In vitro determination of hemoglobin A1c for diabetes diagnosis and management: technology update

It is fascinating to consider the analytical improvements that have occurred since glycated hemoglobin was first used in routine clinical laboratories for diabetes monitoring around 1977; at that time methods displayed poor precision, there were no calibrators or material with assayed values for qua...

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Bibliographic Details
Published inPathology and Laboratory Medicine International Vol. 6; no. default; pp. 21 - 31
Main Authors John, Garry, English, Emma, Milosevich, Elise
Format Journal Article Book Review
LanguageEnglish
Published Macclesfield Taylor & Francis Ltd 01.07.2014
Dove Medical Press
Subjects
Anemia
Cardiovascular disease
Diabetes
Glucose
Heart attacks
Hemodialysis
Hemoglobin
Hyperglycemia
Insulin resistance
Metabolism
Patients
Prevention programs
Studies
United Kingdom > UK
England
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Summary:It is fascinating to consider the analytical improvements that have occurred since glycated hemoglobin was first used in routine clinical laboratories for diabetes monitoring around 1977; at that time methods displayed poor precision, there were no calibrators or material with assayed values for quality control purposes. This review outlines the major improvements in hemoglobin A1c (HbA1c) measurement that have occurred since its introduction, and reflects on the increased importance of this hemoglobin fraction in the monitoring of glycemic control. The use of HbA1c as a diagnostic tool is discussed in addition to its use in monitoring the patient with diabetes; the biochemistry of HbA1c formation is described, and how these changes to the hemoglobin molecule have been used to develop methods to measure this fraction. Standardization of HbA1c is described in detail; the development of the IFCC Reference Measurement Procedure for HbA1c has enabled global standardization to be achieved which has allowed global targets to be set for glycemic control and diagnosis. The importance of factors that may interfere in the measurement of HbA1c are highlighted.
ISSN:1179-2698
1179-2698
DOI:10.2147/PLMI.S48403