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dc.contributor.authorNayak, Ananth U
dc.contributor.authorSingh, Baldev M
dc.contributor.authorDunmore, Simon J
dc.date.accessioned2019-06-03T14:06:30Z
dc.date.available2019-06-03T14:06:30Z
dc.date.issued2019-05-10
dc.identifier.citationAnanth U Nayak, Baldev M Singh, Simon J Dunmore (2019) Potential clinical error arising from use of HbA1c in diabetes: effects of the Glycation Gap, Endocrine Reviews, 40(4), pp. 988–999. https://doi.org/10.1210/er.2018-00284en
dc.identifier.issn0163-769Xen
dc.identifier.doi10.1210/er.2018-00284en
dc.identifier.urihttp://hdl.handle.net/2436/622395
dc.description.abstractThe Glycation Gap (GGap) and the similar Hemoglobin Glycation Index (HGI) define consistent differences between glycated hemoglobin and actual glycemia derived from fructosamine or mean blood glucose respectively. Such a disparity may be found in a substantial proportion of people with diabetes, being > than 1 unit of glycated HbA1c% or 7.2 mmol/mol in almost 40% of estimations. In this review we define these indices, explain how they can be calculated and that they are not spurious, being consistent in individuals over time. We evaluate the evidence that GGap and HGI are associated with variation in risk of complications and mortality and demonstrate the potential for clinical error in the unquestioning use of HbA1c. We explore the underlying etiology of the variation of HbA1c from mean glucose in blood plasma including the potential role of enzymatic deglycation of hemoglobin by fructosamine-3-kinase. We conclude that measurement of GGap and HGI are important to diabetes clinicians and their patients in individualization of therapy and the avoidance of harm arising from consequent inappropriate assessment of glycemia and use of therapies.en
dc.formatapplication/PDFen
dc.languageen
dc.language.isoenen
dc.publisherThe Endocrine Societyen
dc.relation.urlhttps://academic.oup.com/edrv/advance-article-abstract/doi/10.1210/er.2018-00284/5487357?redirectedFrom=fulltexten
dc.subjectGlycation Gapen
dc.subjectHGIen
dc.subjectHbA1cen
dc.subjectDiabetes Complicationsen
dc.titlePotential clinical error arising from use of HbA1c in diabetes: effects of the Glycation Gapen
dc.typeJournal articleen
dc.identifier.journalEndocrine Reviewsen
dc.date.updated2019-05-28T11:08:40Z
dc.date.accepted2019-04-05
rioxxterms.funderUniversity of Wolverhampton
rioxxterms.identifier.projectUOW030619SDen
rioxxterms.versionAMen
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/en
rioxxterms.licenseref.startdate2020-05-10en
dc.source.volume40
dc.source.issue4
dc.source.beginpage988
dc.source.endpage999
dc.description.versionPublished online
refterms.dateFCD2019-06-03T14:06:10Z
refterms.versionFCDAM
refterms.dateFOA2019-06-03T14:06:31Z


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