Reevaluating HbA1c: The Gold Standard Questioned in Indian Diabetes Diagnosis

Experts argue that relying solely on HbA1c for diabetes diagnosis in India could lead to misclassification, especially in regions with prevalent anaemia and blood disorders. Traditional glucose tests remain the preferred choice, as HbA1c might misrepresent actual blood glucose levels due to hemoglobin variations.

Recent discussions have surfaced regarding the reliability of the HbA1c test as the sole diagnostic tool for diabetes, particularly in India. The Lancet Regional Health Southeast Asia published a viewpoint highlighting that the glycated haemoglobin test may not truly reflect blood glucose levels for many Indians.

According to V Mohan, Chairman of Mohan's Diabetes Specialities Centre, while HbA1c is essential for assessing long-term glucose control, glucose tests remain more accurate for diagnosis. The review, supported by scientific studies, emphasizes that HbA1c used in isolation can double the recorded prevalence of diabetes.

Also contributing to the debate, experts noted that HbA1c readings could be misleading in regions like India, where haemoglobin disorders are common. Professor Anoop Misra from Fortis C-DOC Centre and Shashank Joshi from Joshi Clinic highlighted these discrepancies, underscoring the necessity for comprehensive diagnostic approaches.