The use of HbA1c is becoming mandatory for good-standard diabetes care thanks to scientific evidence generated over the past two decades worldwide. HbA1c as a reflection of chronic hyperglycaemia is also becoming a key indicator increasingly used for the diagnosis of diabetes. however, underserved populations in poor countries have little awareness of or access to this important diagnostic and monitoring tool. As a new technology, the feasibility of large-scale dissemination of HbA1c determination in resource-limited countries, and the cost-effectiveness of its use under those circumstances is questionable. The translation of scientific evidence gathered around HbA1c in poor environments requires appropriate investigation. a multi-centre study in 10 diabetes care facilities in guinea and Cameroon is ongoing to evaluate the feasibility and benefit of improving access to HbA1c with immediate feedback on diabetes-related outcomes.