Addressing Shortfalls of Laboratory HbA Using a Model That Incorporates Red Cell Lifespan

Overview

Journal Elife

Specialty Biology

Date 2021 Sep 13

PMID 34515636

Citations 12

Authors

Yongjin Xu

Richard M Bergenstal

Timothy C Dunn

Ramzi A Ajjan

Affiliations

Soon will be listed here.

Abstract

Laboratory HbA 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 HbA 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 HbA, allowing the calculation of person-specific adjusted HbA (aHbA). Median (IQR) RBC lifespan was 100 (86-102) and 100 (83-101) days in T1D and T2D, respectively. The median (IQR) absolute difference between aHbA and laboratory HbA 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. aHbA and laboratory HbA showed clinically relevant differences. This suggests that the widely used measurement of HbA can underestimate or overestimate diabetes complication risks, which may have future clinical implications.

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