Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan

eLife

Yongjin Xu¹  Timothy C Dunn¹  Richard M Bergenstal²  Ramzi A Ajjan³ 

[1] Abbott Diabetes Care, Alameda, United States;International Diabetes Center, Park Nicollet, HealthPartners, Minneapolis, United States;Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom;

关键词: glycated haemoglobin;    red cell lifespan;    kinetic modelling;    complications;    cellular glucose uptake;    continuous glucose monitoring;    Human;   

DOI  :  10.7554/eLife.69456

来源: eLife Sciences Publications, Ltd

【 摘 要 】

Laboratory HbA1c does not always predict diabetes complications and our aim was to establish a glycaemic measure that better reflects intracellular glucose exposure in organs susceptible to complications. Six months of continuous glucose monitoring data and concurrent laboratory HbA1c were evaluated from 51 type 1 diabetes (T1D) and 80 type 2 diabetes (T2D) patients. Red blood cell (RBC) lifespan was estimated using a kinetic model of glucose and HbA1c, allowing the calculation of person-specific adjusted HbA1c (aHbA1c). Median (IQR) RBC lifespan was 100 (86–102) and 100 (83–101) days in T1D and T2D, respectively. The median (IQR) absolute difference between aHbA1c and laboratory HbA1c was 3.9 (3.0–14.3) mmol/mol [0.4 (0.3–1.3%)] in T1D and 5.3 (4.1–22.5) mmol/mol [0.5 (0.4–2.0%)] in T2D. aHbA1c and laboratory HbA1c showed clinically relevant differences. This suggests that the widely used measurement of HbA1c can underestimate or overestimate diabetes complication risks, which may have future clinical implications.

【 授权许可】

CC BY