Felis ISSN 2398-2950

Glycosylated hemoglobin

Contributor(s): Jane Miller, Dr Linda Fleeman

Overview

  • Glycosylated hemoglobin (GHb) results from non-enzymatic chemical binding of glucose to the amino-terminal of valine of the beta-chain of the hemoglobin molecule.
  • This reaction is irreversible and the amount of GHb can change depending on the blood glucose concentration and the lifespan of erythrocytes (approximately 65-75 days in cats).
  • GHb concentration is therefore believed to reflect the mean blood glucose concentration during the lifespan of the erythrocytes.
  • In normal animals only a small proportion of hemoglobin molecules are glycosylated, this increases as exposure to glucose increases.
  • The stable form of GHb is measured and expressed as a percentage of the total hemoglobin.
  • Measurement of GHb concentration in blood may assist in monitoring control of diabetes mellitus in cats.
  • A veterinary GHb assay (A1CARE, Baycom Diagnostics) became commercially available for the first time in 2017.
  • Glycosylated serum protein (fructosamine Blood biochemistry: fructosamine) is well established and currently is more commonly used than GHb.

Sampling

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Tests

Availability

  • A1Care, Baycom Diagnostics.

Validity

Sensitivity

  • This is not a sensitive test because it reflects the mean blood glucose concentration over a long period. In the dog it takes at least 2 weeks of abnormal glucose concentration to affect the GHb concentration.
  • Transient stress-induced hyperglycemia in cats does not affect GHb concentration.

Specificity

  • Not very specific.
  • GHb results in diabetic cats can be in the normal range.
  • The effect of anemia on GHb concentrations in the cat has not been reported, but it will likely decrease the result.

Result Data

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Further Reading

Publications

Refereed papers

  • Recent references from VetMed Resource and PubMed.
  • Behrend E, Holford A, Latham P, Rucinsky R & Schulman R (2018) 2018 AAHA Diabetes management guidelines for dogs and cats. JAAHA 54, 1-21 Full Article.
  • Bakhtiari H, Torkian M, Shahbazkia H R et al (2013) Glycosylated hemoglobin is a good indicator of blood glucose status in Persian cats. Comp Clin Path 22(6), 1225-1228.
  • Rudinsky R, Cook A, Haley S et al (2010) 2010 AAHA Diabetes management guidelines for dos and cats. JAAHA 46(3), 215-224 Full article.
  • Elliot D A, Nelson R W, Reusch C E et al (1999) Comparison of serum fructosamine and blood glycosylated hemoglobin concentrations for assessment of glycemia control in cats with diabetes mellitus. JAVMA 214(12), 1794-1798 PubMed.
  • Hoenig M & Ferguson D C (1999) Diagnostic utility of glycosylated hemoglobin concentrations in the cat. Domest Anim Endocrinol 16(1), 11-17 PubMed.
  • Haberer B & Reusch C E (1998) Glycated hemoglobin in various pathological conditions - investigations based on a new fully automated method. JSAP 39, 510-517 PubMed.
  • Elliot D A, Nelson R W, Feldman E C et al (1997) Glycosylated hemoglobin concentration for assessment of glycemic control in diabetic cats. J Vet Intern Med 11, 161-165.
  • Akol K G, Waddle J R & Wilding P (1992) Glycosylated hemoglobin and fructosamine in diabetic and non-diabetic cats. JAAHA 28, 227-230.
  • Delack J B and Stogdale L (1983) Glycosylated hemoglobin measurement in dogs and cats. Implications for its utility in diabetic monitoring. Can Vet J 24, 308-311.


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