 percent.