Figure 2: Proposed diagnostic algorithm using HbA1c test for diagnosis Patient at high risk of diabetes according to AUSDRISK or at risk according to guidelines HbA1c test Above diagnostic Below diagnostic cutoff, diabetes cutoff (<6.5%)- suspected- no HbA1c ≥ 6.5% diabetes than once per Asymptomatic- Re- HbA1c test year test according to Confirmatory HbA1c test guidelines, not more Symptomatic- repeat cutoff (<6.5%)- 6 5% 6 5% Below no diabetes or diagnostic possible re cutoff (<6.5%)- no diabetes or possible test Diabetes confirmed Diabetes confirmed HbA1c ≥ HbA1c ≥ Commence Commence management management (without (without need to need to assess assess baseline baseline severity with severity with HbA1c HbA1c test) Comparator The correct comparators for the HbA1c test are fasting or random plasma glucose tests and oral glucose tolerance tests, where necessary (Colagiuri et al 2009a). MBS item descriptors for the comparators are listed in Table 2. According to the pathway at Figure 1 and based on
Figure 2: Proposed diagnostic algorithm using HbA1c test for diagnosis Patient at high risk of diabetes according to AUSDRISK or at risk according to guidelines HbA1c test Below diagnostic cutoff (<6.5%)- no diabetes Above diagnostic cutoff, diabetes suspected- HbA1c ≥ 6.5% Asymptomatic- Re- test according to guidelines, not more than once per year Symptomatic- repeat HbA1c test Confirmatory HbA1c test Below diagnostic cutoff (<6.5%)- no diabetes or possible test Diabetes confirmed HbA1c ≥ 6 5% cutoff (<6.5%)- no diabetes or possible re Diabetes confirmed HbA1c ≥ 6 5% Commence management (without need to assess baseline severity with HbA1c test) Commence management (without need to assess baseline severity with HbA1c Comparator The correct comparators for the HbA1c test are fasting or random plasma glucose tests and oral glucose tolerance tests, where necessary (Colagiuri et al 2009a). MBS item descriptors for the comparators are listed in Table 2. According to the pathway at Figure 1 and based on
1267-HbA1c-FinalDAP-accessible.docx