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Glycosylated haemoglobin in children with insulin-dependent diabetes mellitus
Insights
Glycosylated hemoglobin (HbA1) levels in children with new-onset insulin-dependent diabetes rapidly decreased with treatment. These HbA1 changes reflect blood glucose control and insulin dosage adjustments.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Insulin-dependent diabetes mellitus (IDDM) requires careful management to control blood glucose levels.
- Glycosylated hemoglobin (HbA1) serves as a long-term marker of glycemic control.
Purpose of the Study:
- To investigate the serial changes in glycosylated hemoglobin (HbA1) during the initial stabilization of newly diagnosed insulin-dependent diabetes in children.
- To correlate HbA1 levels with clinical parameters such as blood glucose, plasma bicarbonate, and insulin dosage.
Main Methods:
- Serial measurement of glycosylated hemoglobin (HbA1) using microcolumn chromatography.
- Monitoring of blood glucose, plasma bicarbonate, serum cholesterol, and triglyceride levels.
- Tracking of insulin dosage and symptom duration in 38 children with newly diagnosed IDDM.
Main Results:
- Initial HbA1 levels significantly decreased within the first 3-5 days of therapy, correlating with improved blood glucose control.
- HbA1 levels reached a nadir around 8.2% within 3 weeks to 6 months and correlated with reduced insulin dosage.
- HbA1 levels increased again in patients followed for over 3-6 months, suggesting potential reversibility of glycosylation.
Conclusions:
- Glycosylated hemoglobin (HbA1) levels change rapidly during initial diabetes stabilization, indicating that glycosylation may not be entirely irreversible.
- HbA1 monitoring provides a reliable indicator of glycemic control during both remission and post-remission phases in pediatric diabetes.
Abstract:
Glycosylated haemoglobin (HbA1) was measured serially by microcolumn chromatography in 38 children with newly diagnosed insulin-dependent diabetes. Initial HbA1 levels of 13.6 +/- 0.5% fell signficiantly from day 0 (prior to therapy) both to day 1 (1.6 +/- 0.2% decrease) and to day 3-5 (2.6 +/- 0.4% decrease) (P < 0.001). This drop correlated closely with changes in blood glucose (P < 0.001), less closely and inversely with plasma bicarbonate levels (P < 0.01), but not with prior duration of symptoms or changes in serum cholesterol and triglyceride concentrations. HbA1 levels reached a nadir of 8.2 +/- 0.3% 3 weeks to 6 months after diagnosis, and correlated with decreasing insulin dosage (P < 0.001). HbA1 levels rose again to 11.4 +/- 0.5% in 21 patients followed for more than 3-6 months. Our results indicate that (1) HbA1 level change rapidly during initial stabilization of insulin-dependent diabetes suggesting that glycosylation may not be entirely irreversible, and (2) HbA1 levels are consistent with clinical assessment of control during remission and postremission phases.