for 3 consecutive months, a fasting glucose and glycosylated hemoglobin were per

Question

for 3 consecutive months, a fasting glucose and glycosylated hemoglobin were performed on a patient. the result are as follows.

                                  Quater1            Quater2              Quater 3

Plasma glucose fasting 280mg/dl           85mg/dl             91mg/dl (Fpg)

Glycosylated hemoglobin 7.8%               15.3%                8.5%

Question

1. in which quater was the patient 's glucose the best controlled? the least controlled?

2. Do the fasting plasma glucose and glycosylated hemoglobin match? whyand why not?

3. whatmethods are used to measure glycosylated hemoglobin?

4. what potential conditions might cause erroneous results?

Explanation / Answer

Solution:

1. Ans: The Fasting Plasma Glucose test is a blood test that determines the amount of glucose level in blood under fasting condition. A fasting blood glucose level between 100 and 125 mg/dl means a person has pre-diabetes whereas, a fasting blood glucose level of 126 mg/dl or higher means a person has diabetes. So, in this case at Quater3 (91 mg/dl) the patient’s glucose level is best controlled.

2. Ans: Yes. Glycated hemoglobin expressed as a percentage of total blood hemoglobin concentration gives a retrospective assessment of the mean plasma glucose concentrating during the preceding 6 – 8 weeks. Its measurement is therefore considered to be a good method of assessing glycemic control. The higher the percentage of circulating Glycated hemoglobin in the diabetes, the poorer the mean diabetic control.

3. Ans: A single glucose determination reflects the glucose level at that time. Glycosylated hemoglobin (GHb) on the other hand reflects the mean glucose level over an extended period of time. Thus GHb reflects the metabolic control of glucose level over a period of time unaffected by diet, insulin, other drugs, or exercise on the day of testing. Several methods are used to measure the amount of bound hemoglobin and glucose. They are electrophoresis, chromatography, and immunoassay. All are based on the separation of hemoglobin bound to glucose from that without glucose.

4. Ans: Results can be influenced    by the person's clinical condition, as well as the test method used. Some methods give false (high or low results) if the person has an abnormal hemoglobin, such as hemoglobin S or F.

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