May 24, 2013

FDA allows A1c test for diagnosing diabetes

This is a Cut and Paste post from the FDA: 
For Immediate Release: May 23, 2013

FDA allows marketing of first A1c test labeled for diagnosing diabetes

Today the U.S. Food and Drug Administration announced that it is allowing marketing of the COBAS INTEGRA 800 Tina-quant HbA1cDx assay (Tina-quant HbA1cDx assay) for the diagnosis of diabetes by health care professionals. This is the first HbA1c test that FDA has allowed to be marketed for this use.

The HbA1c tests, or A1c tests, currently on the market are FDA-cleared for monitoring a patient’s blood glucose (sugar) control, but not for diagnosing diabetes. A1c tests measure the percentage of hemoglobin A1c that is bound to glucose, giving a patient’s average glucose level over a three-month period.

Diabetes is a serious, chronic metabolic condition where the body is unable to convert glucose into the energy needed to carry out daily activities. An estimated 25.8 million people in the United States have diabetes, including seven million people who remain undiagnosed. If left untreated, high blood glucose levels (hyperglycemia) can lead to serious long-term problems such as stroke, heart disease, and damage to the eyes, kidneys, and nerves.

The diagnostic criteria for diabetes have changed over time. Based on the research and recommendations of international diabetes experts, many health care providers have already been using some A1c tests to diagnose diabetes, in addition to the established diagnostic procedures of a fasting blood glucose test and an oral glucose tolerance test to diagnose diabetes. However, before today, A1c tests were not specifically designed or granted permission by FDA to be marketed for diabetes diagnosis, making it difficult to know which A1c tests were accurate enough for this purpose. The Tina-quant HbA1cDx assay, a laboratory-based test, can be used to both accurately diagnose diabetes and monitor blood glucose control.

“Providing health care professionals with another tool to identify undiagnosed cases of diabetes should help them provide patients appropriate guidance on treatment before problems develop,” said Alberto Gutierrez, Ph.D., director of the Office of In Vitro Diagnostics and Radiological Devices at FDA’s Center for Devices and Radiological Health.  “As the Tina-quant HbA1cDx assay was designed for diabetes diagnosis and has been reviewed by the FDA, physicians can have confidence that this test is reasonably safe and effective when used for its intended purposes of monitoring and diagnosing diabetes.”

In support of marketing clearance, investigators analyzed 141 blood samples and found less than six percent difference in the accuracy of test results from the Tina-quant HbA1cDx assay compared to results from the standard reference for hemoglobin analysis.

The Tina-quant HbA1cDX assay is available by prescription for use in clinical laboratories. Over-the-counter HbA1c tests should not be used by patients to diagnose diabetes, and only a qualified health care professional should make a diagnosis of diabetes. Individuals who receive a diabetes diagnosis should discuss with their physician what they need to do to manage their diabetes.

Hemoglobin A1c tests, including the Tina-quant HbA1cDx assay, should not be used to diagnose diabetes during pregnancy and should not be used to monitor diabetes in patients with hemoglobinopathy, hereditary spherocytosis, malignancies, or severe chronic, hepatic and renal disease. This test should not be used to diagnose or monitor diabetes in patients with the hemoglobin variant hemoglobin F.

The Tina-quant HbA1cDx assay is manufactured by Roche, of Basel, Switzerland.  Roche’s North American headquarters are located in Indianapolis, Ind.


  1. Makes sense, but I hope this doesn't preclude a regular fingerstick or even urine-glucose test from being given when a patient comes in and exhibits the symptoms. As it is, that seems to get overlooked too often already, especially with kids.

    But on another note, how many different types of A1c test are there? This specifically mentions the Cobas Integra 800 thingamajig....whatever that is.

  2. I think this is overall good news.
    The issue I have is from personal experience.
    Back before my duaghter was diagnosed I would occassionally check her sugars (I already had one son diagnosed with T1).
    Periodically she would come up with numbers in the low 60's, even the upper 50's. I hadn't ever caught a number above 200 prior to her diagnosis. Never had her A1C checked prior to diagnosis.
    Fast forward to my current predicament. My Middle child has a wonky pancreas but has not been diagnosed with type 1. His A1C (per TrialNet screenings) is 4% but he failed his last GTT with a 2 hours number of 207.
    I have periodically checked his sugars. Again often in the low 60's and even some in the upper 50's just like my daughter in the year before her diagnosis. I have also caught numbers in the high 100s and low 200s.
    A1C is an average. If you average my middles 60's with his 200's you will get a very pretty 4%. If A1C ever becomes the norm in diagnosing diabetes it could be bad - not that anyone is suggesting it will be. His pancreas is in serious disregulation. It is wonky. Too much production sometimes, too little others. Anyway - thats my two cents.