Metabolism of blood sugar are now very widespread, and their identification and monitoring of blood glucose levels is a necessary and routine laboratory practice. Strict metabolic control concentration of sugar (glucose) in the blood is necessary to prevent the occurrence of chronic complications of diabetes on the kidneys, eyes, nerves and cardiovascular system. Therefore, a modern approach to diagnosis and therapy involves the determination of glycemia (blood glucose) usually "starving", as well as part of the glucose tolerance test, and in some cases two hours after the main meal. It is particularly important test for determining the so-called. glycosylated hemoglobin (HbA1c), especially in patients with diabetes, as the blood glucose level varies significantly throughout the day.
Test HbA1c is an indicator of blood sugar levels over an extended period of time, during the last three months, which is the average life span of red blood cells. The patient's blood glucose reacts with hemoglobin in red blood cells, and is directly proportional to the level of HbA1c level, glucose, because its value increases with the increase in blood glucose levels. HbA1c is taken from venous blood at any time of the day and should be taken if the patient has eaten or received insulin.
Until recently, the HbA1c value expressed as a percentage of the total hemoglobin, but due to a number of different methods for its determination (HPLC, Immunoturbidimetry) introduced a new way of expression - glycosylated hemoglobin millimoles per mole of total hemoglobin (mmol / mol). For example, the reference range for healthy population of 20 mmol / mol and 42 mmol / mol, which corresponds to the result of four to six percent for its recent expression in percentages. A large number of laboratories issued parallelism both values for ease of understanding.
In diabetics, it is advisable for good sugar control to HbA1c value to be seven percent (or 53 mmol / mol). If the value of this parameter consistently greater than eight percent (or the new 64 mmol / mol), it is necessary for the doctor to change therapy for diabetes.
If it is a person whose property is only a suspicion of diabetes, doctors refer to them first blood test and OGTT. Not badly done immediately and HbA1c test, they will immediately see and fluctuations in blood glucose levels that can not see the previous tests. In patients with good glycemic control achieved it is necessary to control the HbA1c at least twice, and the optimum four times a year, and the changes of treatment.
Does not replace glucose test
It should be noted that this test is not a substitute for the measurement of blood glucose or for the oral glucose tolerance test (OGTT). These tests have different functions, even though used for the diagnosis of diabetes, a glucose level of HbA1c shows a longer period of time. It serves to avoid the daily determination of sugar in the blood, as well as for monitoring the effects of therapy.
author is head of the laboratory sector of laboratory diagnostics "Heksalab".
Source: novosti.rs, Aleksandar Djokic
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Category : Diabetes