Clinical evaluation of measuring glycosylated hemoglobin levels for assessing the long-term blood glucose control in diabetics.

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Abstract
The glycosylated Hb levels were determined in the hemolysates obtained from 14 normal subjects and 67 patients with adult-onset diabetes mellitus, using a column chromatographic procedure. The levels of HbA1a+b and HbA1c and the sum of HbA1a+b and HbA1c (HbA1a+b + HbA1c) in normal subjects averaged 2.3 .+-. 0.4 (SD), 5.3 .+-. 0.8 and 7.6 .+-. 1.0%, respectively. Although a slight increase in HbA1a+b was found in patients with diabetes mellitus (mean .+-. SD = 2.8 .+-. 0.7%), it was not significantly different from that in normal subjects. Despite the wide range, HbA1c and HbA1a+b + HbA1c were significantly increased in patients with diabetes mellitus (6.9 .+-. 1.8% for HbA1c, P < 0.01 and 9.7 .+-. 2.2% for HbA1a+b + HbA1c, P < 0.01). A significant correlation existed between the glycosylated Hb and plasma glucose levels determined in the same blood (r = +0.57, P < 0.001). The glycosylated Hb levels correlated significantly with the average glucose levels for several months preceding the Hb measurements. A striking correlation was evident in the plots of HbA1a+b + HbA1c against the mean plasma glucose for 3 mo. prior to the Hb measurements, which had r = 0.79 (P < 0.001). Apparently the glycosylated Hb reflect the time-averaged blood glucose levels in diabetics for approximately the preceding 3 mo., indicating the usefulness of measuring the glycosylated Hb in assessing long-term blood glucose control in diabetics.

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