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Journal article
One HbA1c Measurement Does Not Tell the Whole Story – 5 Case Studies
Clinical laboratory science, Vol.28(4), pp.232-237
10/01/2015
Abstract
Red blood cells (RBCs) are freely permeable to glucose and do not require insulin to facilitate its transport. [...]a percent of hemoglobin is glycated in all individuals, those without diabetes (HbA1c reference range <5.7%), and those with type 1 and type 2 diabetes. The HbA1c value has a high correlation with average blood glucose for the previous 2-3 months in individuals with either type 1 or type 2 diabetes.6.7 The look back time period is related to the average time that a hemoglobin molecule is available for glycation. The average life span of RBCs is 120 days.11 Conditions that alter the life span of the RBC, such as hemolytic anemia, iron deficiency anemia, and blood loss will negate this association.12 The student should be educated that the presence of hemoglobin variants, such as HbS, HbE and HbC, interferes with some HbA1c methods.10'13 As yet undetermined variability between individuals can also affect the rate of glycation.14 The ADA continues to recommend bi-annual measurement of HbA1c for individuals with diabetes who are in good glycemic control, and more frequent testing if therapy has changed.10 Blood glucose is influenced by diet, hydration, exercise, illness, and medication. Because the glucose was not steady state, the final HbAlc of 10.8% (with its eAG of 263 mg/dL) was misleading.
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Details
- Title
- One HbA1c Measurement Does Not Tell the Whole Story – 5 Case Studies
- Publication Details
- Clinical laboratory science, Vol.28(4), pp.232-237
- Resource Type
- Journal article
- Publisher
- American Society for Clinical Laboratory Science
- Copyright
- Copyright 2015 American Society for Clinical Laboratory Science Inc. All rights reserved.
- Identifiers
- 99380185568706600
- Academic Unit
- Usha Kundu, MD College of Health; Medical Laboratory Sciences
- Language
- English