National Diabetes Data Group: Report of the Expert Committee on Glucosylated Hemoglobin

National Diabetes Data Group: Report of the Expert Committee on Glucosylated Hemoglobin The slow chemical reaction between glucose and proteins leads to continuous production of nonenzymatically glucosylated proteins in blood and tissues. The steady-state level of glycosylation of specific proteins is proportional to both the average glucose concentration and the lifespan of the protein in the circulation or tissues. Because the level of glucosylated hemoglobin has been shown to provide an index of blood glucose concentration during the previous 1-2-mo period, it is being used increasingly in the clinical management of diabetes. There has been considerable confusion in this field regarding terminology, methodology, and interpretation of assays of glucosylated hemoglobin. In this report we review the relative merits and limitations of various procedures that have been developed for the measurement of glucosylated hemoglobins. We have attempted to identify preferred methods and reliable standards for the accurate and reproducible measurement of glucosylated hemoglobins. In addition, we present an assessment of the current value of glucosylated hemoglobin measurements in the detection and management of diabetes and guidelines for the use and interpretation of these measurements.