Awanui is harmonising HbA1c testing across all laboratories by transitioning from the Bio-Rad D-100 to the Roche C513 platform. Awanui Auckland has successfully used the Roche platform for several years, and this change aligns with our commitment to improving efficiency and maintaining high-quality patient care.
The current HbA1c reference interval and diagnostic, monitoring and treatment thresholds will also be adjusted in due course, awaiting national change approval from NZ Diabetes working groups. These changes will ensure consistency and alignment with best-practice guidelines across all public and private laboratories nationwide.
The new method will come into effect on 31 March 2025. There will, for now, be no change in clinical HbA1c interpretation or diabetes management practices.
Considerations for Hb Variants and Analytical Limitations
The Roche C513 method, like other HbA1c assays, may be affected by haemoglobin variants (e.g., HbS, HbC, HbE) and certain rare haemoglobinopathies, potentially leading to inaccurate HbA1c results. While the C513 has improved variant detection compared to earlier methods, some interferences remain. In cases where results are inconsistent with the clinical picture, the following approach is recommended:
- Alternative Biomarkers: If an Hb variant is suspected or the HbA1c result does not correlate with clinical findings, consider using fructosamine or glucose-based criteria (fasting glucose, oral glucose tolerance test) to assess glycaemic control.
- Clinical Correlation: Regularly review patient history, ethnicity, and previous HbA1c trends, particularly for patients with known haemoglobinopathies.
- Laboratory Alerts: When an interfering Hb variant is suspected, the laboratory will issue a comment advising alternative assessments.
We appreciate your support in implementing this change. If you have any questions or require further clarification, please do not hesitate to reach out.
Dr Melissa Yssel
Clinical Lead – Chemical Pathology, Awanui Labs