Haemoglobin A1c concentrations in men and women with diabetes.

Jones, R. L.; Johnston, D I; Allison, S; Peacock, Ian; Hosking, David J.; Tattersall, R. B.

doi:10.1136/bmj.289.6455.1381-b

Cited by 6 publications

(1 citation statement)

References 2 publications

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“…While the five-point blood-glucose profiles employed in the study may not accurately reflect ambient blood-glucose levels, the mean levels on the two profiles differed significantly between high and low glycators, suggesting that these observed differences in glycation are not thereby explained. There is no systematic gender difference in glycated haemoglobin [34], a difference which some previous studies have suggested [35,36].…”

Section: Discussionmentioning

confidence: 61%

Unexplained variability of glycated haemoglobin in non-diabetic subjects not related to glycaemia

Forrest²,

et al. 1990

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We have studied levels of glycated haemoglobin in a sample of 223 people aged over 40 years without known diabetes mellitus screened in a community study. Each had a glucose tolerance test and glycated haemoglobin measured by four methods - agar gel electrophoresis with and without removal of Schiff base, affinity chromatography and isoelectric focusing. The correlation coefficients between 2 h blood glucose and levels of glycated haemoglobin were between 0.43 and 0.64. This poor correlation was not explained on the basis of assay or biological variability of either 2 h blood glucose or glycated haemoglobin. Multiple regression analysis showed that other assays of glycated haemoglobin contributed to the variance of any single glycated haemoglobin value by 0.1%-52.9% (median 12.8%) compared to the variance of 18.6%-41.4% (median 30.8%) explained by 2 h blood glucose alone, suggesting that in a non-diabetic population, the degree of glucose intolerance may explain only one third of the variance of glycated haemoglobin levels, but other factors operate to produce consistent changes in levels of glycated haemoglobin. Investigation of 42 subjects with consistently high (20 subjects) or low (22 subjects) levels of glycated haemoglobin relative to their 2 h blood glucose level showed no difference in age, gender, body mass index, haemoglobin levels or smoking, although 50% of low glycators had impaired glucose tolerance. Neither ambient blood-glucose levels, as estimated on two five-point blood-glucose profiles, nor dietary intake of carbohydrate, starch, sugars, fibre or alcohol, explained the difference between high and low glycators. The determinants of the consistent interindividual differences in levels of glycated haemoglobin in non-diabetic subjects remain to be determined.

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Section: Discussionmentioning

confidence: 61%

Unexplained variability of glycated haemoglobin in non-diabetic subjects not related to glycaemia

Forrest²,

et al. 1990

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Difficult Diabetes

Saunders¹,

Williams²

2004

International Textbook of Diabetes Mellitus

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Diabetes can be a very difficult disease to manage. This is particularly true when confronted with a patient who attends with recurrent episodes of hypoglycemia, diabetic ketoacidosis, or mixed glycemic instability. This chapter aims to explain the common causes of such presentations, and the suitable investigations to identify a treatable cause. Further to this, if a diagnosis cannot be reached and the problems still persist, the chapter then discusses the diagnosis and management of “brittle diabetes.” This complex and often misunderstood disease affects only a very small minority of patients with type 1 diabetes but requires a considered and careful approach to its diagnosis and treatment. Such issues are discussed within this chapter.

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