Atkin SL, Butler AE, Hunt SC, et al. - Since retinopathy has been used to determine the glucose or HbA1c threshold for diagnosing diabetes, researchers sought to determine if an HbA1c diagnostic threshold of < 6.5% could be identified based on a urinary albumin-creatinine ratio (UACR) of ≥ 30 mg/g in individuals who did not have diabetes. In 2011–2018 nationally representative cross-sectional National Health and Nutrition Examination Surveys (NHANES; cycles 7–10 inclusive), an UACR was measured in 20,158 candidates. There was no clinically useful diagnostic threshold for HbA1c below 6.5% for elevated UACR risk, with increased risk only visible at HbA1c ≥ 7.0%. Thus, in NHANES, the retinopathy-derived HbA1c threshold of 6.5% captures the risk of diabetic nephropathy.