Hemoglobin A1c Measurements over Nearly Two Decades: Sustaining Comparable Values throughout the Diabetes Control and Complications Trial and the …

M Steffes, P Cleary, D Goldstein, R Little… - Clinical …, 2005 - academic.oup.com
M Steffes, P Cleary, D Goldstein, R Little, HM Wiedmeyer, C Rohlfing, J England, J Bucksa…
Clinical chemistry, 2005academic.oup.com
Background: Clinical trials require assays that provide consistent results during the course of
a study. The hemoglobin A1c (HbA1c) assay, a measure of chronic glycemia, is critical to the
study of diabetes control and complications. Methods: The Diabetes Control and
Complications Trial (DCCT) and its follow-up study, the Epidemiology of Diabetes
Interventions and Complications (EDIC), required 20 years of consistent HbA1c results,
measured by three different ion-exchange HPLC procedures. To maintain and document …
Abstract
Background: Clinical trials require assays that provide consistent results during the course of a study. The hemoglobin A1c (HbA1c) assay, a measure of chronic glycemia, is critical to the study of diabetes control and complications.
Methods: The Diabetes Control and Complications Trial (DCCT) and its follow-up study, the Epidemiology of Diabetes Interventions and Complications (EDIC), required 20 years of consistent HbA1c results, measured by three different ion-exchange HPLC procedures. To maintain and document consistent HbA1c results measured in the DCCT and EDIC Central Biochemistry Laboratory, a backup laboratory used frozen hemolysates as long-term calibrators and a HPLC method with a single lot of Bio-Rex 70 resin.
Results: Over 20 years, long-term quality-control values have remained constant. Four studies of nondiabetic ranges produced nearly identical values [mean (SD), 5.1 (0.5)%, 4.9 (0.3)%, 5.0 (0.4)%, and 5.0 (0.3)%].
Conclusion: The overall consistency of the HbA1c assays during the 20-year course of the DCCT and EDIC has been critical in establishing the benefits of intensive therapy and in understanding the relationship between long-term glycemia and the development and progression of the complications of diabetes.
Oxford University Press