Addressing shortfalls of laboratory HbA(1c) using a model that incorporates red cell lifespan Journal Article uri icon
  • Laboratory HbA(1c) 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(1c) 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(1c), allowing the calculation of person-specific adjusted HbA(1c) (aHbA(1c)). 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(1c) and laboratory HbA(1c) 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(1c) and laboratory HbA(1c) showed clinically relevant differences. This suggests that the widely used measurement of HbA(1c) can underestimate or overestimate diabetes complication risks, which may have future clinical implications.

  • Link to Article
    publication date
  • 2021
  • published in
  • eLife  Journal
  • Research
  • Blood
  • Diabetes
  • Drugs and Drug Therapy
  • Measurement
  • Monitoring, Physiologic
  • Additional Document Info
  • 10