USE OF HEMOGLOBIN A1C TO DIAGNOSE DIABETESIntroductionIn 2009, the international expert committee, composed of experts from the American Diabetes Association (ADA), of the European Association for the Study of Diabetes, and the International Diabetes Federation published a report recommending the use of hemoglobin A1c (HbA1c) to diagnose diabetes (American Diabetes Association [ADA], 2013; International Committee of experts, 2009). HbA1c is a widely used marker of chronic blood sugar because it reflects an individual's average blood sugar level over a 2 to 3 month period (ADA, 2013). Furthermore, HbA1c is widely used as a standard biomarker for the adequacy of glycemic management of individuals (ADA, 2013; Bao et al., 2010). The ADA supports the decision made by the International Expert Committee to use the threshold of HbA1c ≥ 6.5. % as a diagnosis of diabetes (ADA, 2013; International Committee of Experts, 2009). The 6.5% threshold is associated with an inflection point for the prevalence of retinopathy, as are the diagnostic thresholds for fasting blood glucose (FPG) and 2-hour blood glucose (2-hour PG) (ADA , 2013; Bao et al., 2010; Prior to the publication of the International Expert Committee report, diabetes was diagnosed with a PGF ≥ 126 mg/dl (Carson, Reynolds, Fonseca, & Munter, 2010). HbA1c has been suggested as a useful test for screening and diagnosis of diabetes because it does not require fasting, has less intraindividual variability, and can better predict diabetes-related complications (Kramer, Araneta, & Barrett-Connor, 2010 ). Since fasting is not required for HbA1c testing, the test can be performed at any time, allowing diabetes to be diagnosed on the same day...... middle of article... ...A1c: Should we extrapolate the recommendations for adults to adolescents? The Journal of Pediatrics, 158, 947-952. Nowicka, P., Santoro, N., Liu, H., Lartaud, D., Shaw, MM, Goldberg, R., Guandalini, C., Savoye, M., Rose, P. and Caprio, S. (2011 ). Usefulness of hemoglobin A1c for the diagnosis of prediabetes and diabetes in obese children and adolescents. Vehik, K., Cuthbertson, D., Boulware, D., Beam, CA, Rodriguez, H., Legault, L., Hyytinen, M., Rewers, MJ, Schatz, DA and Krischer, JP (2012). Performance of HbA1c as an indicator of early diagnosis of type 1 diabetes in children and young people. Diabetes Care, 35, 1821-1825. Van't Riet, E., Alssema, M., Rijkelijkhuizen, JM, Kostense, PJ, Hijpels, G. and Dekker, JM (2010). Relationship between A1C and glucose levels in the general Dutch population: Hoorn's new study. Diabetes care, 33, 61-66.