Meet Your A1C, How a tiny molecule became a diabetes keystone

[Northerner]

One of the greatest advancements in diabetes treatment started out as an oddity. ?I said to myself?what is this? This isn?t fitting with any of the known hemoglobins,? said Samuel Rahbar, MD, PhD, in an interview last July, recalling his first impressions of the hemoglobin A1C, a protein in human blood.

Rahbar died last November at the age of 83, but he will be remembered as the man who discovered that diabetes can raise blood levels of hemoglobin A1C, which is arguably one of the most important biological molecules in modern medicine?although it wasn?t immediately recognized as such a big deal. Since Rahbar?s A1C discovery in 1968, the protein has traveled a winding road to attain its current place in the center of diabetes medicine.

Here is a brief history of the A1C molecule, the star of the valuable blood test that, in a single simple percentage, offers a look at average blood glucose levels over the past two to three months.

http://forecast.diabetes.org/a1c-feb2013

 

[trophywench]

I'm pleased to read this - I could recall they didn't use 'glycosulated haemoglobin' testing to begin with but couldn't recall what they DID do! LOL

 

[HelenM]

Interesting. Its quite sobering to realise how new the test is .


I'm not sure that they've got it quite right about the US and the 'new' test.
I understood that the new methodology and standardisation is being introduced everywhere including the US.
The yanks are are giving results aligned to the DCCT but they are doing so by using a formula, just as we do when we convert new units to old.

They got round the problem in the UK and elsewhere by expressing it as mmol/mol rather than a percentage so it wasn't liable to be confused

( ie 50mmol/mol expressed as a percentage would be 5%. That would have be confusing; lots of people miraculously improved ... Actually that happened when a few of the smaller countries decided to jump the gun without thinking it through. I remember a couple of people on forums reporting incredibly low HbA1cs and it transpired they had been given percentage results from IFCC tests. )

 

[Northerner]

Interesting. Its quite sobering to realise how new the test is .


I'm not sure that they've got it quite right about the US and the 'new' test.
I understood that the new methodology and standardisation is being introduced everywhere including the US.
The yanks are are giving results aligned to the DCCT but they are doing so by using a formula, just as we do when we convert new units to old.

They got round the problem in the UK and elsewhere by expressing it as mmol/mol rather than a percentage so it wasn't liable to be confused

( ie 50mmol/mol expressed as a percentage would be 5%. That would have be confusing; lots of people miraculously improved ... Actually that happened when a few of the smaller countries decided to jump the gun without thinking it through. I remember a couple of people on forums reporting incredibly low HbA1cs and it transpired they had been given percentage results from IFCC tests. )

So let me get this right! If we had used the IFCC test from the start then all HbA1c tests would be around 1-2% lower than we have got used to using the DCCT method? And we now use the IFCC test, but when converting to a percentage we jiggle the number so it matches up with what we would have expected from the DCCT test?

 

[HelenM]

Yes, that's about right.
See graph at top of page, notice it's % IFCC/% NGSP (DCCT)