Abstract
As the concentration of total glycosylated hemoglobin (Hb AI) may be responsive to acute fluctuations in blood glucose, and as Hb AIc is known to have increased in vitro oxygen affinity, we evaluated whether acute variations in Hb AI were accompanied by changes in hemoglobin-oxygen affinity in insulin-dependent diabetic children.
Blood glucose, Hb AI, hemoglobin-oxygen affinity and related parameters were determined in 42 diabetic children in the fasting state before insulin and 6 h later following their usual insulin dose and meals. During the 6-h period significant increases occurred in the mean concentrations of blood glucose and Hb AI (P<0.001), and a correlation was present between the increment in blood glucose and that in Hb AI (r=0.62, P<0.001). The mean hemoglobin-oxygen affinity also increased, but this change was found to be unrelated to the increase in Hb AI. The increment in hemoglobin-oxygen affinity correlated with an increment in blood pH (r=0.49, P<0.001). Hemoglobin concentration, hematocrit, and red cell 2,3-DPG content were significantly elevated in the diabetic children compared to 30 healthy children (P<0.005), and in the diabetic children the Hb AI correlated with hemoglobin, hematocrit and erythrocyte count (P<0.05).
The present study indicates that in juvenile diabetics rapid fluctuations may occur in Hb AI which are glucose-dependent, whereas the simultaneous minor change in hemoglobin-oxygen affinity appears to be pH-dependent.
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Ditzel, J., Kawahara, R., Mourits-Andersen, T. et al. Changes in blood glucose, glycosylated hemoglobin and hemoglobin-oxygen affinity following meals in diabetic children. Eur J Pediatr 137, 171–174 (1981). https://doi.org/10.1007/BF00441311
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DOI: https://doi.org/10.1007/BF00441311