Contribution of fasting and postprandial plasma glucose to HbA(1c)

HbA1c has been regarded as the gold standard of glucose homeostasis assessment in diabetes, theoretically providing an indication of the time-weighted average of plasma glucose concentration over the preceding 6ââ"šÂ¬Ã¢â‚¬Å“8 weeks [1]. Reduction of HbA1c has been associated with a reduction of risk of both micro- and macrovascular diabetic complications by primary intervention studies [2]. However, HbA1c may not completely reflect glucose control, especially short-term postprandial glucose excursions [3ââ"šÂ¬Ã¢â‚¬Å“5], and acute increases in blood glucose appear to have a significant independent role in the pathogenesis of diabetic complications [3,6ââ"šÂ¬Ã¢â‚¬Å“8]. Accordingly, the relative contribution of fasting and postprandial glucose levels to the value of HbA1c has been discussed in recent medical literature [5,9ââ"šÂ¬Ã¢â‚¬Å“14]. We have developed a mathematical model of haemoglobin glycation to assist the clinical interpretation of this measurement [15].