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Clinical Chemistry 39: 833-835, 1993;
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Clinical Chemistry, Vol 39, 833-835, Copyright © 1993 by American Association for Clinical Chemistry

Increased fetal hemoglobin in insulin-treated diabetes mellitus contributes to the imprecision of glycohemoglobin measurements

ES Kilpatrick, M Small, A Rumley and MH Dominiczak
Department of Pathological Biochemistry, Western Infirmary, Glasgow, Scotland, UK.

An increased prevalence of fetal hemoglobin (HbF) has been described in pediatric insulin-dependent patients. The popular electroendosmotic method for glycohemoglobin includes HbF. In an adult population comprising 50 insulin-treated and 57 non-insulin-treated diabetic patients and 57 control subjects, we measured HbF by HPLC and measured glycohemoglobin by both HPLC and an electroendosmotic method. Of the insulin-treated patients, 46% had concentrations of HbF > or = 0.5%, compared with 25% of non-insulin-treated patients and 23% of controls (P < 0.02). In the insulin-treated patients, the two glycohemoglobin methods correlated best when the HPLC measurements included HbF (r = 0.92 vs r = 0.84). Fructosamine concentrations correlated best with glycohemoglobin concentrations determined by methods that accounted for HbF. The true between-batch CV of the electroendosmotic assay increased (from 4.33% to 8.33%) when variable interpatient HbF concentrations were included. Thus, HbF must be considered when interpreting glycohemoglobin measured by an electroendosmotic method and when comparing it with other measures of glycemic control.


The following articles in journals at HighWire Press have cited this article:


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 BMJHome page
E. S Kilpatrick, A. G Rumley, M. H Dominiczak, and M. Small
Authors' reply
BMJ, March 18, 1995; 310(6981): 741 - 741.
[Full Text]

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 BMJHome page
S Bulusu
Variant haemoglobin may affect measurements
BMJ, March 18, 1995; 310(6981): 740b - 740.
[Full Text]

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 BMJHome page
E. S Kilpatrick, A. G Rumley, M. H Dominiczak, and M. Small
Authors' reply
BMJ, December 3, 1994; 309(6967): 1512 - 1512.
[Full Text]

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 BMJHome page
E S Kilpatrick, A G Rumley, M H Dominiczak, and M Small
Glycated haemoglobin values: problems in assessing blood glucose control in diabetes mellitus
BMJ, October 15, 1994; 309(6960): 983 - 986.
[Abstract] [Full Text]


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Copyright © 1993 by the American Association for Clinical Chemistry.