Hæmoglobin A1: An Indicator of the Metabolic Control of Diabetic Patients

Gonen, Boas; Rochman, H.; Rubenstein, A. H.; Tanega, SoniaP.; Horwitz, D. L.

doi:10.1016/s0140-6736(77)90237-9

Cited by 334 publications

(128 citation statements)

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“…There are conflicting reports on the correlation of Hb A I with the fasting concentrations of serum cholesterol and triglycerides [7,13,14,28]. In the present study, the Hb Ax values from Week 8 did correlate significantly with the mean serum triglyceride values for Week 3, 4 and 7 and with the serum cholesterol at Weeks 3 and 4 but these correlations were of a low magnitude.…”

Section: Discussioncontrasting

confidence: 74%

“…On the other hand, the rate of decline of Hb Aic values following imposition of rigorous diabetic control in a group of five diabetics described by Koenig et al [12] appeared inconsistent with a reduction in rate of synthesis alone. Furthermore, high correlations have been reported between Hb Aic values and virtually simultaneous blood glucose concentrations [13,14]. Finally, short-term changes in blood glucose concen-O012-186X/79/0017/0213/$01.60 trations have been reported to influence Hb A~c values [15].…”

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confidence: 99%

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Temporal relationship of glycosylated haemoglobin concentrations to glucose control in diabetics

et al. 1979

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Summary. To examine the temporal relationship between Hb Aic values and various indices of blood glucose control, 38 diabetic and 28 nondiabetic youth counsellors employed at two summer camps for diabetic children took part in an eight-week study. Each week fasting determinations were made of Hb AI, Hb Al~ , serum cholesterol, triglyceride and growth hormone and plasma glucose. Total daily urine glucose excretion was measured approximately two times per week, capillary glucose values were measured fasting and at 11 a. m. and 3 p. m. on two days per week, and urine glucose was measured semiquantitatively four times per day. As Hb AI was correlated highly with Hb AI0 (r = 0.997), it was used as the primary index of glycosylated haemoglobin. The mean values of Hb AI, serum cholesterol and triglycerides and fasting plasma glucose were all significantly elevated in the diabetic group but only Hb AI values provided total separation of the two groups. Within the diabetic group the Week 8 Hb A I values showed a significant correlation with the Week 8 mean capillary glucose concentrations, the proportion of urine tests showing 2% and 0% glycosuria, and mean serum triglycerides. Correlations of Week 8 Hb A~ with the mean values of these glycaemic parameters for each week of the study demonstrated low order correlations with the glycaemie measures of Week 1, and a progressive increase in the degree of correlation reaching a plateau with the glycaernic measures of Week 4 to 8. Similar correlation analysis using the Hb Ai values from Week 4 confirmed these findings. Therefore, while Hb AI provides an index of the control of diabetes, it appears to be more acutely responsive to blood glucose alteration than generally recognized.

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Section: Discussioncontrasting

confidence: 74%

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confidence: 99%

Temporal relationship of glycosylated haemoglobin concentrations to glucose control in diabetics

et al. 1979

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“…The concentration of glycated Hb is increased within erythrocytes of patients in proportion to the degree of chronic hyperglycaemia; it is an indirect measure of the average blood glucose concentration over the previous 2 to 3 months [3]. Glycated Hb is widely used for monitoring long-term glycaemic control in known diabetic patients [5][6][7][8], and the prognostic value of glycated Hb has been investigated in a longitudinal study design of patients with normal glucose tolerance [9]. Measurement of glycated Hb offers some practical advantages over the OGTT; it is not influenced by time of day, recent activity levels, metabolic stress, or food intake [7].…”

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confidence: 99%

Glycated haemoglobin predicts progression to diabetes mellitus in Pima Indians with impaired glucose tolerance

et al. 1994

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Summary Glycated haemoglobin could offer several practical advantages over the OGTT for assessing glucose metabolism. Initial cross-sectional studies (1983)(1984)(1985) on 381 subjects (mostly Pima Indians) described the relationship between HbAlc (a specific glycated Hb) and the OGTT. We performed follow-up OGTTs and HbA~c measurements on 257 of these same subjects 1.6-6.1 years later. Subjects were again grouped according to both the result of the OGTT (normal, IGT or diabetes, by WHO criteria) and HbA~ result (normal or elevated based on mean + 1.96 SD of normal). Of 66 subjects with IGT at baseline, 47 (71%) had normal HbAlo and 19 (29 % ) had elevated HbAlo. Twentysix (39 %) of these subjects had diabetes at follow-up. Of these subjects with IGT, a significantly greater percentage of subjects with elevated HbAlc at baseline (68 %) showed worsening to diabetes than those with a normal HbAlo (28%); (chi-square =7.8, dr= 1, p < 0.01). Thus, in subjects with IGT, glycated Hb may be a useful predictor of progression to diabetes. [Diabetologia (1994) 37: 252-256] Key words Follow-up study, glycated Hb, HbA~ c, IGT, Pima Indians.The OGTT is often used to diagnose diabetes mellitus as well as to detect more mildly impaired carbohydrate metabolism. Measurement of glycated Hb has been suggested as an alternative to the OGTT for assessing glucose metabolism [1][2][3][4]. The concentration of glycated Hb is increased within erythrocytes of patients in proportion to the degree of chronic hyperglycaemia; it is an indirect measure of the average blood glucose concentration over the previous 2 to 3 months [3]. Glycated Hb is widely used for monitoring long-term glycaemic control in known diabetic patients [5][6][7][8], and the prognostic value of glycated Hb has been investigated in a longitudinal study design of patients with normal glucose tolerance [9]. Measurement of glycated Hb offers some practical advantages over the OGTT; it is not influenced by time of day, recent activity levels, metabolic stress, or food intake [7]. Only minimal patient cooperation is required before and during the test, and only one small blood sample is required.Our initial cross-sectional studies [4] described the relationship between HbAlc, a specific glycated Hb, and OGTT. In 381 subjects (mostly Pima Indians) from a population with a high prevalence of non-insulin-dependent diabetes mellitus, HbA~c had high specificity and moderate sensitivity as a screening test for diabetes defined by the OGTT using WHO criteria [4]. Here we re-examine these same individuals 1 to 6 years later to investigate the prognostic value of glycated Hb. By using both OGTT and glycated Hb results, we attempted to identify, among a group of high risk subjects, those who are at greatest risk of developing diabetes.

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“…Thus, measurement of glycosylated haemoglobin provides an objective, retrospective index of glycaemic control [8][9][10][11][12]. Serial measurements should provide a truer reflection than previously possible of long-term glycaemic control in prospective studies of the development of diabetic complications.…”

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Non-enzymatic glycosylation and the chronic complications of diabetes: an overview

Kennedy¹,

1984

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Hæmoglobin A1: An Indicator of the Metabolic Control of Diabetic Patients

Cited by 334 publications

References 14 publications

Temporal relationship of glycosylated haemoglobin concentrations to glucose control in diabetics

Temporal relationship of glycosylated haemoglobin concentrations to glucose control in diabetics

Glycated haemoglobin predicts progression to diabetes mellitus in Pima Indians with impaired glucose tolerance

Non-enzymatic glycosylation and the chronic complications of diabetes: an overview

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