Full engagement in health

on the quantitative relation between overall blood glucose control and complications, but might also risk increasing blindness and cardiovascular events through higher attained blood glucose concentrations. 4 Is there a way out?Not to make use of the advance introduced by the International Federation of Clinical Chemists would be unreasonable.Alternatives considered at a recent meeting convened by the International Diabetes Federation included continued reporting to the diabetes control and complications trial's standard (using the defined relation between the two standards), a coordinated global switch to reporting to the new, lower standard of the International Federation of Clinical Chemists, reporting in absolute units (such as g/kg rather than percentage), or reporting in average blood glucose equivalents.As people with diabetes already measure their own glucose concentrations by self monitoring, the last of these has some attraction.However, even this approach would still need a major global education initiative, and whether the globally influential North American community would be prepared to carry through any such change is unclear at present.Meanwhile one message seems clear.Piecemeal switching of the reporting standard by individual laboratories or even countries is likely to lead to confusion and ignorance among patients and healthcare professionals that could seriously damage individual health outcomes in people with diabetes.Therefore, individual practitioners need to remain sensitive to these risks, while requiring the international diabetes community to continue to move forward in achieving a coordinated programme, which makes use of the new standard.