ADA Standards of Care 2023 — Key Updates
A clear overview of the most relevant ADA recommendations for HbA1c use in diagnosis and long‑term diabetes management, including thresholds, testing frequency, and clinical decision points.
What will you learn?
Clinical Role of HbA1c in Diabetes Management
How HbA1c supports both initial diagnosis and ongoing monitoring, and why it remains a cornerstone marker despite biological and analytical limitations.
Understanding HbA1c Testing Methodologies
A comparison of major analytical technologies (HPLC, immunoassay, enzymatic methods, capillary electrophoresis), highlighting their principles, strengths, and potential sources of bias.
Interpreting Results in Complex Clinical Scenarios
Guidance on recognizing and managing interferences such as hemoglobin variants, anemia, altered red cell turnover, and other factors that may distort HbA1c values.
Choosing the Right HbA1c Platform for Your Laboratory
Key criteria for evaluating or transitioning to a new testing system, including accuracy, workflow efficiency, standardization, and alignment with NGSP/IFCC requirements.
Practical Insights from Emory University Hospital
Real‑world examples illustrating how analytical challenges are addressed in practice, and how optimized workflows can improve reliability and clinical impact.
“Understanding the strengths and limitations of HbA1c methodologies is essential for accurate diabetes diagnosis and monitoring.”
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.
About Dr Janetta Bryskin
Dr. Bryksin is the System Medical Director for Core Laboratories at Emory Healthcare in Atlanta.
She is a board‑certified clinical chemist with extensive experience in method evaluation, laboratory standardization, and the implementation of advanced testing technologies.
Her work focuses on improving analytical quality, managing interferences, and ensuring reliable HbA1c testing aligned with ADA and NGSP/IFCC standards.
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Our Speaker
Janetta Bryksin, PhD, DABCC, FADLM
System Medical Director for Core Laboratories, Emory Healthcare (EHC), Atlanta, GA