Glycosylated hemoglobin : decoding , rate , reasons for the increase
Analyses And Studies / / May 07, 2016
- glycosylated hemoglobin - what is it?
- Causes reduce HbA1C
- advantages compared with the conventional analysis for sugar
- As tested?
- Interpretation of test results
glycosylated hemoglobin - what is it?
erythrocytes contain specific iron-containing protein that is needed to transport oxygen and carbon dioxide.Glucose (sugar, carbohydrates) can not enzymatically coupled with it, forming glycated hemoglobin (HbA1C).This process is significantly accelerated by the increased concentration of sugar (hyperglycemia).The average life span of red blood cells in an average of about 95 - 120 days, so the HbA1C level displays integrated glucose concentration over the past 3 months.Normal b
Causes increase is primarily related to the violation of carbohydrate metabolism and long-term high glucose in the blood in such cases:
- Diabetes mellitus type 1 (insulin-dependent) - when insufficient insulin (pancreas hormone) is broken utilization of carbohydrates the body's cells, which leads tolong-term increase in the concentration.
- Diabetes mellitus type 2 (non-insulin dependent) - is associated with impaired glucose utilization in normal insulin production.
- Improper treatment of elevated levels of carbohydrates, leading to prolonged hyperglycemia.
reasons for increase of glycated hemoglobin, is not related to the concentration of glucose in the blood:
- alcohol poisoning;
- poisoning by lead salts;
- iron deficiency anemia;
- removal of the spleen - the spleen is an organ in which the utilization of red blood cells (the "graveyard" of red blood cells), so its absence leads to an increase in their life expectancy and improve HbA1C;
- uremia - lack of kidney function causes accumulation of blood metabolites and education karbogemoglobina, which is similar to the glycosylation properties.
Causes reduce HbA1C
indicator Reduction of glycated hemoglobin is a pathological symptom, occurs in such cases:
- Severe blood loss - with normal hemoglobin and glycosylated lost.
- blood transfusion (blood transfusion) - diluting its normal HbA1C fraction, which is not connected with carbohydrates.
- Hemolytic anemia (anemia) - a group of hematological diseases in which the average life span of red blood cells is reduced, respectively, before they perish, and cells with glycosylated HbA1C.
- Prolonged hypoglycemia - a decrease in glucose.
Keep in mind that a defective form of hemoglobin can distort the analysis results and give a false increase or decrease in its glycosylated form.
advantages compared with the conventional analysis of sugar glucose
Content - labile component, which changes under the influence of various factors:
- Ingestion - cause an increase in peak concentration of carbohydrates, which returned to normal within a few hours.
- emotional factor stress the day before delivery of the analysis increases in blood glucose due to hormone production, increase its level.
- Reception antidiabetic drugs, physical activity reduces glucose.
Therefore, one-stage test for sugar levels can show it to increase, which is not always evidence of a violation of its exchange.Conversely, normal maintenance - does not mean there are no problems with carbohydrate metabolism.On the level of glycosylated hemoglobin defective these factors do not affect.That is why its definition - an objective measure in early detection of disorders of carbohydrate metabolism in the body.
Indications for study:
Overall, the study conducted for an objective determination of violation of carbohydrate metabolism and is performed in such cases:
- Diabetes mellitus type 1, accompanied by a pronounced irregular carbohydrates over a short period of time.
- Early determination of the presence of diabetes mellitus type 2.
- Violation of carbohydrate metabolism in children.
- diabetes with abnormal renal threshold, when a significant portion of carbohydrates excreted by the kidneys.
- Women who are pregnant and who have diabetes have been identified, type 1 or 2 before.Gestational diabetes
- - increase in blood sugar levels during pregnancy, when the earlier diabetes never had.Analysis of sugar in which case it may show a decrease as much of the nutrients from the blood are transferred to the growing fetus.
- control therapy - the value of glycosylated hemoglobin shows the concentration of sugar over a long period of time, allowing you to judge the effectiveness of the treatment, which for diabetics by the results of the analysis can be adjusted.
Why is it important to identify as early as possible violations of sugar metabolism in the body?
Prolonged high blood sugar level indicator leads to irreversible consequences in the body due to its binding with proteins, namely:
- defective glycosylated HbA1C no longer performs the oxygen transport function adequately, which causes tissue hypoxia and organ.The higher the score, the more reduced the level of oxygen in the tissues.
- Visual disturbances (retinopathy) - binding of glucose to the retinal proteins and lens of the eye.
- Renal failure (nephropathy) - postponement of carbohydrates in the renal tubules.
- heart disease (cardiomyopathy) and vascular.
- Violation of peripheral nerve bodies (polyneuropathy).
vein for analysis of whole blood is taken in an amount of 2.5 ml and mixed with an anticoagulant to prevent its collapse.This makes it possible to store up to 1 week, temperature + 2 ° C 5 no particular recommendations before a blood test for glycosylated hemoglobin are not needed, unlike the sugar test.
frequency definition of the laboratory index in diabetes is the same for both men and women, and is the frequency in 2 - 3 months when I type, 6 months - II of type.Pregnant - control at 10 - 12 weeks of gestation with a mandatory analysis of sugar.
Interpretation of test results
Transcription analysis of values to determine the level of HbA1C is not complicated.Its increase of 1% from the norm corresponds to an increase of glucose concentration by 2 mmol / L.Such HbA1C indicators with the appropriate level of glucose and the state of carbohydrate metabolism can be presented in tabular form:
level of HbA1C,%
average concentration of glucose in the last 3 months, mmol / l
carbohydrate exchange is normal, there is no diabetes
prediabetes, diabetes, compensated,lack of effectiveness of its treatment
Subcompensated diabetes should pay attention to the possible emergence of its complications
10 and above
Decompensated diabetes with the development of irreversible changes
diabetes mellitus - a serious disease with long-term chronic increase in blood sugar levels and the emergence of irreversible complications.
in modern laboratory diagnostics used in the analysis of glycated hemoglobin (HbA1C), which shows the integral index of the concentration of sugar in the past 3 months, allowing you to objectively assess the quality of the treatment of carbohydrate metabolism disorders or spend their early diagnosis.
Diabetes mellitus - a serious disease with long-term chronic increase in blood sugar levels and the emergence of irreversible complications.In modern laboratory diagnostics used in the analysis of glycated hemoglobin (HbA1C), which shows the integral index of the concentration of sugar in the past 3 months, allowing you to objectively assess the quality of the treatment of carbohydrate metabolism disorders or spend their early diagnosis.