Abstract
We have investigated the relationship between fetal hemoglobin (HbF) levels and metabolic control in subjects with insulin-dependent (N = 79) and non-insulin-dependent diabetes mellitus (N = 242). HbF and hemoglobin A1c (HbA1c) levels were increased in subjects with type 1 and type 2 diabetes as compared to levels in nondiabetic individuals (P < 0.0001), and were significantly higher in type 1 than in type 2 diabetes subjects. Lower levels of HbA1c and HbF were observed in type 2 diabetes subjects treated by diet, intermediate levels in those treated with oral hypoglycemic agents, and higher levels in those treated with insulin. HbF and HbA1c levels were correlated in type 1 diabetes (R2 = 0.57, P < 0.0001) and type 2 diabetes (R2 = 0.58, P < 0.0001) subjects. Following intense treatment, twelve diabetic patients showed significant improvement both in HbA1c and HbF values. We conclude that increased HbF levels reflect poor metabolic control in subjects with diabetes mellitus.
Highlights
Several hemoglobin subfractions are formed by glycation of hemoglobin A (HbA), including HbA1a, HbA1b, the labile intermediate form (Hb-L-A1c) and glycated hemoglobin A1c (HbA1c)
HbA1c levels were increased in subjects with type 1 and type 2 diabetes as compared to subjects from control groups 1 and 2 (Table 1, Figure 1), and were significantly higher in type 1 than in type 2 diabetes subjects
We have observed lower levels of both HbA1c and HbF in type 2 diabetes subjects who were treated with diet only, intermediate levels in those treated with oral hypoglycemic agents (OHA), and higher levels in the subjects treated with insulin
Summary
Several hemoglobin subfractions are formed by glycation of hemoglobin A (HbA), including HbA1a, HbA1b, the labile intermediate form (Hb-L-A1c) and glycated hemoglobin A1c (HbA1c). Fetal hemoglobin (HbF) is produced in a subpopulation of erythrocytes termed Fcells and is the predominant hemoglobin in fetal life and early infancy. HbF levels were shown to be increased in some subjects with type 1 diabetes [6,7,8], but data on HbF levels in type 1 diabetes are scarce. No data are available for subjects with type 2 diabetes, and the correlation of HbF levels with the quality of metabolic control in diabetic subjects remains unclear. We have investigated the relation between HbF and metabolic control in subjects with type 1 and type 2 diabetes
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