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 AIc, 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 semi-quantitatively four times per day. As Hb AI was correlated highly with Hb AIc (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 AI 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 AI with the mean values of these glycaemic parameters for each week of the study demonstrated low order correlations with the glycaemic measures of Week 1, and a progressive increase in the degree of correlation reaching a plateau with the glycaemic 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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Rahbar, S.: An abnormal hemoglobin in the red cells of diabetics. Clin. Chim. Acta22, 296–298 (1968)
Rahbar, S., Blumenfield, O., Ranney, H.M.: Studies of an unusual hemoglobin in patients with diabetes mellitus. Biochem. Biophys. Res. Commun.36, 838–843 (1969)
Bunn, H.F., Haney, D.N., Gabbay, K.H., Gallop, P.M.: Further identification of the nature and linkage of the carbohydrate in hemoglobin AIc. Biochem. Biophys. Res. Commun.67, 103–109 (1975)
Bookchin, R. M., Gallop, P. M.: Structure of hemoglobin AIc. Nature of the N-terminal B-chain blocking group. Biochem. Biophys. Res. Commun.32, 86–93 (1968)
Koenig, R. J., Blobstein, S. H., Cerami, A.: Structure of carbohydrate on hemoglobin AIc. J. Biol. Chem.252, 2992–2997 (1977)
Bunn, H. F., Haney, D. M., Kamin, S., Gabbay, K. H., Gallop, P.M.: The biosynthesis of human hemoglobin AIc: Slow glycosylation of hemoglobin in vivo. J. Clin. Invest.57, 1652–1659 (1976)
Gabbay, K. H., Hasty, K., Breslow, J. L., Ellison, R. C., Bunn, H. F., Gallop, P. M.: Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus. J. Clin. Endocrinol. Metab.44, 859–864 (1977)
Trivelli, L. A., Ranney, H. M., Lai, H.-T.: Hemoglobin components in patients with diabetes mellitus. N. Engl. J. Med.284, 353–357 (1971)
Harris, J. W., Kellermeyer, R. W.: Red cell destruction and the hemolytic disorders (Chapter 9). In: The red cell. Revised ed., pp. 517–523. Cambridge: Harvard Press 1970
Peterson, C. M., Jones, R. L.: Minor hemoglobins, diabetic “control” and diseases of postsynthetic protein modification. Ann. Intern. Med.87, 489–491 (1977)
Ditzel, J., Kjaergaard, J.-J.: Hemoglobin AIc concentrations after initial insulin treatment for newly discovered diabetes. Med. J.1, 741–742 (1978)
Koenig, R. J., Peterson, C. M., Jones, R. L., Saudek, C. D., Lehrman, M., Cerami, A.: Correlation of glucose regulation and hemoglobin AIc in diabetes mellitus. N. Engl. J. Med.295, 417–420 (1976)
Dolhofer, R., Stadele, A., Wieland, O. H.: Clinical and biochemical studies on the significance and formation of hemoglobin AIc, and AIa+b in diabetes mellitus. Klin. Wochenschr.55, 945–954 (1977)
Gonen, B., Rubenstein, A. H., Rochman, H., Tanega, S. P., Horwitz, D. L.: Hemoglobin AI: An indicator of the metabolic control of diabetic patients. Lancet1977 II, 734–736
Karamanos, B., Christacopoulos, P., Zachariou, N., Korkolis, S.: Rapid changes of the hemoglobin AIc (Hb AIc) fraction following alterations of diabetic control. Diabetologia13, 406 (1977)
Cole, R. A., Soeldner, J. S., Dunn, P. J., Bunn, H. F.: A rapid method for the determination of glycosylated hemoglobins using high pressure liquid chromatography. Metabolism27, 289–301 (1978)
Leon, L., Rush, R. L., Turrell, J.: Automated simultaneous cholesterol and triglyceride determination of the Auto-Analyzer instrument. In: Advances in automated analysis, Vol. 1. Technicon International Congress-1970, pp. 503–507. Miami, Florida: Thurman Assoc. 1971
Boden, G., Soeldner, J. S.: A sensitive double antibody radioimmunoassay for human growth hormone (HGH): Levels of HGH following rapid tolbutamide infusion. Diabetologia3, 413–421 (1967)
Alpert, N. L.: Instrument Series: Report No. 14, Glucose Analyzer and BUN Analyzer. Lab World24, 40–47 (1973)
Sumner, J. B.: A more specific reagent for determinations of sugar in urine. J. Biol. Chem.65, 393–395 (1925)
Armor, D. J., Couch, A. S.: The data text primer, pp. 59–63, 71–74, 92–93. New York: The Free Press 1972
Huisman, T. J. H., Dozy, A. M.: Studies on the heterogeneity of hemoglobin. V. Binding of hemoglobin with oxidized glutathione. J. Lab. Clin. Med.60, 302–319 (1962)
Hansen, A.-P.: Abnormal serum growth hormone response to exercise in juvenile diabetics. J. Clin. Invest.49, 1467–1478 (1970)
Hansen, A.-P.: Serum growth hormone patterns in female juvenile diabetics. J. Clin. Endocrinol. Metab.36. 638–646 (1973)
Passa, P., Sauville, C., Canivet, J.: Influence of muscular exercise in plasma levels of growth hormone in diabetics with and without retinopathy. Lancet1974 II, 72–74
Hanssen, K. F.: Immunoreactive growth hormone in plasma and urine in juvenile diabetics before and during initial insulin treatment. Acta Endocrinol. (Kbh.)75, 50–63 (1974)
Peterson, C. M., Jones, R.L., Koenig, R. J., Melvin, E.T., Lehrman, M. L.: Reversible hematologic sequelae of diabetes mellitus. Ann. Intern. Med.86, 425–429 (1977)
Peterson, C.M., Koenig, R.J., Jones, R. L., Saudek, C.D., Cerami, A.: Correlation of serum triglyceride levels and Hb AIc concentrations in diabetes mellitus. Diabetes26, 507–509 (1977)
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Dunn, P.J., Cole, R.A., Soeldner, J.S. et al. Temporal relationship of glycosylated haemoglobin concentrations to glucose control in diabetics. Diabetologia 17, 213–220 (1979). https://doi.org/10.1007/BF01235857
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DOI: https://doi.org/10.1007/BF01235857