title: Position statement executive summary: guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.
abstract: BACKGROUND
  Multiple laboratory tests are used in the diagnosis and management of patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially.
  
  
  METHODS
  An expert committee compiled evidence-based recommendations for the use of laboratory analysis in patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. A draft of the guidelines was posted on the Internet, and the document was modified in response to comments. The guidelines were reviewed by the joint Evidence-Based Laboratory Medicine Committee of the AACC and the National Academy of Clinical Biochemistry and were accepted after revisions by the Professional Practice Committee and subsequent approval by the Executive Committee of the American Diabetes Association.
  
  
  BACKGROUND
  In addition to the long-standing criteria based on measurement of venous plasma glucose, diabetes can be diagnosed by demonstrating increased hemoglobin A(1c) (HbA(1c)) concentrations in the blood. Monitoring of glycemic control is performed by the patients measuring their own plasma or blood glucose with meters and by laboratory analysis of HbA(1c). The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed.
  
  
  CONCLUSIONS
  The guidelines provide specific recommendations based on published data or derived from expert consensus. Several analytes are found to have minimal clinical value at the present time, and measurement of them is not recommended.
authors: Department of Laboratory Medicine, National Institutes of Health, Bethesda, Maryland, USA. sacksdb@mail.nih.gov
authors: David B
authors: DB
authors: Sacks
authors: Mark
authors: M
authors: Arnold
authors: George L
authors: GL
authors: Bakris
authors: David E
authors: DE
authors: Bruns
authors: Andrea Rita
authors: AR
authors: Horvath
authors: M Sue
authors: MS
authors: Kirkman
authors: Ake
authors: A
authors: Lernmark
authors: Boyd E
authors: BE
authors: Metzger
authors: David M
authors: DM
authors: Nathan
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