Glycosylated Hemoglobin Assays in the Management and Diagnosis of Diabetes Mellitus

doi:10.1059/0003-4819-101-5-710

Glycosylated Hemoglobin Assays in the Management and Diagnosis of Diabetes Mellitus

Excerpt

Glycosylated hemoglobins represent stable ketoneamine or aldehyde-amine linkages formed by a nonenzymatic, post-translational process of glycosylation of hemoglobin that occurs throughout the lifespan of the erythrocyte (1). The finding that glycosylated hemoglobin levels may be elevated up to three times normal in persons with diabetes mellitus led to consideration of glycosylated hemoglobin measurement as an aid for diagnosing and managing these patients (2-4).

Hemoglobin A is the major component of hemoglobin, comprising approximately 90% of hemoglobin found in the erythrocytes of average normal adults. Some glycosylated hemoglobins are negatively charged and thus migrate more quickly than hemoglobin A on cation

Acknowledgments

ACKNOWLEDGMENTS: The Clinical Efficacy Assessment Project (CEAP) of the American College of Physicians is designed to evaluate and inform College members and others about the safety and efficacy of diagnostic and therapeutic modalities. Evaluation of technologies begins with a notice in the Annals of Internal Medicine and the ACP Observer inviting comments. Appropriate members of the Council of Medical Societies and the Council of Subspecialty Societies as well as other experts are asked to review technologies. The CEAP statements thus represent a synthesis of the literature and expert opinion and are intended to reflect the current state-of-the-art knowledge concerning a technology. Statements may be reconsidered as new information becomes available.

Article and Author Information

↵* This paper was authored by J. Sanford Schwartz, M.D., and Carolyn M. Clancy, M.D., and was developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Donald E. Olson, M.D., Chairman; David Banta, M.D.; Howard S. Frazier, M.D.; Richard B. Hornick, M.D.; Seymour Perry, M.D.; and Wilus C. Maddrey, M.D. Members of the Health and Public Policy Committee for the 1984-85 term include Edwin P. Maynard III, M.D., Chairman; John H. Eisenberg, M.D.; Richard G. Farmer, M.D.; Daniel D. Federman, M.D.; John R. Hogness, M.D.; Leo E. Hollister, M.D.; Charles E. Lewis, M.D.; Donald E. Olson, M.D.; Malcolm L. Peterson, M.D.; Theodore B. Schwartz, M.D.; and Helen L. Smits, M.D. This paper was adopted by The Executive Committee of the Board of Regents on 13 September 1984.
Grant support: The Clinical Efficacy Assessment Project is funded by the John A. Hartford Foundation.
▸Requests for reprints should be addressed to Linda Johnson White; Clinical Efficacy Assessment Project, Department of Health and Public Policy, American College of Physicians, 4200 Pine Street; Philadelphia, PA 19104.