[Facts and problems of the structural clarification, determinative methods and clinical value of glycosylated hemoglobins]

Abstract

First of all a report is given on the structural peculiarities of the glycohaemoglobins and an appreciation of the non-enzymatic glycosylation reactions with different hexoses is performed. Furthermore a critical judgment of the different methods for the determination of glycosylated haemoglobins follows with the results that in conformity with the international literature the smallest expense and the highest effectiveness must be ascribed to column chromatographic and photometrical methods. The importance of glycosylated haemoglobins for a long-range judgment of the situation of metabolism in diabetics is proved. According to this in particular clearly increased Hb A1 and Hb A1c values are identical with a bad situation of metabolism. Moreover its importance as an additional diagnostic criterion in the bordersphere of the pathological carbohydrate tolerance is emphasized. The effects of different influence factors, e.g. pregnancy, drugs, lipid metabolism and of certain affections on the concentration of glycohaemoglobins are also discussed.