Estimated average glucose is based on which parameter? (PNQ)
|B||Post prandial blood glucose|
|D||Random blood sugar|
1). Impaired glucose tolerance on an oral GTT is indicated by 2 hrs after glucose load 140-199 mg/dl; fasting blood sugar 100 to 125 mg/dl.
2). Fasting is defined as no caloric intake for at least 8 h. Normal FBS < 100 mg%
3). 1 mmol/lit of blood sugar = 18 mg% of blood sugar
Monitoring glycemic control: (Ref. Hari-18th ed., Pg.-2992)
1). Glycated hemoglobin (= HbA1C)
a). HbA1C is produced by nonenzymatic condensation of glucose molecules with Hb molecule.
b). In a normal adult HbA1C constitutes <5.6% of the total adult haemoglobin.
c). Levels relate to mean glucose level over previous 8-12 wks (i.e RBC half-life).
d). HbA1C is the single best parameter to know about diabetic control.
2). Fructosamine (glycated plasma protein) levels reflect diabetic control over previous 2-3 wks: may be used in pregnancy to assess shorter term control, and in patients with hemoglobinopathies which interfere with HbA1C tests.
Recent Advances: (Ref. Hari-18th ed. Pg.-2992)
eAG (Estimated Average Glucose)
1). HBA1C should be measured in all individuals with DM during their initial evaluation and as part of their comprehensive diabetes care.
2). As the primary predictor of long-term complications of DM, the HBA1C should mirror, to a certain extent, the short-term measurements of Self-monitoring of blood sugar (SMBG).
3). These two measurements are complementary in that recent intercurrent illnesses may impact the SMBG measurements but not the HBA1C.
4). Likewise, postprandial and nocturnal hyperglycemia may not be detected by the SMBG of fasting and pre-prandial capillary plasma glucose but will be reflected in the HBA1C.
5). In standardized assays, the HBA1C approximates the following mean plasma glucose values:
HBA1C (%) to eAG (mg/dl)
1). 6.0% = 126 mg/dl
2). 9.0% = 212 mg/dl
3). 7.5% = 169 mg/dl
4). 7.0% = 154 mg/dl
5). 10.0% = 240 mg/dl mg/dl
6). 8.5% = 197 mg/dl
7). 8.0% = 183 mg/dl
8). 6.5% = 140
9). 9.5% = 226 mg/dl