Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan

Laboratory HbA1c 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 HbA1c were evaluated...

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Autores principales:	Yongjin Xu, Richard M Bergenstal, Timothy C Dunn, Ramzi A Ajjan
Formato:	article
Lenguaje:	EN
Publicado:	eLife Sciences Publications Ltd 2021
Materias:	glycated haemoglobin red cell lifespan kinetic modelling complications cellular glucose uptake continuous glucose monitoring Medicine R Science Q Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/61914c6109ee47a8a9e12467d7fdc9e8
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spelling	oai:doaj.org-article:61914c6109ee47a8a9e12467d7fdc9e82021-11-29T12:11:16ZAddressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan10.7554/eLife.694562050-084Xe69456https://doaj.org/article/61914c6109ee47a8a9e12467d7fdc9e82021-09-01T00:00:00Zhttps://elifesciences.org/articles/69456https://doaj.org/toc/2050-084XLaboratory HbA1c 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 HbA1c 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 HbA1c, allowing the calculation of person-specific adjusted HbA1c (aHbA1c). Median (IQR) RBC lifespan was 100 (86–102) and 100 (83–101) days in T1D and T2D, respectively. The median (IQR) absolute difference between aHbA1c and laboratory HbA1c 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. aHbA1c and laboratory HbA1c showed clinically relevant differences. This suggests that the widely used measurement of HbA1c can underestimate or overestimate diabetes complication risks, which may have future clinical implications.Yongjin XuRichard M BergenstalTimothy C DunnRamzi A AjjaneLife Sciences Publications Ltdarticleglycated haemoglobinred cell lifespankinetic modellingcomplicationscellular glucose uptakecontinuous glucose monitoringMedicineRScienceQBiology (General)QH301-705.5ENeLife, Vol 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	glycated haemoglobin red cell lifespan kinetic modelling complications cellular glucose uptake continuous glucose monitoring Medicine R Science Q Biology (General) QH301-705.5
spellingShingle	glycated haemoglobin red cell lifespan kinetic modelling complications cellular glucose uptake continuous glucose monitoring Medicine R Science Q Biology (General) QH301-705.5 Yongjin Xu Richard M Bergenstal Timothy C Dunn Ramzi A Ajjan Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan
description	Laboratory HbA1c 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 HbA1c 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 HbA1c, allowing the calculation of person-specific adjusted HbA1c (aHbA1c). Median (IQR) RBC lifespan was 100 (86–102) and 100 (83–101) days in T1D and T2D, respectively. The median (IQR) absolute difference between aHbA1c and laboratory HbA1c 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. aHbA1c and laboratory HbA1c showed clinically relevant differences. This suggests that the widely used measurement of HbA1c can underestimate or overestimate diabetes complication risks, which may have future clinical implications.
format	article
author	Yongjin Xu Richard M Bergenstal Timothy C Dunn Ramzi A Ajjan
author_facet	Yongjin Xu Richard M Bergenstal Timothy C Dunn Ramzi A Ajjan
author_sort	Yongjin Xu
title	Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan
title_short	Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan
title_full	Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan
title_fullStr	Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan
title_full_unstemmed	Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan
title_sort	addressing shortfalls of laboratory hba1c using a model that incorporates red cell lifespan
publisher	eLife Sciences Publications Ltd
publishDate	2021
url	https://doaj.org/article/61914c6109ee47a8a9e12467d7fdc9e8
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Addressing shortfalls of laboratory HbA1c using a model that incorporates red cell lifespan

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