Comparative evaluation of three assay systems for automated determination of hemoglobin A1c

Heinemann

et al. 2016

Target HbA values given in the most National Therapeutic Guidelines for patients with diabetes and cut-off HbA values for diabetes diagnosis are usually not taking the age of the respective patients into account; despite the fact that an increase in HbA in subjects without diabetes with age is known for some time. In order to further quantify the association between age and HbA in non-diabetic subjects an analysis of one German register was performed. In this cross-sectional study we analyzed data from 7 699 visits of 2 921 patients without diabetes (age 46.6 y [range 18-93 y]; 69.1% women; BMI 27.6±6.4 kg/m²) who had at least one HbA and blood glucose measurement. Data were drawn from an electronic patient record system (EMIL™) in which data were collected between 01/1992 and 01/2014. The patients were divided in 6 age groups (< 30 years [n=1 057];>30-40 years [n=1 160];>40-50 years [n=1 693];>50-60 years [n=1 523];>60-70 years [n=1 310];>70 years [n=956]) and the HbA values of these groups were compared. Patients with: gestational diabetes use of systemic glucocorticoids, malignant neoplasm, age<18 y at time of first visit and IGT were excluded. HbA measurements were DCCT adjusted. Patients with age>70 years have a 0.47% [5.14 mmol/mol] higher HbA compared to those<30 years. The mean HbA of the age groups was:<30 4.98% [30.96 mmol/mol],>30-40 5.07% [31.99 mmol/mol],>40-50 5.17% [33.10 mmol/mol],>50-60 5.33% [34.79 mmol/mol],>60-70 5.42% [35.79 mmol/mol] and>70 years 5.45% [36.10 mmol/mol]. In a multiple linear model the regression coefficient for each year of age increase was β=0.0074 (p<0.001); thus age results in an increase of 0.074% in HbA per decade. HbA increases significantly with ageing in people without diabetes. The use of different cut-off values for every age range for diagnosis of diabetes should be discussed.

mentioning

confidence: 99%

HbA1c and Age in Non-Diabetic Subjects: An Ignored Association?

Heinemann

et al. 2016

“…This development is presumably a consequence of the reduction of the applied methods. In the last 20 years 5 methods [3,5,6] are mainly used: high performance liquid chromatography, immunologically based methods, affinity chromatography, capillary electrophoresis and enzymatic methods. It seems that unreliable methods are no longer applied.…”

Section: Resultsmentioning

confidence: 99%

Comparison of HbA1c Measurements using 3 Methods in 75 Patients Referred to One Outpatient Department

Böer

et al. 2017

“…The data were collected between 1992-01-01 and 2014-02-01. The HbA 1c was measured with high-performance liquid chromatography (HPLC) from BioRad ® (BioRad ® Variant HemoglobinAnalyzer, coefficient of variation: < 4 % [24]) from 1992 up to 2004 as well as with another HPLC method (TOSOH G8 UIN 20305, coefficient of variation: < 2 % [25]) between 2005 and 2014. In order to record the exact medication intake, we used: 1) prescription plans of primary care physicians; 2) prescription plans obtained from inpatient stay (if any); 3) prescription plans of our own clinic; 4) self-medication reported by patients.…”

Section: Methodsmentioning

confidence: 99%

Association Between Glycaemic Control and the Intake of Thiazide Diuretics, Beta Blockers and Levothyroxine in People Without Diabetes

Kuniß

et al. 2019

Objective The pharmacological additional information for many medications includes warnings stating that the blood sugar control may be worsened by the intake of certain drugs. However a quantification of the effects is missing. This may result in confusion for patients as well as for their physicians. The aim of this study was to assess a potential association between medication (beta blockers, thiazides, levothyroxine) and HbA1c in people without diabetes. Methods In this cross-sectional study we analysed data from 2 921 people (7 699 visits) without diabetes (age 46.6 y; 69.1% women; BMI 27.6±6.4 kg/m²; HbA1c 5.2%) who had at least one HbA1c determination and a complete documentation of their drug intake. An oral glucose tolerance test was not performed. The participants were divided in 8 groups (no regular drug intake, levothyroxine alone, beta blockers alone, thiazides alone, combination 2 of 3, combination of all 3). Patients with known distorting influences of the HbA1c were excluded. Results People with no regular drug intake had an HbA1c of 5.4% [35.8 mmol/mol]. The HbA1c of the group that took all 3 drugs in combination was 5.6% [38.2 mmol/mol]. A multiple linear mixed model showed an increase in HbA1c for thiazides (β=0.0558, p=0.025) and a decrease for combination of levothyroxine and thiazide (β=−0.0765, p=0.010). Conclusion Thiazides and the combination of levothyroxine and thiazides were associated with slight changes in HbA1c. In this study there was no association between the intake of beta blockers and HbA1c. At least for people without diabetes these effects seem to be of minor importance.