Pathlab update: HbA1c updated diagnostic thresholds

The Diabetes National Clinical Network has issued updated HbA1c diagnostic thresholds to align New Zealand reporting with global standards and to support improved patient outcomes.

• Diabetes: HbA1c ≥ 48 mmol/mol (lowered from the current ≥ 50 mmol/mol).
• Prediabetes: HbA1c 42 – 47 mmol/mol (increased from the current 40 mmol/mol).
• Normal: HbA1c < 42 mmol/mol.
• A confirmatory test will not be required where the initial HbA1c is > 53 mmol/mol.

HbA1c result flagging will occur if the result is 42 mmol/mol or above (currently this is 40 mmol/mol). In addition, explanatory comments will be added depending on the HbA1c result (as provided by the Diabetes National Clinical Network).

The above changes were implemented by Pathlab on Wednesday 22 April, ahead of the Ministry of Health deadline of 1 July 2026.

See the Pathlab test website for a complete list of HbA1c levels and applicable comment.