HbA1c: An Important Biomarker in diagnosis and prognosis of diabetes patients

 

One of the main purposes of laboratory tests is to aid medical reasoning after obtaining the clinical history and performing the physical examination by the laboratory team. To this end, all test execution phases, especially the pre-analytical phase, must be conducted following the technical rigor necessary to ensure patient safety and accurate results, so that the conduction of the patient's prognosis is more assertive.

The measurement of HbA1c, when measured in whole blood, by immunoturbidimetric assay, in biochemical equipment from the XL family, such as the XL 200 equipment, plays an important role in the diagnosis of Diabetes.

Diabetes is a global endemic with rapidly increasing prevalence in both developing and developed countries. The American Diabetes Association has recommended glycated hemoglobin (HbA1c) as a possible substitute to fasting blood glucose for diagnosis of diabetes. HbA1c is an important indicator of long-term glycemic control with the ability to reflect the cumulative glycemic history of the preceding two to three months. The valuable information provided by a single HbA1c test has rendered it as a reliable biomarker for the diagnosis and prognosis of diabetes.

Hemoglobin A1c was first separated from other forms of hemoglobin by Huisman and Meyering in 1958 using a chromatographic column. Its increase in diabetes was first described in 1969 by Samuel Rahbar et al.

When sugar enters our bloodstream, it attaches to hemoglobin, in red blood cells. Everybody has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of red blood cells that have sugar-coated hemoglobin.

XL 200, biochemistry analyzer, from the XL family, for measuring analytes, such as HbA1c.

A normal A1c level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1c, the greater your risk is for developing type 2 diabetes.

Glycated hemoglobin testing is recommended for both checking the blood sugar control in people who might be prediabetic and monitoring blood sugar control in patients with more elevated levels, termed diabetes mellitus. For a single blood sample, it provides far more revealing information on glycemic behavior than a fasting blood sugar value. The American Diabetes Association guidelines are similar to others in advising that the glycated hemoglobin test be performed at least twice a year in patients with diabetes who are meeting treatment goals and quarterly in patients with diabetes whose therapy has changed or who are not meeting glycemic goals.

Transasia is proud to have helped more than 5,000 laboratories across India to serve more than 24 Lac patients, for their HbA1c test through XL HbA1c kit on Fully automatic Biochemisrtry analysers in FY 22-23. To serve more than 50,000 Laboratories across India having Semi-Automatic biochemistry analysers, Transasia has recently launched Hba1c kit in Liquixx range to perform HbA1c test on any SAA. Liquixx HbA1c boasts of a linearity up to 16 %, and excellent correlation with Gold Standard HPLC.

Author: Gaurav Bhide, Product Manager Biochemistry.

 

BIBLIOGRAPHIC REFERENCES

1.       Huisman TH, Martis EA, Dozy A (1958). "Chromatography of hemoglobin types on carboxymethylcellulose". J. Lab. Clin. Med. 52 (2): 312–327. PMID 13564011.

2.       Rahbar S, Blumenfeld O, Ranney HM (1969). "Studies of an unusual hemoglobin in patients with diabetes mellitus". Biochem. Biophys. Res. Commun. 36 (5): 838–843. doi:10.1016/0006-291X(69)90685-8. PMID 5808299.

3.       American Diabetes Association (2007). "Standards of medical care in diabetes". Diabetes Care. 30 (Suppl 1): S4–S41. doi:10.2337/dc07-S004. PMID 17192377.