REFLECTION OF GLYCATED HAEMOGLOBIN (HbA1c) ON GLYCEMIC INDEX (GI) DURING DIABETES

Sunil Solanki, Chirag Suchak, Prakash Thakkar, Sanjay Thakkar, Rohit Patel, Jignesh Chaudhary, Fuzail Ahmad, Vasudev Thakkar, Ajay Parihar, Rajesh Trivedi and Prof. Dr. Dhrubo Jyoti Sen*

ABSTRACT

Glycosylated or Glycated hemoglobin (HbA1c): Hemoglobin to which glucose is bound. Glycosylated hemoglobin is tested to monitor the long-term control of diabetes mellitus. The level of glycosylated hemoglobin is increased in the red blood cells of persons with poorly controlled diabetes mellitus. Since the glucose stays attached to hemoglobin for the life of the red blood cell (normally about 120 days), the level of glycosylated hemoglobin reflects the average blood glucose level over the past 3 months. The normal level for glycosylated hemoglobin is less than 7%. Diabetics rarely achieve such levels, but tight control aims to come close to it. Levels above 9% show poor control, and levels above 12% show very poor control. It is commonly recommended that glycosylated hemoglobin be measured every 3 to 6 months in diabetes. The Diabetes Control and Complications Trial (DCCT) showed that diabetics who keep their glycosylated hemoglobin levels close to 7% have a much better chance of delaying or preventing diabetes complications that affect the eyes, kidneys, and nerves than people with levels 8% or higher. A change in treatment is almost always needed if the level is over 8%. Lowering the level of glycosylated hemoglobin by any amount improves a person's chances of staying healthy. Glycosylated hemoglobin is also known as glycohemoglobin or as hemoglobin A1C (the main fraction of glycosylated hemoglobin). The Glycemic Index (GI) is a value assigned to foods based on how slowly or how quickly those foods cause increases in blood glucose levels. Also known as "blood sugar," blood glucose levels above normal are toxic and can cause blindness, kidney failure, or increase cardiovascular risk. Foods low on the glycemic index (GI) scale tends to release glucose slowly and steadily. Foods high on the glycemic index release glucose rapidly. Low GI foods tend to foster weight loss, while foods high on the GI scale help with energy recovery after exercise, or to offset hypo- (or insufficient) glycemia. Long-distance runners would tend to favor foods high on the glycemic index, while people with pre- or full-blown diabetes would need to concentrate on low GI foods. Why? People with type 1 diabetes and even some with type 2 can't produce sufficient quantities of insulin—which helps process blood sugar—which means they are likely to have an excess of blood glucose. The slow and steady release of glucose in low-glycemic foods is helpful in keeping blood glucose under control.

Keywords: Glycated hemoglobin, Glycemic Index, Fasting Blood Sugar, Postprandial Blood Sugar.