Assessment of two glycated hemoglobin immunoassays

Vargas, Miguel; Gómez, Betty Judith Pazmiño; Lorenti, Fanny Elsa Vera; Condo, G.M. Álvarez; Neira, Edgar I. Rodas; Verón, Dolores; Veron, M. Fernández; Cercado, Alicia G.; Bahar, Burhanuddin; Tufró, Alda

doi:10.1016/j.endinu.2019.09.011

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…In fact, affinity methods have already been suggested as an acceptable and more useful method for reflecting glycemic control because they mainly measure glycohemoglobin regardless of the glycation site and hence may be clinically more accurate [ 15 ]. Studies have shown that results from the HbA1c immunoassays were also comparable to those from HPLC assays, showing good correlation, appropriate precision, and low bias [ 20 ]. Immunoassays utilizing various antibodies raised against specific epitopes of hemoglobin, for example, the Amadori product of glucose plus the first eight amino acids on the N-terminal end of the beta chain of hemoglobin, and many more, have shown good correlation with established methods for estimating glycohemoglobin [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

An incidental finding of a hemoglobin E variant in a diabetic patient with an abnormal glycated hemoglobin level: a case report

Karki,

Lamichhane,

Jha

et al. 2024

J Med Case Reports

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Background Glycated hemoglobin is a well-known marker for evaluating long-term glycemic control. However, the accuracy of glycated hemoglobin measurement can be affected by the presence of hemoglobin variants, which makes the determination and interpretation of glycated hemoglobin values in terms of glycemic control not only difficult but also misleading. Here we present the first ever case of a patient with type 2 diabetes with hemoglobin E from Nepal, diagnosed incidentally because of spurious glycated hemoglobin levels. Case presentation A 45-year-old Hindu Mongolian female with a history of type 2 diabetes for around 9 years but not very compliant with follow-ups was referred to our facility for plasma fasting and postprandial blood glucose levels and glycated hemoglobin. Fasting and postprandial blood sugars were found to be high. A consistent very low glycated hemoglobin by two different high-performance liquid chromatography (HPLC) methods compelled us to call the patient for a detailed clinical history and for the records of investigations done in the past. The patient has been a known case of type 2 diabetes for around 9 years and presented irregularly for follow-up visits. Around 4 years ago, she presented to a healthcare facility with fatigue, severe headaches, pain in the abdomen, discomfort, and dizziness for a couple of months, where she was shown to have high blood glucose. She was referred to a tertiary-level hospital in Kathmandu, where she was prescribed metformin 500 mg once daily (OD). Due to her abnormal hemoglobin A1c reports, she was then sent to the National Public Health Laboratory for repeat investigations. Her blood and urine investigations were sent. Complete blood count findings revealed high red blood cell and white blood cell counts, a low mean corpuscular volume, and a high red cell distribution width-coefficient of variation. Other parameters, including serum electrolytes, renal function tests, liver function tests, and urine routine examinations, were within normal limits. A peripheral blood smear revealed microcytic hypochromic red cells with some target cells. Hemoglobin electrophoresis showed a very high percentage of hemoglobin E, a very low percentage of hemoglobin A2, and normal proportions of hemoglobin A and hemoglobin F. A diagnosis of homozygous hemoglobin E was made, and family screening was advised. Conclusions Clinicians should be aware of the limitations of glycated hemoglobin estimation by ion exchange high-performance liquid chromatography in patients with hemoglobin E and other hemoglobin variants. If the clinical impression and glycated hemoglobin test results do not match, glycated hemoglobin values should be determined with a second method based on a different principle, and glycemic status should be confirmed through alternative investigations, preferably those that are not influenced by the presence of hemoglobin variants (for example, boronate affinity chromatography, fructosamine test, glycated albumin test, the oral glucose tolerance test, continuous glucose monitoring, etc.). Consistent or even doubtful results should also raise the suspicion of a hemoglobin variant, which should be confirmed through further evaluation and investigations.

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Section: Discussionmentioning

confidence: 99%

An incidental finding of a hemoglobin E variant in a diabetic patient with an abnormal glycated hemoglobin level: a case report

Karki,

Lamichhane,

Jha

et al. 2024

J Med Case Reports

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“… 38 We used capillary blood samples and equipment to conduct point-of-care immunoassay (DCA Vantage Analyzer, Siemens) which has shown sufficient correlation with the reference method, high-performance liquid chromatography. 39 The method of analysis is calibrated against International Federation of Clinical Chemists standard. The same equipment was used at each measurement time point and a checklist for calibration and maintenance was followed in accordance with the manufacturer’s recommendations.…”

Section: Methodsmentioning

confidence: 99%

Impact of an Acceptance and Commitment Therapy programme on HbA1c, self-management and psychosocial factors in adults with type 1 diabetes and elevated HbA1c levels: a randomised controlled trial

Wijk,

Amsberg,

Johansson

et al. 2023

BMJ Open

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ObjectiveTo evaluate the impact of an Acceptance and Commitment Therapy (ACT) programme, tailored for people living with type 1 diabetes, on glycated haemoglobin (HbA1c), self-management and psychosocial factors among individuals with HbA1c>60 mmol/mol compared with treatment as usual (TAU).SettingAn endocrinologic clinic in Sweden.ParticipantsIn this randomised controlled trial, 81 individuals with type 1 diabetes, aged 18–70 years with HbA1c>60 mmol/mol, were randomly assigned to either an ACT group intervention or TAU. Exclusion criteria were: unable to speak Swedish, untreated or severe psychiatric disease, cortisone treatment, untreated thyroid disease and newly started insulin pump therapy. At the 2-year follow-up, HbA1c was measured in 26 individuals.InterventionThe ACT programme comprised seven 2-hour sessions held over 14 weeks and focused on acceptance of stressful thoughts and emotions, and to promote value-based committed action.OutcomesThe primary outcome was HbA1c, and the secondary outcomes were measures of depression, anxiety, general stress, fear of hypoglycaemia, diabetes distress, self-care activities, psychological flexibility (general and related to diabetes) and quality of life. The primary endpoint was HbA1c 2 years after the intervention programme. Linear mixed models were used to test for an interaction effect between measurement time and group.ResultsLikelihood ratio test of nested models demonstrated no statistically significant interaction effect (χ2=0.49, p=0.485) between measurement time and group regarding HbA1c. However, a statistically significant interaction effect (likelihood ratio test χ2=12.63, p<0.001) was observed with improved scores on The Acceptance and Action Questionnaire in the intervention group after 1 and 2 years.ConclusionsNo statistically significant difference was found between the groups regarding the primary outcome measure, HbA1c. However, the ACT programme showed a persistent beneficial impact on psychological flexibility in the intervention group. The dropout rate was higher than expected, which may indicate a challenge in this type of study.Trial registration numberNCT02914496.

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One-pot method based on CRISPR/Cas12a-triggered entropy-driven RNA circuit for sensitive glycated hemoglobin A1c assay

Chai,

Gao,

Chai

et al. 2025

Sensors and Actuators B: Chemical

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Assessment of two glycated hemoglobin immunoassays

Cited by 6 publications

References 24 publications

An incidental finding of a hemoglobin E variant in a diabetic patient with an abnormal glycated hemoglobin level: a case report

An incidental finding of a hemoglobin E variant in a diabetic patient with an abnormal glycated hemoglobin level: a case report

Impact of an Acceptance and Commitment Therapy programme on HbA1c, self-management and psychosocial factors in adults with type 1 diabetes and elevated HbA1c levels: a randomised controlled trial

One-pot method based on CRISPR/Cas12a-triggered entropy-driven RNA circuit for sensitive glycated hemoglobin A1c assay

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