Complication and mortality rates increase with poor glucose control. Early diagnosis together with good glucose monitoring and control are crucial to reduce the burden of diabetes.
The diagnosis and monitoring of diabetes long relied on determination of blood glucose levels. However, glucose levels fluctuate considerably depending on food intake and other factors and to diagnose earlier stages of diabetes, at least two blood glucose tests on different days are required. These measurements require fasting before sampling but fasting values do not reflect what happens after meals. An oral glucose tolerance test (OGTT) is therefore sometimes also required. Values are then determined 2 hours after an oral dose of 75 g of glucose, a time-consuming test. Although these methods are useful, alternatives reflecting the mean glucose levels during a longer period have been sought to simplify diagnosis and monitoring.
As various sugars bind to some degree to proteins in different tissues, methods to measure these protein/sugar adducts have been developed. These reflect the glucose levels over a longer period of time. One of the proteins to which glucose binds is haemoglobin.
The fraction of hemoglobin that is bound to glucose - HbA1c - now serves as a powerful tool for assessing long-term glycaemic control. HbA1c also correlates well with the risk of development of complications related to diabetes, which is a very important aspect. In the future HbA1c is likely to become a useful tool also for the diagnosis and evaluation of all forms of diabetes mellitus and patients at risk of developing diabetes, making it possible to detect diabetes earlier.
In the laboratory, our proprietary immunoassay technology for measurement of HbA1c is utilised in the Abbott AxSYM and ARCHITECT systems. Our own clinical chemistry assay also provides a flexible, accurate and precise method for measurement of this vital marker.
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As a general marker of overall health status, few tests carry greater predictive weight than Homocysteine. The amount of Homocysteine in your blood is one of the best independent indicators of how healthy you are.