Determination of the Glycosylated Hemoglobins (Hb AI) with a New Microcolumn Procedure: Suitability of the Technique for Assessing the Clinical Management of Diabetes Mellitus

Abstract

Fifty-seven children who attended a diabetes camp were divided into five groups on the basis of retrospective evaluation of the management of their diabetes mellitus over the previous three or more months. Shortly after their arrival at camp, fasting blood samples were obtained for the measurement of glucose and the quantitation of Hb AI and for hemoglobin typing. Samples were obtained from 12 normal (nondiabetic) camp personnel at the same time. The Hb AI components were measured by the “macrocolumn” procedure of Trivelli et al., by the colorimetric procedure of Flukinger and Winterhalter, and by a new microcolumn procedure employing columns and reagents provided by Isolab, Inc. As might be expected from a number of previous reports by other investigators, there was no significant correlation of the percentage of Hb AI with single fasting blood sugar values. Hb AI tended to decrease as the management of diabetes became more adequate according to clinical ratings. Comparison of the Hb AI (Hb AIa+b+c) determinations showed an acceptable correlation of percentages obtained by the relatively laborious macrocolumn procedure and the more facile microcolumn procedure, indicating that the latter would be clinically useful. Values of Hb AIc obtained by the colorimetric procedure, which has been proposed as a procedure suitable for the clinical laboratory, did not correlate well with Hb AIc values determined by the macrocolumn technique, nor did these show as good an inverse relationship to the ratings of the management of diabetes.