Trovati M, Baratono S, Cerutti F, David O, Lorenzati R, Sacchetti C, Pagano G
Acta Diabetol Lat. 1981;18(1):37-44. doi: 10.1007/BF02056104.
We studied the behavior of fast hemoglobin fractions in newly discovered diabetic patients, before and in the 10 days immediately following the beginning of insulin therapy, in order to verify whether or not the rapid improvement of glycemic control involved a rapid reduction of total HbA1 and of its fractions. We observed a rapid and highly significant fall of HbA1(a+b+c) and HbA1c levels after only 1 or 2 days of insulin therapy, followed by a slower decrement in the other 3-10 days. HbA1(a+b) showed a slower decrement trend, reaching levels significantly below baseline values only after 7-10 days. These results suggest that rapid changes occurring in glycosylated hemoglobin levels after the beginning of insulin treatment in newly discovered diabetic patients involve mainly HbA1c. The kinetics of glycosylated hemoglobin reduction, with a first rapid decrement followed by a slower one, may suggest the hypothesis that rapid changes are due to reversible Schiff base de-glycosylation, the ketoamine linkage being the true index of long term glycemic control.
我们研究了新发现的糖尿病患者在胰岛素治疗开始前及开始后的10天内快速血红蛋白组分的行为，以验证血糖控制的快速改善是否涉及总糖化血红蛋白（HbA1）及其组分的快速降低。我们观察到，胰岛素治疗仅1或2天后，HbA1（a+b+c）和HbA1c水平就迅速且极显著下降，随后在接下来的3 - 10天内下降速度较慢。HbA1（a+b）显示出较慢的下降趋势，仅在7 - 10天后才达到显著低于基线值的水平。这些结果表明，新发现的糖尿病患者开始胰岛素治疗后糖化血红蛋白水平的快速变化主要涉及HbA1c。糖化血红蛋白降低的动力学，先是快速下降，随后下降速度较慢，这可能提示这样一种假设，即快速变化是由于可逆的席夫碱去糖基化，酮胺键才是长期血糖控制的真正指标。
