Recommendations for A1C testing1 are summarized on this slide An A1C test should be performed at least two times a year in patients who are meeting their treatment goals and have stable glycemic control (E) In patients whose therapy has changed or who are not meeting glycemic goals, the A1C test should be performed quarterly (E); this helps determine whether a patient’s glycemic targets are being reached and maintained When needed for timely decisions on when to change therapy, point-of-care testing (POC) for A1C may be used (E) The A1C test is subject to certain limitations: conditions that affect erythrocyte turnover (e.g., hemolysis, blood loss) and hemoglobin variants must be considered, particularly when the A1C result does not correlate with the patient’s clinical situation;2 in addition, A1C does not provide a measure of glycemic variability or hypoglycemia For patients prone to glycemic variability (especially type 1 diabetic patients, or type 2 diabetic patients with severe insulin deficiency), glycemic control is best judged by the combination of result of self-monitoring of blood glucose (SMBG) testing and A1C The A1C may also serve as a check on the accuracy of a patient’s meter and adequacy of the SMBG testing schedule37References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S18-S19. Sacks DB, Arnold M, Bakris GL, et al. National Academy of Clinical Biochemistry. Position statement executive summary: guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care 2011;34:1419-1423.