Variations in hemoglobin A1c and blood glucose in children with newly diagnosed diabetes mellitus described by a biokinetic model.

Hemoglobin A1c (HbA1c) and the blood glucose concentrations were measured in 26 children with newly diagnosed diabetes mellitus from the start of insulin treatment and during the remission and post-remission phases. The results were analysed according to a biokinetic model which describes HbA1c as a function of the preceeding blood glucose level during the lifetime of the erythrocytes. The correlation between HbA1c and blood glucose at the start of treatment improved significantly when the model was modified to accomodate a change in the blood glucose level at the time when the first diabetic symptoms were noticed. The individual HbA1c values measured after 1, 2 and 3 weeks of insulin treatment were compared with values predicted from the biokinetic model and preceeding blood glucose measurements. There was a significant positive correlation between observed and predicted values, and the correlation increased with the length of the observation period. In all children the HbA1c level declined and reached a nadir 10 to 15 weeks after initiation of treatment. A significant negative correlation between the duration of remission and the HbA1c level was observed. It is concluded that the biokinetic model compares favourably with the observed variations in HbA1c and blood glucose levels which occur in newly diagnosed diabetes mellitus during the first weeks of insulin treatment.