1. Type 1 diabetes (due to b-cell destruction, usually leading to absolute insulin deficiency) 2. Type 2 diabetes (due to a progressive insulin secretory defect on the background of insulin resistance) 3. Gestational diabetes mellitus (GDM) (diabetes diagnosed in the second or third trimester of pregnancy that is not clearly overt diabetes) 4. Specific types of diabetes due to other causes, e.g., monogenic diabetes syndromes (such as neonatal diabetes and maturity-onset diabetes of the young [MODY]), diseases of the exocrine pancreas (such as cystic fibrosis), and drugor chemical-induced diabetes (such as in the treatment of HIV/AIDS or after organ transplantation)

Classification and diagnosis of diabetes

KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease

http://pic1.cmt.com.cn/newspic/files/dm-guidelines-ccp.pdf

American association of clinical endocrinologists and american college of endocrinology - clinical practice guidelines for developing a diabetes mellitus comprehensive care plan - 2015.

Background: Glycohemoglobin (gHb), measured as hemoglobin (Hb) A1c or as total gHb, provides a common means for assessing long-term glycemic control in individuals with diabetes mellitus. Genetic variants and chemically modified derivatives of Hb can profoundly affect the accuracy of these measurements, although effects vary considerably among commercially available methods. The prevalence of genetic variants such as HbS, HbC, and HbE, and chemically modified derivatives such as carbamyl-Hb among patient populations undergoing testing is not insignificant. Clinical laboratories and sites responsible for point-of-care testing of gHb need to be aware of the interferences produced in assays by these Hbs.

Approach: We conducted a review of the literature describing the effects of variant Hbs on gHb assay methods commonly used in clinical laboratories.

Content: This review summarizes the documented effects of both common and uncommon Hb variants and derivatives on the measurement of gHb. Where known, we discuss mechanisms of interference on specific assays and methodologies. We specifically address effects of commonly encountered Hbs, such as carbamyl-Hb, HbS, HbC, HbE, and HbF, on assays that use cation-exchange chromatography, immunoassays, or boronate affinity methods for measuring gHb.

Summary: A variety of patient- and laboratory-related factors can adversely affect the measurement of gHb in patients harboring Hb variants or derivatives. Identification of the variant or derivative Hb before or during testing may allow accurate measurement of gHb by the selection of a method unaffected by the given variant or derivative. However, laboratories should make available alternative, non-Hb-based methods for assessing long-term glycemic control in individuals with HbCC, HbSS, or HbSC disease, or with other underlying disorders where the concentration of gHb does not accurately reflect long-term glycemic control.

/pdf/effects-of-hemoglobin-variants-and-chemically-modified-31f6k684bx.pdf

Effects of Hemoglobin Variants and Chemically Modified Derivatives on Assays for Glycohemoglobin

The implantation process involves complex and synchronized molecular and cellular events between the uterus and the implanting embryo. These events are regulated by paracrine and autocrine factors. Trophoblast invasion and migration through the uterine wall is mediated by molecular and cellular interactions, controlled by the trophoblast and the maternal microenvironment. This review is focused on the molecular constituents of the human trophoblast, their actions and interactions, including interrelations with the uterine endometrium.

/pdf/human-trophoblast-function-during-the-implantation-process-34arq9ws6x.pdf

Human trophoblast function during the implantation process

Abstract This parameter’s results accuracy has a special importance in the management of diabetic patients since targets for optimal glycemic control are established using HbA1c values. Several error sources can influence the obtained value, some of them can be counteracted (ex. pipetting errors, storage), and others should be taken into consideration at the interpretation of the result (ex. presence of hemoglobin variants). The aim of this study was to compare four chromatographic methods regarding the costs and the influence of certain error sources on the accuracy of the result. Materials and methods: Samples and controls were analyzed using Variant I, Micromat II and In2it (Bio-Rad) systems, and the BIOMIDI reagent kit for HbA1c measurement. Results: Positive correlation could be observed comparing the results obtained using different methods, except the patients presenting elevated HbF. Pipetting errors modify the results up to 5% in case of Variant I, and up to 10% in case of Micromat II in the tested range. One day of improper storage at room temperature causes 3% deviation from the actual value using the Variant I analyzer and 5% in case of Micromat II and In2it equipment. As a conclusion, depending on the number of samples, automated chromatographic analyzers are the most appropriate equipments for the determination of HbA1c.

/pdf/comparison-of-four-chromatographic-methods-used-for-4818wqvw23.pdf

Trefor Higgins

Papers

Comparison of four chromatographic methods used for measurement of glycated hemoglobin

Evaluation of new methods for quantifying albumin and IgG in cerebospinal fluid (CSF) on an ADVIA 1800

A tale of HbA1c utilization in 4 Alberta cities

Centralization of multisite reagent lot-to-lot validation for Ortho Clinical Vitros chemistry instruments

More on the measurement of glycohemoglobin in patients with hemoglobin D