Hemoglobin A_(1c) in Diabetes: Panacea or Pointless?

摘要

Glycation is the nonenzymatic attachment of a monosaccharide to amino groups of proteins. The reaction has been recognized for many years in the food industry, where it is known as browning (also termed the Maillard reaction) and is responsible for the formation of commonly ingested items, such as toast. In patients with diabetes, glucose accumulation results in enhanced glycation of many proteins, both in tissues (e.g., the lens) and in the blood. Of these, glycated hemoglobin (GHb) is by far the most frequently measured in patient care. Hemoglobin (Hb) in healthy adults consists predominantly of HbA, which has 2a- and 2β-chains.