Original articleGlycosylated hemoglobin (Hb Ai) as an indicator of therapy effects in different clinical types of diabetes
Review articleOpen access
Abstract:

AbstractThe levels of glycosylated hemoglobin (Hb AI), intermittent glycemia and glycosuria over 24 hr, Mw index, fasting serum cholesterol and triglycerides, and 24-hr proteinuria were determined in 20 healthy subjects and 88 diabetics representing different clinical types of diabetes mellitus. In each of the subjects all the tests were carried out on a single day. The other investigations included endogenous creatinine clearance, ECG and ophthalmoscopic examination of the eye-fundus.The mean Hb AI levels in the “A” control group (up to 40 yr of age) and in the “B” control group (41–60 yr) were X̄ ± SD = 6.8 ± 0.65% and X̄ ± SD = 6.49 ± 0.99% of the total hemoglobin concentration, respectively. A significant increase in Hb AI concentration was found in all the diabetic patients. The increase, independent of the subject's age, clinical type of diabetes and the therapy employed, was related to the degree of hyperglycemia.In Type I diabetes there was no positive correlation between Hb AI concentration on the one hand and fasting glycemia, the 24-hr profile of glycemia, glycosuria and Mw index on the other. The latter indices of diabetes mellitus control seem thus to differ in value and significance. In Type II diabetes, both newly-diagnosed and of long duration, treated with the sulfonylurea derivatives, a marked correlation was found between Hb AI level and fasting glycemia, the mean value of 8 glycemia determinations over 24-hr, Mw index and 24-hr glycosuria. In Type II diabetes treated with insulin a correlation was established between Hb AI and other findings, except fasting glycemia. Hence, in diabetes of a more stable course, as opposed to Type I diabetes, determination of Hb AI is of less value.Triglyceride concentration was correlated with Hb AI concentration only in Type II diabetes of long duration, treated with the sulfonylurea derivatives. A significant correlation between Hb AI and cholesterol concentrations was found only in newly-diagnosed Type I diabetes.A comparative analysis of the results obtained seems to suggest that Hb AI concentration is also an indicator of the effects of diabetes therapy over longer intervals.

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