From North Carolina, USA:
My daughter is six years old and was diagnosed typeá1 about a year ago. She takes two shots a day of combined NPH and Regular. I recently read a book, printed in 1997, that said that the average of blood glucose levels determined by the hemoglobin A1c test, not whether you have periods of highs and lows, determines the long-term complications. Is there any updated information on this?
The HbA1c value reflects the amount of glucose that is bound to the hemoglobin molecule, and there have been several studies which relate average blood sugar levels to the A1c. However, glycosylation of hemoglobin, itself, is of no physiological importance except as a mirror of the related linking of glucose to other proteins that form the walls of small blood vessels especially in the eye and the kidney. Increased glycosylation in these situations, over time, will produce structural and functional changes which are the basis of complications.
The exact biochemical mechanisms underlying all this are very complex, but you may come to read of AGE's (Advanced Glycation End products) which are smaller molecules that play a part in effecting these changes and which can be measured in the serum. Day to day fluctuations in blood sugars obviously do affect A1c levels. It almost impossible to interpret their significance unless you can calculate an average concentration of blood glucose which is of course what the A1c does.
Last Updated: Tuesday April 06, 2010 15:09:14
This Internet site provides information of a general nature and is designed for educational purposes only. If you have any concerns about your own health or the health of your child, you should always consult with a physician or other health care professional.
This site is published by T-1 Today, Inc. (d/b/a Children with Diabetes), a 501c3 not-for-profit organization, which is responsible for its contents. Our mission is to provide education and support to families living with type 1 diabetes.
© Children with Diabetes, Inc. 1995-2018. Comments and Feedback.