行业动态
Interpretation of HbA1c - 5 Key Points in clinical application
Published：2017-12-04
Source：[英文]世界杯直播
Glycated hemoglobin (HbA1c) does not affected by transient elevation of blood sugar. It can reflect average blood sugar level in the past 2-3 month with high stability. HbA1c is considered an important indicator of long-term management of patients with blood glucose control and monitoring of blood glucose levels of diabetes. Its content mainly depends on the blood glucose concentration and the contact time between blood glucose and hemoglobin. The biological variation between individuals is less than 2.0%.
HbA1c is also an important basis in adjusting treatment in clinical therapy. It has very important value in the diagnosis and evaluation of diabetes. Blood glucose control with HbA1c as the goal can reduce the risk of diabetic microvascular and macrovascular complications.
The synthesis rate of glycated hemoglobin is proportional to the concentration of sugar in the environment in which hemoglobin is located. Its biological variability is small, and properties are relatively stable. It does not require patients to reserve an empty stomach in blood collection. It can be collected at any time and is not affected by meals. Compared with intravenous blood glucose, it can reflect the long-term blood glucose situation.
One: Clinical Value
Long-term Blood Glucose Monitoring in Diabetes
In the clinical diagnosis and treatment of diabetic patients, the measurement of a single blood glucose can only reflect the blood glucose level at the time of blood drawing, and the blood glucose changes along with eating and glucose metabolism, which cannot explain the overall picture of the disease for a long period of time. By detecting the changes in the content of glycated hemoglobin in the patient, the average blood glucose level of the patient in the last 2 to 3 months can be obtained.
Diagnosis of Diabetes
Glycated hemoglobin can be used not only as an indicator of diabetes monitoring, but also as an early indicator of diabetes. In 2010, ADA included HbA1c ≥ 6.5% as a diagnostic criterion for diabetes.
Helps Detect and Prevent Chronic Complications Of Diabetes
By monitoring the content of glycated hemoglobin in diabetic patients, it is possible to effectively monitor the changes in patients' blood glucose levels in the near future and determine the occurrence and development of complications in diabetic patients through the test results.
Indicators of Diabetes Control During Pregnancy
It is of great significance for the prevention of the development of huge fetuses, malformed fetuses, stillbirths, and acute and chronic complications of pregnant women with diabetes.
Differential Diagnosis of Stress Hyperglycemia
For coma whose cause is unclear or who are being infused with glucose (blood glucose increased), it is of great value to diagnose glycated hemoglobin urgently. For diabetic patients with particularly high glycated hemoglobin, we should be alert to the occurrence of acute comorbidities such as ketoacidosis.
Two: Influence Factor
Glycated hemoglobin is the combined product of hemoglobin and glucose in red blood cells. Therefore, any factors that cause changes in the quantity and quality of hemoglobin will interfere with the determination of HbA1c and affect the results. Interfering factors include hemoglobin disease, derived hemoglobin, abnormalities in the life cycle of red blood cells, drugs, certain disease states, pregnancy, etc.
Three: Target Control
Glycated hemoglobin control
Applicable people
＜6%
1. New diagnosis, young, no complications and associated diseases, hypoglycemic treatment without side effects such as hypoglycemia and weight gain;
2. People who do not need glucose intervention;
3. Diabetes with pregnancy;
4. Newly discovered diabetes during pregnancy
＜6.5%
1. < 65 years old without diabetes complications and severe associated diseases;
2. Diabetic patients planning for pregnancy
＜7.0%
1. < 65 years of age using insulin therapy;
2. ≥ 65 years old, no risk of hypoglycemia, good organ function, survival time> 15 years;
3. Diabetic patients who plan to receive insulin treatment
≤ 7.5%
People who already have cardiovascular disease or have a very high risk of cardiovascular disease
＜8.0%
≥ 65 years old, with an expected survival period of 5 to 15 years;
＜9.0%
1. ≥ 65 years old or the expected survival time of malignant tumor is < 5 years;
2. People at high risk of hypoglycemia;
3. People who have difficulty in implementing the treatment plan such as mental, intellectual or visual impairment;
4. Medical conditions are too bad
Studies have found that if diabetic patients can reduce the level of glycated hemoglobin to below 7%, the complications of diabetes will be greatly reduced. If the glycated hemoglobin is> 9%, it means that patients with persistent high blood sugar will develop diabetic nephropathy, arteriosclerosis, retinopathy, etc. Complications, and there may be acute complications such as ketoacidosis.
Therefore, it is recommended that if diabetic patients have reached the standard for glycemic control, and the state of glycemic control is relatively stable, they should receive at least 2 glycated hemoglobin tests every year. Patients should have glycated hemoglobin measurement every 3 months.
Beijing Strong Biotechnologies Inc.
Gcell
Glycated hemoglobin assay reagent
Applicable
instruments
This kit is suitable for all kinds of automatic biochemical analyzers. It is recommended that customers use this kit on biochemical analyzers for testing and verify based on laboratory conditions.
Reference interval
With reference to relevant literatures, and through data verification, the normal reference interval of our company is: 4-6%.
It is recommended that each laboratory establish its own normal reference interval based on age, gender, diet, and region.