Estimation of HbA1c and impact of continuous glucose monitoring in hypoglycemic states

Abstract

Glycosylated hemoglobin (HbA1c) is formed when glucose combines with hemoglobin present in red blood cells making it glycated. Hypoglycemia is presented by less sugar binding with the hemoglobin compared to in hyperglycemia. HbA1c is considered to be a gold standard for measuring glycemic index in diabetic patients. This indicates the burden of blood glucose in subjects with diabetes mellitus. As the normal life span of red blood cells (RBCs) is 90–120 days, therefore HbA1c predicts the average glucose level of 90 days period. Currently, it is being used to combat the burden of diabetes worldwide. There are several cost-effective and high sensitivity & specificity techniques that are being used for the measurement of HbA1c. Most advanced methods include HPLC and enzyme-based. However, there are some variants of hemoglobin that interfere with it. As this is one of the essential parameters to study the progression of diabetes in a patient, a cost-effective and reliable method is required for the estimation.