A PROSPECTIVE CLINICAL STUDY TO ESTIMATE GLYCOSYLATED HAEMOGLOBIN LEVELS IN NON DIABETIC SUBJECTS IN THIRD AND FOURTH DECADES OF LIFE

Abstract

Hemoglobin A1c was initially identified as an unusual hemoglobin in patients with diabetes by Rahbar et al. in1960s. Around same time, there was a strong suspicion that hyperglycemia was related to the vascular complications observed in individuals with diabetes, but the association was difficult to prove due to lack of objective markers of glucose control². As stated by Knowles in a paper reviewing the subject in 1964,”The most doubtful measurement of all is that of control… for it is impossible to determine with certainty the chemical state of patients during their day-to-day life and activity.”³. From the discovery of HbA1c, multiple small studies were conducted correlating it to blood glucose measurements, with the hypothesis that it could be used as an objective measurement of glucose control.^2,4 It was introduced into wide spread clinical use in the 1980s and subsequently became a corner stone of clinical practice⁵ .The Diabetes Control and Complications Trial (DCCT) and UK  Prospective Diabetes Study (UKPDS) demonstrated that in Type1 and Type2 diabetes, respectively intensive glucose control, reflected in glucose and HbA1c measurements, decreased risk of complications^6,7. To improve diabetes control worldwide by introducing a global standardization for HbA1c measurement, changes in the methods of reporting HbA1c have been proposed.