METABOLIC CONTROL IN CHILDREN WITH INSULIN DEPENDENT DIABETES MELLITUS ASSESSED BY HEMOGLOBIN A1c

Abstract

The glycosylated Hb component, HbA1c, was estimated in 92 children with insulin dependent diabetes mellitus by an isoelectric focusing procedure during an observation period of 18 mo. A significant correlation between HbA1c and the actual metabolic control according to clinical ratings was found. A seasonal variation in the concentration of the HbA1c was observed, with the lowest level in the months of June and July, consistent with an improved metabolic control in the diabetic children during the summer period. A direct relationship was found between metabolic control as assessed by HbA1c and retarded linear growth expressed as standard deviation score for height. Children with poorly controlled diabetes (initial HbA1c level above 12.5%) improved their carbohydrate tolerance shown by a significantly lower glycohemoglobin level at the end of the observation period. Consequently, HbA1c is particularly useful in the routine management of insulin dependent diabetic children in poor metabolic control. Frequent determinations are necessary since in these patients the glucose profiles are prone to great variations, which may lead to changes in the HbA1c concentration of .apprx. 1% in a week.