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HbA1c Is No Longer Suitable For Monitoring Blood Sugar in Patients on Dialysis

2012-11-30 17:19

Medical center of Wake Forest University in America does a research recently reports that HbA1c which has been used as the golden standard to monitor one’s blood sugar in diabetics is no longer suitable for those who are on dialysis already.

Blood sugar level monitoring becomes one important part for people with Diabetes, and HbA1c is used for monitoring one’s blood glucose as the most frequently used index. This standard is widely recognized by the field of medicine. Even so, nephrologists have found that this golden standard isn’t appropriate for those who already have suffered from end stage of kidney disease secondary to Diabetes (Diabetic Nephropathy). GA (glycated albumin) however seems like more effective than HbA1c.

According to what Dr. Barry I. Freedman said, multiple organs won’t function normally in most of the patients with ESRD. For instance, most patients on dialysis are living with anemia and their red blood cell count is lower than normal value. All those factors have a great impact on the accuracy of HbA1c. He said that, “test result of HbA1c is accurate as long as the lifespan of erythrocytes is shortened.” Patients on dialysis have a shortened erythrocytes life expectancy which affects the test result of HbA1c. Usually, HbA1c is much lower than it actually does since various influences.

In USA, about 500,000 patients are receiving hemodialysis. Meanwhile, around 50% of them have ESRD induced by Diabetes. DM becomes one of the most frequently causes accounting for End-stage Renal Disease. Due to its high mortality, monitoring their blood sugar level accurately means a lot.

Researchers compared these two test results of HbA1c and GA, and then found out that the former golden standard couldn’t indicate accurately about patients’ survival rate etc. Instead, GA becomes much more precisely for patients’ survival rate and their hospitalization rate.

You can also find this news from Clinical Journal of the American Society of Nephrology.

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