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Better measures of glucose control . . . and other stories

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5673 (Published 26 October 2016) Cite this as: BMJ 2016;355:i5673

Glycated haemoglobin depends on cell age

The most commonly used measure of blood glucose control in diabetes is the percentage of haemoglobin in circulation that is glycated—that is, HbA1c. But in about a third of people this measure gives a false indication of actual blood glucose levels over the preceding 23 months. A team at Harvard University has found that this is almost entirely due to variations in the turnover rate of red blood cells (Sci Transl Med doi:10.1126/scitranslmed.aaf9304). Older cells inevitably pick up more glucose. The team proposes that the individual turnover rate for red blood cells (which is stable and measurable) might need to be measured before relying on HbA1c as an indicator of glucose control.

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