ABSTRACT

In this article, biochemistry and methods of determination of glycated hemoglobin (HbA1c) and their utilization for monitoring long-term glycemic control of diabetes mellitus are reviewed.

Monitoring the glycaemic state of patients is cornerstone of diabetic care. The tests used most widely in monitoring the glycemic status of people with diabetes are blood glucose and glycated hemoglobin.

As blood glucose level determination is an indicator of acute glycemic state, HbA1c value reflects mean glucose level during the previous 2-3 months' period and is a useful indicator for risk assessment of diabetic complications.

HbA1c levels of the all diabetic patients should be determined at the commencement of treatment as well as for monitoring purposes with the interval of twice a year and once in each three months period, for stable diabetic cases and for unstable cases like insulin dependent diabetics, respectively.

Despite existence of more than 30 various methods for determination of HbA1c level in blood samples, each technique has its unique property concerning the analyte determined and the sorts of interferences. Nevertheless, the effort for the internationally accepted standardization for determination of HbA1c levels is yet on the way.

Thus, physicians should take the method characteristics and the possible interferent analytes (e.g. hemoglobinopathies) of the technique employed for HbA1c determinations into consideration, while evaluating the results of the tests.