運用糖化血色素推估平均血糖值

Application of Glycated Hemoglobin to Estimate Average Blood Glucose Level

樓亞洲(Yea-Jou Lou) ； 張美智(Mei-Chi Chang)

《北市醫學雜誌》 6卷5期 (2009/10) Pp. 333-340

摘要

糖化血紅素(HbA1c)的百分比可反映出紅血球生存期間的加權平均血糖濃度，是評估血糖控制最重要的指標，用於治療調整的依循、亦可預估併發症發生的危險率。病患平日的血糖自我監測值(SMBG)是反映當次之血糖值，每日高低起伏。惟二者相互搭配，才能找出血糖問題所在，但二者單位分別為%和mg/dl，易造成病患困惑；因此目前由HbA1c值，依ADAG研究推算的平均血糖值(eAG)，其單位與SMBG同為mg/dl，病患較熟悉，較易接受。有利於病患瞭解長期血糖控制情況，eAG與SMBG之間的差異，得以調整飲食、運動和藥物；美國ADA亦推薦廣用HbA1c附加eAG之報告系統，以加強病患對血糖的認知，並有助於臨床醫療人員對病患的衛教。期望在台灣推廣HbA1c附加eAG之應用，對病患血糖控制更有助益。

關鍵字

糖尿病 ； 糖化血紅素 ； 推估平均血糖值

並列摘要

Diabetes mellitus (DM) currently affects approximately one million individuals in Taiwan. DM is a chronic progressive complex disease. Intensive glycemic control can reduce or delay the risk of developing complications. Measurement of glycosylated hemoglobin (HbA1c) is fundamental to the management of patients with DM. HbA1c represents the integrated glucose concentration over the preceding two to three months. It is, therefore, free of the fluctuations that occur daily in blood glucose concentration. Numerous different HbA1c assay methods are performed by different laboratories and this can result in an extensive variation in HbA1c values. The National Glycohemoglobin standardsizes Program (NGSP) on standardization process has significantly reduced the variation in HbA1c measurement among laboratories. NGSP-certified methods are used worldwide. The estimated average glucose (eAG) is derived from HbA1c and is reported in units (mg/dl) that are familiar to patients and clinicians. The American Diabetes Association (ADA) recommends that the eAG be used and reported in addition to HbA1c. This reporting system is also recommended for application in Taiwan.

並列關鍵字

diabetes mellitus ； glycosylated hemoglobin ； estimated average glucose