The Diabetes National Clinical Network has issued updated HbA1c diagnostic thresholds to align HbA1c reporting in New Zealand with international best practice guidelines (WHO, ADA). These changes aim to support earlier detection and intervention, reduce inequities, and improve patient outcomes, particularly in younger patients and high-risk population groups.

Awanui Labs will implement these changes on 20 May 2026, ahead of the Ministry of Health implementation deadline of 1 July 2026.

What is changing:

• Diagnostic threshold for Type 2 Diabetes: HbA1c ≥48 mmol/mol (lowered from the current ≥50 mmol/mol)
• No confirmatory test required if the initial HbA1c is >53 mmol/mol
• Prediabetes range: HbA1c 42–47 mmol/mol (revised from the current 41–49 mmol/mol)
• Normal: HbA1c <42 mmol/mol (previously <41 mmol/mol)

HbA1c result flagging will occur for all results ≥42 mmol/mol.

Interpretive comments will be appended to reports according to the HbA1c result, in line with recommendations from the Diabetes National Clinical Network.

Reference: https://www.diabetes.org.nz/news-and-update/changes-to-hba1c-diagnostic-criteria

Dr Melissa Yssel
Clinical Lead – Chemical Pathology
Awanui Labs