INTERNATIONAL COMMUNICATION OFFICE

OF PEDIATRIC ENDOCRINE SOCIETIES

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COORDINATOR
        Ragnar Hanas, MD, PhD

Issue No. 33                                     September, 2007

   NEWSLETTER

Setting the standard of clinical diabetes care

HbA1c has been used for decades to evaluate diabetes care in clinical practice. Three standards have been used worldwide; DCCT, Japan (~0.5% below DCCT) and Sweden (~1.0% below DCCT). This has been confusing for doctors trying to evaluate international papers where no clear equivalent to DCCT numbers has been given, and for patients searching the Internet for information. The International Federation of Clinical Chemists (IFCC) has recently managed to analyze the "true" HbA1c by mass spectroscopy and this level is ~1.5-2 % below the DCCT numbers.  

Everyone agrees that the IFCC method should be used to calibrate laboratory machines and that this is a major step forward. However, there has been a considerable debate as to which numbers to use in clinical practice. The organizations IFCC, ADA, EASD and IDF have in 2007 signed a Consensus Statement which says that HbA1c results are to be reported world-wide in DCCT units (%) using a master equation based on the IFCC calibration, IFCC units (mmol/mol) and HbA1c-derived average glucose (ADAG) based on the results of an international study that presented preliminary results at EASD 2007 in Amsterdam. Thus, we will keep the "clinical gold standard" of DCCT HbA1c numbers, which so many studies and clinical guidelines have been using, but they will be based on the more accurate calibration of the IFCC method. Reporting ADAG as well will simplify the understanding of the risk of long-term complications when talking to patients and relatives. This is a very good example of how collaboration and negotiation between laboratory and clinical organizations can find a solution that benefits both the scientific community, clinical care providers and people with diabetes. 

This is the final newsletter of my tenure as Coordinator. I would like to thank all those who contributed to COPES for the last two years and encourage them and others to continue their support in this ongoing effort. Special thanks to Jeff Hitchcock from Children with Diabetes for hosting the website and Novo-Nordisk for sponsoring the printed newsletter. I now hand over to the new COPES Coordinator, Dr. Luciano Cavallo from Bari, Italy.

VICE-COORDINATOR

Luciano Cavallo, MD

AFFILIATED SOCIETIES

Australasian Paediatric

Endocrine Group

(APEG)

Asia Pacific Paediatric

Endocrine Society

(APPES)

British Society for Paediatric

Endocrinology and Diabetes

(BSPED)

European Society for

Paediatric Endocrinology

(ESPE)

International Society for Pediatric

and Adolescent Diabetes

(ISPAD)

Israel Society of Paediatric

Endocrinology (ISPE)

Japanese Society for

Pediatric Endocrinology

(JSPE)

The Lawson Wilkins

Pediatric Endocrine Society

(LWPES)

Sociedad Española de Endocrinología Pediátrica

(SEEP)

Sociedad Latino Americana de

Endocrinologia Pediátrica

(SLEP)