Rapid and slow rate of decrease in HbA_{1a + b} and HbA_1c during improved glycaemic control

Abstract

The change in glycosylated haemoglobins was studied with a column chromatographic method when glycaemic control was rapidly improved in nine diabetic patients. The patients were followed for 3 weeks or more. There was a decrease in HbA_1a+b and HbA_1c within the first few days of improved control and this decrease was faster than later on. The initial decrease of HbA_1a+b was faster than that of HbA_1c. In individual patients the initial decrease in glycosylated haemoglobins correlated with the initial rate of decrease in blood glucose. It is concluded that HbA_1a+b and HbA_1c decrease biphasically during improved glycaemic control. The rapid initial decrease may be due to labile HbA₁ and it is large enough to influence the value of HbA₁ as an indicator of long-term glycaemic control in some patients.

Key-words:

• diabetic treatment
• glycosylated haemoglobins
• HbA₁
• HbA_1c
• labile HbA₁
• improved glycaemic control