Glycated hemoglobin (HbA1c) is a product of the spontaneous reaction between hemoglobin and elevated glucose levels in the blood. It is included among the so-called advanced glycation end products, of which is the most important for the clinical diagnosis of diabetes mellitus, and it can serve as an alternative to glycemia measurement. Compared to the diagnosis of diabetes mellitus by glycemia, the HbA1c level is less influenced by a short-term problem with diabetes compensation. Mass spectroscopy and chromatographic techniques are among the standard methods of HbA1c level measurement. Compared to glycemia measurement, there is lack of simple methods for diabetes mellitus diagnosis by means of the HbA1c assay using a point-of-care test. This review article is focused on the surveying of facts about HbA1c and its importance in diabetes mellitus diagnosis, and surveying standard methods and new methods suitable for the HbA1c assay under point-of-care conditions. Various bioassays and biosensors are mentioned and their specifications are discussed.

• Klíčová slova
• advanced glycation end products, analysis, bioanalysis, biosensor, chromatography, diabetes, diagnosis, glucose, hand held assay, lateral flow test, mass spectrometry,
• MeSH
• biosenzitivní techniky MeSH
• diabetes mellitus MeSH
• glykovaný hemoglobin analýza   MeSH
• krevní glukóza MeSH
• lidé MeSH
• point of care testing * MeSH
• vyšetření u lůžka MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• glykovaný hemoglobin MeSH
• krevní glukóza MeSH

Background: The aim was to compare the efficacy of real-time continuous glucose monitoring (rtCGM) and intermittently scanned continuous glucose monitoring (isCGM) focusing on glycated hemoglobin (HbA1c) as the primary endpoint. Methods: The CORRIDA LIFE was a 12-month, real-world, nonrandomized study that is part of the CORRIDA clinical trials program. The study compared rtCGM (Dexcom G5 or G6) and isCGM (FreeStyle Libre 14-Day; Abbott) in adults with type 1 diabetes (T1D). Only patients on multiple daily insulin injections or continuous subcutaneous insulin infusion with no automatic functions were included in this study. Primary outcome was the difference in HbA1c between study groups at 12 months. Results: One hundred ninety-one adults with T1D (mean age 40 ± 13 years, HbA1c 8.1% ± 3.4% [65 ± 14 mmol/mol]) participated in this study; 81 patients initiated rtCGM and 110 initiated isCGM. After 12-months, HbA1c was significantly lower with rtCGM versus isCGM (7.1% ± 3.1% [54.1 ± 10.1 mmol/mol] vs. 7.7% ± 3.3% [61.2 ± 12.2 mmol/mol]), P = 0.0001. The percentage of time in hypoglycemia (<70 mg/dL [<3.9 mmol/L]) was lower among rtCGM vs. isCGM participants [4.3% ± 2.8% vs. 6.4% ± 5.3%], P = 0.003). Patients with rtCGM spent less time in clinically significant hypoglycemia (<54 mg/dL [<3.0 mmol/L]) (0.9% ± 1.0% vs. 2.3% ± 2.5%, P < 0.0001) and more time in target range (70-180 mg/dL [3.9-10 mmol/L]) than isCGM users (67.5% ± 14.8% vs. 57.8% ± 17.0%), P = 0.0002. Conclusions: rtCGM was superior to isCGM in HbA1c, hypoglycemia, and other glycemic outcomes. Our findings provide guidance to clinicians when discussing monitoring options with their patients. The study was registered at www.clinicaltrials.gov (NCT04759495).

• Klíčová slova
• Continuous glucose monitoring, Continuous subcutaneous insulin infusion, Flash glucose monitoring, Glycated hemoglobin, Hypoglycemia, Multiple daily insulin injections, Time in range, Type 1 diabetes,
• MeSH
• diabetes mellitus 1. typu * farmakoterapie   MeSH
• dospělí MeSH
• glykovaný hemoglobin analýza   MeSH
• hypoglykemie * prevence a kontrola   farmakoterapie   MeSH
• hypoglykemika terapeutické užití   MeSH
• inzulin terapeutické užití   MeSH
• krevní glukóza MeSH
• lidé středního věku MeSH
• lidé MeSH
• selfmonitoring glykemie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• glykovaný hemoglobin MeSH
• hypoglykemika MeSH
• inzulin MeSH
• krevní glukóza MeSH

Hyperglycaemia is the common characteristic for diabetes patients. Prolonged hyperglycaemia due to absolute or relative lack of insulin is the cause of microangiopathy. Glucose reacts with both blood vessel wall proteins and plasmatic proteins and erythrocyte haemoglobin. This characteristic of glucose is used to monitor the level of diabetes compensation. The level of glycated haemoglobin reflects glycaemia for the last 2 to 3 months. It began to be used in diabetology in the 1980's. This outline paper deals with some of the pitfalls with which glycated haemoglobin has been recently associated. The first part is dedicated to factors influencing haemoglobin glycation. The second, methodological part focuses on factors influencing its assessment and interpretation. The third part concentrates on the options for the substitution ofglycated haemoglobin by other diabetes compensation markers.

• MeSH
• diabetes mellitus krev   MeSH
• glykovaný hemoglobin analýza   fyziologie   MeSH
• krevní glukóza analýza   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• glykovaný hemoglobin MeSH
• krevní glukóza MeSH

• MeSH
• glykovaný hemoglobin metabolismus   MeSH
• krevní glukóza metabolismus   MeSH
• lidé MeSH
• těhotenství krev   MeSH
• Check Tag
• lidé MeSH
• těhotenství krev   MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• glykovaný hemoglobin MeSH
• krevní glukóza MeSH

• MeSH
• diabetes mellitus 1. typu krev   MeSH
• dospělí MeSH
• glykovaný hemoglobin analýza   MeSH
• lidé MeSH
• novorozenec krev   MeSH
• těhotenství při diabetu krev   MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec krev   MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• glykovaný hemoglobin MeSH

Growing evidence suggests that diabetes mellitus is associated with impairment of the intestinal barrier. However, it is not clear so far if the impairment of the intestinal barrier is a consequence of prolonged hyperglycemia or the consequence of external factors influencing the gut microbiota and intestinal mucosa integrity. Aim of the study was to perform an estimation of relationship between serological markers of impairment of the intestinal barrier: intestinal fatty acid-binding protein (I-FABP), cytokeratin 18 caspase-cleaved fragment (cCK-18), and soluble CD14 (sCD14) and markers of prolonged hyperglycemia, such as the duration of diabetes mellitus and glycated hemoglobin (HbA1c) via a correlation analysis in patients with diabetes mellitus. In 40 adult patients with type 1 diabetes mellitus and 30 adult patients with type 2 diabetes mellitus the estimation has been performed. Statistically significant positive correlation was found between cCK-18 and HbA1c (r=0.5047, p=0.0275) in patients with type 1 diabetes mellitus with fading insulitis (T1D). In patients with type 1 diabetes mellitus with ongoing insulitis (T1D/INS) and in patients with type 2 diabetes mellitus (T2D), no statistically significant positive correlations were found between serological markers of intestinal barrier impairment (I-FABP, cCK-18, sCD14) and duration of diabetes or levels of HbA1c. Similarly, in cumulative cohort of patients with T1D/INS and patients with T1D we revealed statistically positive correlation only between HbA1c and cCK-18 (r=0.3414, p=0.0311). Surprisingly, we found statistically significant negative correlation between the duration of diabetes mellitus and cCK-18 (r=-0.3050, p=0.0313) only in cumulative group of diabetic patients (T1D, T1D/INS, and T2D). Based on our results, we hypothesize that the actual condition of the intestinal barrier in diabetic patients is much more dependent on variable interactions between host genetic factors, gut microbiota, and environmental factors rather than effects of long-standing hyperglycemia (assessed by duration of diabetes mellitus or HbA1c).

• MeSH
• antigeny CD14 MeSH
• biologické markery MeSH
• diabetes mellitus 1. typu * diagnóza   metabolismus   MeSH
• diabetes mellitus 2. typu * diagnóza   MeSH
• dospělí MeSH
• glykovaný hemoglobin analýza   MeSH
• hyperglykemie * MeSH
• lidé MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antigeny CD14 MeSH
• biologické markery MeSH
• glykovaný hemoglobin MeSH

Type-2-diabetes mellitus (T2DM) is a global problem of medical, social and economic consequences. Physical activity is a vital therapy in patients with T2DM, but some of them cannot exercise for various reasons. The purpose of our pilot study was to determine whether a combination of neuromuscular electrostimulation (NMES) and insulin therapy could improve the management of T2DM patients with hemiplegia caused by an ischemic stroke. Fifteen immobile patients with T2DM on insulin therapy were enrolled in the study. NMES was applied to their lower limbs for 60 min, 5 days a week, over a period of 12 weeks. The intervention caused statistically significant reductions in the blood concentrations of glycated hemoglobin, total cholesterol and low-density cholesterol in the participants. Furthermore, systolic and diastolic blood pressure levels were significantly lower. More randomized clinical trials are needed to accurately measure the effect of NMES on T2DM treatment and to determine whether it can be an alternative for physical activity for immobile patients with T2DM.

• Klíčová slova
• hemiplegia, ischemic stroke, neuromuscular electrical stimulation (NMES), physical therapy, type 2 diabetes mellitus (T2DM),
• MeSH
• cévní mozková příhoda * MeSH
• diabetes mellitus 2. typu * komplikace   terapie   MeSH
• elektrická stimulace MeSH
• elektrostimulační terapie * MeSH
• glykovaný hemoglobin MeSH
• hemiplegie MeSH
• hemodynamika MeSH
• inzulin terapeutické užití   MeSH
• ischemická cévní mozková příhoda * MeSH
• ischemie mozku * MeSH
• lidé MeSH
• lipidy MeSH
• pilotní projekty MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• glykovaný hemoglobin MeSH
• inzulin MeSH
• lipidy MeSH

Patients with less severe glycated haemoglobin (HbA1c) targets may find it difficult to achieve the target values of lipid parameters treatment at high cardiovascular risk. We have been monitoring the correlation between levels of triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) with glycosylated haemoglobin (HbA1c) by IFCC method (method of testing according to the International Federation of Clinical Chemistry and Laboratory Medicine) and by DCCT method (Diabetes Control and Complication Trial) as well as body mass index (BMI) at the time of diagnosis of the disease, that could help identify patients with an increased risk of cardiovascular disease. In the cohort study we were monitoring outpatients with newly diagnosed type 2 diabetes mellitus during a 5 year period. Patients (117 men, 83 women), aged from 30 to 92 years were conducted sampling blood glucose, HbA1c (IFCC/DCCT), HDL, LDL, TG. At baseline, the patients height, weight, waist circumference, calculated BMI and blood pressure were measured. Waist circumference was measured in the horizontal plane in the middle of the distance between the upper edge of the iliac crest and the lower edge of the last rib in the breath. Our study did not exclude patients taking statin or fibrate. The high HbA1c values increased the risk of elevating LDL-cholesterol levels and TAG levels in the whole group (p = 0.012) and (p = 0.017), and the high BMI values increased the risk of lowering HDL-cholesterol levels in the female population (p = 0.010). The results of our study stratify the increased risk of atherogenicity in these groups. HbA1c is a direct marker of elevated LDL and TAG, and indirect marker for coronary artery disease risk assessment.

• Klíčová slova
• Body Mass Index, Lipoproteins, body mass index, glycated haemoglobin, hypoglycemia, type 2 diabetes mellitus,
• MeSH
• diabetes mellitus 2. typu * MeSH
• dospělí MeSH
• glykovaný hemoglobin MeSH
• HDL-cholesterol MeSH
• kohortové studie MeSH
• krevní glukóza MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• triglyceridy MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• glykovaný hemoglobin MeSH
• HDL-cholesterol MeSH
• krevní glukóza MeSH
• triglyceridy MeSH

Using a mathematical model, the authors analyze the relationship between glycemia and glycated haemoglobin concentration (GHb). This relationship is more complex that it seems at first sight as GHb concentration in erythrocytes is the outcome of two processes: glucose binding to haemoglobin and continuous turnover of erythrocytes in blood. Old erythrocytes carry information on glycemia of longer duration than do the younger ones. The result is that hyperglycemias which occurred immediately before to GHb estimation have a greater effect on GHb concentration than those that occurred former. Due to the fact that behind a certain value of GHb different hyperglycemic periods can be hidden, the compensation of a patient with diabetes mellitus cannot be assessed only on the basis of GHb concentration. The assessment can only be made when using criteria which take into consideration glycemia, glycated plasmatic protein, and glycated haemoglobin values in a complex way.

• MeSH
• biologické modely MeSH
• erytrocyty metabolismus   MeSH
• glykovaný hemoglobin metabolismus   MeSH
• hyperglykemie krev   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• glykovaný hemoglobin MeSH

An original setup for analysis of glycated haemoglobin (HbA1c) in blood is reported. The construction employed a combination of the piezoelectric biosensor for glycated haemoglobin and the flow-through photometric sensor for total haemoglobin (Hb). The modification of gold electrodes with 3-aminophenylboronic acid (APBA) as a specific ligand was studied; the chemisorbed conjugate of APBA with a long-chain thiocompound provided the best affinity for HbA1c. The effect of various operating parameters, such as flow rate and instrumental setup, was optimised. The total haemoglobin content was analysed as absorbance of the haemoglobin-cyanide derivative at 540 nm. Only one standard (calibrator) diluted in various ratio was necessary for calibration and 1 microl of blood was sufficient for analysis. The full range of HbA1c content (4-15%) in blood can be analysed; the working ranges of total and glycated haemoglobin were 50-2000 and 10-90 microg/ml, respectively. The developed method was successfully evaluated on blood samples collected from diabetics.

• MeSH
• biosenzitivní techniky * MeSH
• glykovaný hemoglobin analýza   chemie   MeSH
• hemoglobiny analýza   chemie   MeSH
• kyseliny boronové MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• 3-aminobenzeneboronic acid MeSH Prohlížeč
• glykovaný hemoglobin MeSH
• hemoglobiny MeSH
• kyseliny boronové MeSH