Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

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For a valid diagnosis using an A1c of >6.5%, which qualifier is necessary?

A1c must be accompanied by fasting blood glucose >126
Patient must have signs and symptoms of hyperglycemia
At least one episode of random plasma glucose >180 is required
A1c must be NGSP certified and a repeat test is recommended

The correct answer is: A1c must be NGSP certified and a repeat test is recommended

For a valid diagnosis of diabetes using an A1c level greater than 6.5%, it is essential that the A1c test is NGSP (National Glycohemoglobin Standardization Program) certified and that a repeat test is recommended. The NGSP certification ensures that the A1c test is standardized for accuracy and precision, making it a reliable measure of long-term glucose control. When the A1c is used as a diagnostic criterion, meeting the regulatory standards ensures that the results are comparable to those derived from clinical studies used to establish diagnostic thresholds. Additionally, the recommendation for a repeat test adds another layer of confirmation. This is important as it helps to rule out lab errors or transient elevations that may not represent the patient’s glycemic control accurately. This process highlights the need for definitive and reliable diagnostic criteria in diabetes care, promoting safe and effective patient management strategies.