B.K.Manjunatha Goud
Ras Al Khaimah Medical and Health Sciences University, UAE
Title: An over view of diabetes mellitus: Emphasis on microalbuminuria and glycated hemoglobin-clinical and biochemical divide
Biography
Biography: B.K.Manjunatha Goud
Abstract
Type 2 diabetes (previously called “adult onset diabetes”) is the most common form of diabetes accounting for about 90 to 95 percent of all diabetes cases. Diabetes can have a significant impact on quality of life by increasing risk for a variety of complications. Diabetic nephropathy is one of the most serious complications of diabetes and the most common cause of end stage renal disease.Presence of microalbuminuria (MA) is an early indicator of diabetic nephropathy.Microalbumin is routinely done to monitor the progression of nephropathy.The measurement of glycosylated hemoglobin (GHb) is one of the wellestablished means of monitoring glycemic control in patients with diabetes mellitus.Glycosylation is a nonenzymatic reaction between free aldehyde group of glucose and free amino groups of proteins. The biosynthesis of glycosylated hemoglobin’s (HbA1a, HbA1b, and HbA1c) occurs slowly, continuously and almost irreversibly throughout the four month life span of erythrocytes and the process is nonenzymatic.Recent reports have shown that the concentration of total glycosylated hemoglobin measured by commonly used methods may change significantly over a period of hours. This reflects the short term fluctuations in glucose concentration. It is now realized that these rapid changes depend on the synthesis or dissociation of the labile fraction of HbA1c, which is not separable from the stable form of HbA1c, by most routine methods. Physicians should be aware of the expected variation in HbA1c measurements as well as factors which can interfere with the estimation of microalbumin, So that high standards are maintained while estimating the MA levels and glycated hemoglobin.