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How to distinguish between blood sugar, glycated hemoglobin, and glycated serum albumin ? Apr 29, 2022

  Blood glucose monitoring is an important part of diabetes management, and its results help to assess the degree of glucose metabolism disorder in diabetic patients, formulate a reasonable hypoglycemic program, reflect the effect of hypoglycemic treatment and guide the adjustment of the treatment plan. Current clinical blood glucose monitoring methods include capillary blood glucose monitoring (hereinafter referred to as "blood glucose monitoring"), continuous glucose monitoring (CGM), glycated hemoglobin (HbA1c) and glycated serum albumin (GA) monitoring using a blood glucose meter. Some people with diabetes cannot tell the difference between capillary blood glucose monitoring, glycosylated hemoglobin monitoring and glycosylated albumin monitoring. These three types of monitoring are mainly described 

 

Points

Blood sugar: It reflects the blood sugar level at a specific time - "the instant", and cannot reflect the blood sugar fluctuations in a day or a period of time.

Glycated hemoglobin: It reflects the average blood glucose level in the past 2 to 3 months. Clinically, glycated hemoglobin has been used as the gold standard for evaluating long-term blood glucose control.

Glycated serum albumin: It reflects the average blood sugar level in the past 2 to 3 weeks, and is a good indicator for evaluating the short-term glucose metabolism control of patients.

 

Blood sugar, Glycated hemoglobin, Glycated serum albumin

1. Blood glucose monitoring

Blood sugar monitoring reflects the blood sugar level at a specific time - the "instant" blood sugar level. Instantaneous blood sugar shows the real blood sugar level. It is affected by many factors such as diet, exercise, mood, sleep, etc. The doctor judges whether the patient has hyperglycemia. Crisis or hypoglycemia can only be detected and diagnosed by monitoring blood sugar.

 

The time points for blood glucose monitoring include: before three meals, 2 hours after three meals, before going to bed and at night (usually 2 to 3 am). The frequency and time of blood glucose monitoring should be determined according to the actual needs of the patient's condition.

2. Glycated hemoglobin - an indicator of long-term blood sugar control

Glycated hemoglobin is a glycated product formed by the combination of glucose and hemoglobin in red blood cells in human blood. Since the half-life of red blood cells is 120 days, the detected value can reflect the average blood glucose level of the past 2 to 3 months. The gold standard for long-term glycemic control status. Doctors will judge the degree of blood sugar control of patients based on the results of glycosylated hemoglobin, which is an important basis for deciding whether to adjust the treatment plan.

So, can glycated hemoglobin monitoring replace blood glucose monitoring? The answer is no. Glycated hemoglobin cannot evaluate the instantaneous blood glucose level at the moment of detection, and cannot obtain relevant information on blood glucose fluctuations. Different blood glucose levels can have the same glycated hemoglobin value. Therefore, assessing blood sugar control only by glycated hemoglobin will not only fail to obtain comprehensive blood sugar information, but also sometimes lead to misdiagnosis, omission of hidden hyperglycemia and unresponsive hypoglycemia, resulting in deviations in the treatment plan and affecting the health of patients. It can be seen that the blood sugar level and the glycosylated hemoglobin reflect the blood sugar situation of the body from different dimensions, and to fully and correctly reflect all the information on blood sugar should be a combination of "points" and "surfaces", and the two cannot be neglected.

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3. Glycated serum albumin—a short-term indicator of glucose metabolism

Glycated serum albumin is the product of non-enzymatic glycation reaction between glucose and plasma albumin in human blood. Because albumin has a short half-life in the body (about 17 to 19 days), its detection value can reflect the recent 2 ~The average blood glucose level within 3 weeks, so glycated serum albumin is a good indicator to evaluate the short-term glucose metabolism control of patients, especially for the evaluation of the curative effect of diabetic patients after adjustment of the treatment plan, such as short-term hospitalization of diabetic patients, glycated serum albumin. Protein may have more clinical reference value than glycated hemoglobin.

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