Selvin · Diabetes care 2021 · narrative review · n=?

Hemoglobin A 1c -Using Epidemiology to Guide Medical Practice: Kelly West Award Lecture 2020.

Cited 51 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and lecture without systematic search methods or primary data

PubMed 34548283 · doi:10.2337/dci21-0035 · record verified 2026-08-29

What was done

Narrative review and award lecture summarizing epidemiological and clinical trial evidence supporting hemoglobin A1c (HbA1c) for diabetes diagnosis, glycemic monitoring, microvascular complication risk, and alternative glycemic markers.

What was found

The abstract reports no numerical data or effect sizes. It qualitatively describes HbA1c as reflecting 2-3 months of glucose exposure with low within-person variability, noting established links to microvascular complications and clinical trials showing risk reduction from lowering HbA1c, alongside limitations in patients with hemoglobin variants or altered red blood cell turnover.

Why it matters

Synthesizes the clinical epidemiology establishing HbA1c as the primary biomarker for diabetes care while identifying clinical scenarios where alternative testing is necessary.

Limits

Narrative review design without systematic search methods, quantitative synthesis, or original data. The abstract provides no specific numerical values, diagnostic cutoffs, or effect estimates.

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