Case Reports Clinical Chemistry 2018 Exercise 2: Limitations of Hemoglobin A1c and Alternative Measures of Long-Term Glycemic Control (CSCC1802)

Primary Audience: Pathologists and Clinical Scientists

Secondary Audience: Residents, Laboratory Technologist/Scientist (Includes all sub-specialty areas), Students, Pathologist Assistants,  Laboratory Directors and Educators

Upon completion of this activity, you will be able to:

• describe the chemical reactions of nonenzymatic glycation of hemoglobin and extracellular plasma proteins;
• discuss the limitations of glycated hemoglobin (HbA1c) as a measure of blood glucose, describing clinical scenarios in which HbA1c is likely to provide a biased or inaccurate estimation of blood glucose;
• contrast the measurement of fructosamine with glycated albumin as alternative indicators of blood glucose;
• select patients who may be better suited for measurement of fructosamine or glycated albumin than HbA1c; and
• describe potential sources of analytic interference or clinical bias for the types of commercially available assays for HbA1c, fructosamine, and glycated albumin.