HbA1c for diagnosing diabetes is lowering
The HbA1c for diagnosing type 2 diabetes is lowering from 50 mmol/mol to 48 mmol/mol. The prediabetes range will change to 42–47 mmol/mol. That means some people who were previously told they did not have type 2 diabetes may now have a diagnosis due to the new HbA1c level being reduced; and others may no longer have pre-diabetes as the diagnosis level has gone up.
If you or someone in your whānau has pre-diabetes it would be good to check what these changes might mean next time you see your doctor or practice nurse. This change is about protecting the long-term health of our communities. Finding diabetes earlier means more time, more options, and more opportunities to stay well.
From 1 July, the national diagnostic thresholds for HbA1c are changing to:
• No diabetes: HbA1c < 42 mmol/mol.
• Pre-diabetes: HbA1c 42 – 47 mmol/mol (previously 41 – 49 mmol/mol)
• Diabetes: HbA1c ≥ 48 mmol/mol (lowered from the current ≥ 50 mmol/mol).
o No confirmatory test now required if HbA1c ≥ 53 mmol/mol
o Confirmatory test required as soon as practical if HbA1c 48 – 52 mmol/mol e.g. repeat HbA1c, fasting glucose or random glucose (if symptomatic)
Why the HbA1c thresholds are changing?
The change aligns New Zealand with international (World Health Organisation) best practice, enables earlier diagnosis and intervention, supports equity by identifying diabetes sooner, particularly for those who develop diabetes at younger ages, and simplifies diagnosis at higher HbA1c levels.
Earlier intervention reduces long-term complications such as cardiovascular disease, kidney failure and retinopathy.
What is changing?
The HbA1c diagnostic threshold for type 2 diabetes is lowering from 50 mmol/mol to 48 mmol/mol. The prediabetes range will change to 42–47 mmol/mol. Approximately 34,500 additional people may meet criteria for diabetes, and around 200,000 people will no longer meet criteria for pre-diabetes.
HbA1c Test Changes – What This Means for You and Your Whānau
1. What is HbA1c?
HbA1c is a simple blood test that shows your average blood glucose levels over the past three months. It helps your doctor or nurse understand whether you may be developing diabetes and whether you need support.
2. What is changing?
The level used to diagnose diabetes is being slightly lowered. This means some people may now be told they have diabetes earlier than before. This change helps people get support sooner.
3. Why is this change being made?
Finding diabetes earlier gives people more time to take action. Early support can help protect your heart, kidneys and eyes, and support your long-term wellbeing. Many people can slow progression or even achieve remission when diabetes is identified early.
4. Does this mean more people suddenly have diabetes?
No. It means the way we measure and identify diabetes has been refined. Some people who were previously told they did not have diabetes may now meet the updated threshold. Many of these people are already connected to primary care.
5. If I am newly diagnosed, will I need medication straight away?
Not necessarily. For many people, the first steps are healthy eating, physical activity, weight management support and regular monitoring. Medication is considered when needed, and decisions are made together with your health provider.
6. I was told I had prediabetes before. What happens now?
Some people who were previously told they had prediabetes may no longer meet that definition. If that applies to you, you may not need annual blood tests for prediabetes. Your health provider will explain what follow-up is appropriate. You can still focus on healthy lifestyle habits that support your wellbeing.
7. Why is there a focus on people under 60?
When diabetes develops earlier in life, it can have a greater long-term impact. Finding it earlier, especially for people under 60, gives more opportunity to protect long-term health. Support will still be tailored to everyone’s age and circumstances.
8. What should I do now?
There is nothing you need to do unless your doctor or nurse contacts you. If you have risk factors for diabetes, have a whānau history of diabetes, or have not had a recent blood test, you may wish to talk with your health provider about whether testing is right for you.
9. How does this support Māori and Pacific whānau?
Māori and Pacific communities are more likely to develop diabetes at a younger age and experience complications earlier. This change helps identify diabetes sooner so that support can begin earlier. Kaupapa Māori and Pacific health providers will continue to play an important role in delivering aiga and whānau-centred support.
10. Will this increase costs for me?
Your usual GP visit fees apply. If you have questions about costs or support options, speak with your health care provider. They can help you understand what support is available.
11. What if I feel worried about this change?
It is normal to feel unsure when health information changes. Remember this change is about earlier support. It gives more time to protect your health. Decisions about care are always made together with you. You are not alone; your health team is there to support you.
12. Where can I get more information?
You can speak with your GP or nurse, contact your local hauora provider, or contact Diabetes New Zealand info@diabetes.org.nz or 0800 342 238. If you prefer support through a kaupapa Māori or Pacific provider, ask your practice about options in your area.
13. Why is this important?
This change is about protecting the long-term health of our communities. Finding diabetes earlier means more time, more options, and more opportunities to stay well.
He oranga whānau te aronga matua - whānau wellbeing is at the centre.