According to the American Diabetes Association, the total annual economic cost of diabetes in 2002 was estimated to be $132 billion, or one out of every 10 health care dollars spent in the United States. A chronic disease with no cure, diabetes is a group of diseases (including Type 1, Type 2, and gestational) marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Nearly 20 million Americans have diabetes and nearly one-third of them don't even know it.
To combat this problem, the U.S. Department of Health and Human Services launched the Diabetes Detection Initiative to find this undiagnosed population through increased testing. Early diagnosis means that early steps can be taken to manage the disease and to prevent or delay complications.
The American Diabetes Association (ADA) recommends the hemoglobin A1C test, or HbA1c, as the best way to determine a patient's blood glucose control over the past 2-3 months. Specifically, the test measures the concentration of glycosylated hemoglobin. A1C levels are measured upon diagnosis, and, depending on a patient's type of diabetes, how well it is controlled, and his or her health-care provider, levels may be measured two to four times per year. Determining blood glucose control through this laboratory testing gives health-care providers the data they need to monitor the disease and to recommend appropriate treatment. Results from a major diabetes study, the Diabetes Control and Complications Trial (DCCT), confirm this test's importance. The study showed that lowering the HbA1c number can potentially reduce the development of complications and that lowering HbA1c levels by any amount improves a person's chances of staying healthy.
All HbA1c tests are not the same, but there is an ongoing international effort to standardize them by organizations like the National Glycoh