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Practitioner Direct

A1C Standards of Care

The American Diabetes Association (ADA) recommends A1C testing to determine a patient’s average blood glucose control. For patients whose therapy has changed or who are not meeting glycemic goals, the A1C test should be performed quarterly. The A1C test should be performed at least two times a year in patients who are meeting treatment goals and who have stable glycemic control. Guidelines about A1C testing by the American Diabetes Association, International Diabetes Federation, and National Institute for Health and Clinical Excellence are summarized in the table below.


Guidelines for A1C testing in patients with diabetes

The goal of therapy is to achieve an A1C as close to the non-diabetic range as possible without severe hypoglycemia

1. ADA Diabetes Care 2007;30(Suppl 1):S4-41
2. NICE 2002.
3. IDF,


Less stringent treatment goals than those noted in the chart above may be appropriate for patients with a history of severe hypoglycemia, patients with limited life expectancies, very young children or older adults, and individuals with comorbid conditions.[1]



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  1. Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2002. Atlanta, GA:
    U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2003.
  2. Standards of Medical Care in Diabetes - 2008. Diabetes Care, Volume 31, Supplement 1, January 2008.
  3. Daniels, E. et al, Point of Care Testing to Improve Glycemic Control.Intl J or Health Care Quality Assurance 2008; 21 (3): pp. 325-335.
  4. Data on file; Evaluation of the A1CNow SELFCHECK with lay-users. August 2008.
    * Study results with healthcare professionals showed that the accuracy of A1CNow+ with fingerstick samples was, on average, 99%. This means that, on average, a true 7.0% A1C could read approximately 6.9%A1C. An individual A1CNow+ result may differ by as much as -1.0% A1C to +0.8% A1C from the true result. This represents the 95% confidence limits of a Bland-Altman plot.
  5. American Diabetes Association. Executive Summary: Standards of Medical Care in Diabetes-2009. Diabetes Care, 32 (S1) 2009, pp. S6-S7.