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Determination and Significance of Glycosylated Hemoglobin (HbA1c)

Ⅰ. Determination of hemoglobin a1c test kit


For diabetic patients, glycated hemoglobin is an important indicator of disease. However, according to the latest study of the IMPROVETM global project started in 2006, 51% of patients have never heard of glycated hemoglobin, and more than 10% of physicians tested their patients less than once a year.


In China, only 1/4 of physicians recognize that the hemoglobin a1c test kit is an important criterion for measuring blood sugar control.


Normal people have three types of hemoglobin, which is HbA, HbF and HbA2, while red blood cells of adults mainly contain HbA. When separating hemoglobin by chromatography method, three sugar-containing components can be eluted, which is HbA1a, HbA1b and HbA1c. They are collectively referred to as glycosylated hemoglobin.


HbA1c is glucosylated hemoglobin and two other kinds are glycated hemoglobin formed by other sugars. Glycated hemoglobin is formed by the combination of HbA and glucose during metabolism, so it can accurately reflect the glucose level in blood.


The determination methods of glycosylated hemoglobin mainly include high pressure liquid method, colorimetric method, chromatography method, electrophoresis method and hemoglobin a1c test kit, etc.


Normal reference value: The average HbA1 of healthy adults is 6.5%, and the range is 5.0% to 8.0%.


Ⅱ. Clinical significance of hemoglobin a1c test kit


1. The measurement of glycated hemoglobin is used to assess the degree of control of diabetes. When diabetes is poorly controlled, the concentration of glycated hemoglobin can be two times more than normality. Because glycated hemoglobin is formed by the non-enzymatic binding of sugars formed after the production of hemoglobin.


Its synthesis process is slow and relatively irreversible, persisting throughout the 120-day lifespan of red blood cells. Its synthesis rate is proportional to the concentration of sugar in the environment in which the red blood cells are exposed.


Therefore, the ratio of glycated hemoglobin can reflect the average blood glucose level in the 1-2 months before the measurement. The renal function test hemoglobin a1c test kit has become a good indicator of the blood sugar control level of diabetes for a long time.


If the HbA1 concentration is higher than 10%, the insulin dose needs to be adjusted. In diabetic patients under monitoring, a 2% change in HbA1 concentration has clinical significance.


2. The measurement of this item cannot be used to diagnose diabetes or determine day-to-day glucose control, nor can it be used to replace daily home examination of urine or blood glucose.


3. If hemoglobin a1c test kit levels are below defined reference ranges, it may indicate a recent episode of hypoglycemia, the presence of an Hb variant, or a shortened lifetime of red blood cells.


4. Any reason to shorten the lifetime of red blood cells will reduce the duration of exposure of red blood cells to glucose. And then HbA1c will reduce, even though the mean blood glucose level may be elevated during this time.


The shortened lifetime of red blood cells may be due to hemolytic anemia or other hemolytic diseases, sickle cell trait, pregnancy, blood loss or chronic blood loss.

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