Berger W, Sonnenberg G E
Schweiz Med Wochenschr. 1980 Mar 29;110(13):485-91.
Two new diagnostic tools to assess blood glucose control in ambulatory diabetics have recently been introduced. The first represents a self-monitoring of ambient blood glucose levels by the patient who prepares capillary blood samples during a day of regular activities. Blood glucose is determined by the laboratory on the following day. Self-monitoring of 24 hr blood glucose profiles is valuable to assess blood glucose excursions, and particularly, to detect unrecognized hypoglycemias. The second new tool is the determination of hemoglobin A1 or A1c which represents an indicator of blood glucose control during the last 3-4 months. We noted in stable non insulindependent diabetics a highly significant correlation between fasting blood glucose levels and hemoglobin A1c content. Since in these patients there is also a close correlation between fasting blood glucose and average daily blood glucose levels, a correlation was calculated between the mean daily blood glucose level and HbA1c content. Derived from this correlation, the average daily blood glucose level can be estimated from the HbA1c value in insulin-dependent diabetics in whom the casual blood glucose may not be representative for their overall blood glucose control. Thus HbA1 resp. HbA1c represents a reflection of the mean blood glucose level during the last 3-4 months. Particularly, it allows the detection of metabolic decompensation which is not clinically evident and which remained undiscovered by single blood glucose measurements.
最近推出了两种新的诊断工具，用于评估门诊糖尿病患者的血糖控制情况。第一种是患者在日常活动期间自行采集毛细血管血样，以自我监测外周血糖水平。血糖检测结果于次日由实验室给出。24小时血糖曲线的自我监测对于评估血糖波动情况非常有价值，尤其是用于检测未被识别的低血糖症。第二种新工具是测定糖化血红蛋白A1或糖化血红蛋白A1c，它代表过去3至4个月期间血糖控制的一个指标。我们注意到，在病情稳定的非胰岛素依赖型糖尿病患者中，空腹血糖水平与糖化血红蛋白A1c含量之间存在高度显著的相关性。由于在这些患者中，空腹血糖与平均每日血糖水平之间也密切相关，因此我们计算了平均每日血糖水平与糖化血红蛋白A1c含量之间的相关性。根据这种相关性，可以从胰岛素依赖型糖尿病患者的糖化血红蛋白A1c值估算出平均每日血糖水平，因为这类患者的随机血糖可能无法代表其整体血糖控制情况。因此，糖化血红蛋白A1或糖化血红蛋白A1c反映了过去3至4个月期间的平均血糖水平。特别是，它能够检测出临床上不明显且单次血糖测量未发现的代谢失代偿情况。
