Putting A1c to Work: ADA Standards, Testing Technologies & Clinical Practice

Abstract
Hemoglobin A1c (HbA1c) remains a cornerstone in the diagnosis and monitoring of diabetes, and its proper use is central to implementing the 2023 American Diabetes Association (ADA) guidelines. While HbA1c testing is widely adopted, interpreting results requires a solid understanding of the underlying methodologies, their strengths and limitations, and the clinical scenarios in which HbA1c may be misleading.

This session will review the role of HbA1c in diabetes management, summarize key recommendations from the current ADA guidelines, and provide an overview of commonly used testing methodologies. Attention will be given to analytical principles, comparative advantages and disadvantages of different methods, and the practical factors laboratories must consider when selecting or transitioning HbA1c platforms. Special situations, including cases where unusual result patterns point to analytical interferences or clinical confounders such as hemoglobin variants, will be discussed to illustrate problem-solving approaches in the laboratory setting.

Drawing from Emory University Hospital’s experience, Dr. Janetta Bryksin will highlight both the theoretical and practical aspects of HbA1c testing, emphasizing how laboratories can optimize accuracy, efficiency, and clinical value in diabetes care.

Learning Objectives:

• Decode the 2023 ADA guidelines. What’s new, What Matters and How it impacts HbA1c testing.
• Explain the role of HbA1c in diagnosing and managing diabetes.
• Compare HbA1c testing methods for accuracy and impact. Not all tests are created equal.
• Analyze Emory’s diabetes testing strategies to identify best practices and opportunities for smarter A1c testing.