A theoretical model to predict the behavior of glycosylated hemoglobin levels☆
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Protein glycation – biomarkers of metabolic dysfunction and early-stage decline in health in the era of precision medicine
2021, Redox BiologyCitation Excerpt :The steady-state level of A1C in vivo is influenced by deglycation of glycation adducts by fructosamine 3-kinase (FN3K) [23,24], red blood cell lifespan (mean 120 days) and glycemic control over the previous 90–120 days [25]. A1C is a weighted measure of mean blood glucose concentration during the 120 days prior to measurement; blood glucose levels in the 30 days immediately prior to blood sampling contribute approximately 50%, whereas levels in prior 90–120 contribute only 10% [26–28]. A1C is a valuable biomarker of medium-term glycemic control, with the disadvantage that intervention trials to improve dysglycemia in prediabetes and hyperglycemia in diabetes must be at least 3 months duration for responsiveness of A1C [29].
Steady-state relationship between average glucose, HbA1c and RBC lifespan
2018, Journal of Theoretical BiologyThe relationship between fasting plasma glucose and HbA<inf>1c</inf> during intensive periods of glucose control in antidiabetic therapy
2014, Journal of Theoretical BiologyCitation Excerpt :Another major limitation which prevents a detailed kinetic analysis is that we do not have a sufficiently good model of glucose changes during the course of treatment; although glucose changes are roughly linear in the first couple of weeks, it remains to be investigated to what extent patients respond to glucose control, and over what timescales. Kinetic models of plasma glucose, hemoglobin and HbA1c have been investigated by several authors since Higgins and Bunn (1981), Beach (1979), Osterman-Golkar and Vesper (2006), Svacina et al. (1990), Hamren et al. (2008), and many of the questions raised there continue to be important in developing a satisfactory understanding of the factors that influence glycation of hemoglobin in diabetes. Finally, we discuss the potential generalization of these ideas to other populations.
Glycated haemoglobin: What is the diagnostic yield at shortened testing intervals?
2011, Diabetes Research and Clinical PracticeCitation Excerpt :Based on expert consensus, a recent American Diabetes Association guideline recommends measuring glycated haemoglobin A1c (HbA1c) at 3–6 monthly interval [1], although significant change in HbA1c level may occur within 30 days of large mean blood glucose fluctuations [2,3].
Increased a1c among adult emergency department patients with type 2 diabetes
2011, Annals of Emergency MedicineCitation Excerpt :An increased A1C level was most strongly associated with an increased ED glucose level, followed by individuals aged 40 to 59 years, Medicaid insurance, and black race. The increases in A1C level reflect long-term control that is not substantially influenced by recent fluctuations in glucose level.8-10 Our findings are consistent with the ED glucose as a marker for longer-term dysglycemia, whereas physiologic stresses or recent caloric ingestions do not alone account for hyperglycemia.
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This manuscript was prepared under NIH grant No. SRC 5 R01 HL20381, “Long-Term Study of Diabetic Vascular Disease” at the University of Washington Department of Surgery.