DIABETES

The epidemic of diabetes mellitus: a global burden

Pathology

Diabetes is a chronic life-threatening condition in which the amount of glucose in the blood is too high because its consumption is impaired. This is due to the fact that the body does not produce enough insulin or does not respond properly to insulin, a hormone enabling cells to absorb glucose.

There are two types of diabetes:

  • Type 1 diabetes is an autoimmune condition that results from the destruction of Langerhans islets in the pancreas causing a lack of insulin production. This form was previously referred as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".
  • Type 2 diabetes is developed over time and was previously referred as “non insulin-dependent diabetes mellitus” (NIDDM). The cause is different from Type 1 diabetes. Two abnormalities are responsible for hyperglycemia:
    • Insulinopenia: pancreas produces an insufficient amount of insulin,
    • Insulin resistance: insulin is produced in a normal amount but is inefficient.

Individuals with diabetes have an increased risk of developing a number of serious health problems. Consistently high blood glucose levels can lead to non-reversible complications affecting the heart and blood vessels, eyes, kidneys, nerves and teeth. In addition, people with diabetes also have a higher risk of developing infections.

Diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation.

In 2014, it is estimated that 387 million people had diabetes worldwide. According to the International Diabetes Federation, this will rise to 592 million by 2030.

IDF Regions and global projections for the number of people with diabetes (20-79 years), 2010-2030

Test principle

HbA1c measures glycated hemoglobin. Since red blood cells have about a 120 day life span, HbA1c reflects the mean glucose concentration of the patient for the previous months. Thus, HbA1c is a widely used biomarker in the management of diabetes. It provides information on the monitoring of long-term glycemic control and an assessment of the risk of developing complications.

HbA1c is defined as the hemoglobin A which is irreversibly glycated at one or both N-terminal valines of the beta chain.

 

Test indications

Capillary electrophoresis is the next generation separation method that provides clear-cut and precise separation of the HbA1c fraction with no altered results in the presence of the most frequent interferences (labile A1c, carbamylated Hb, HbF, heterozygous S, C, D and E). The high resolution power of the method allows the incidental detection of homozygous hemoglobin variants (sicke cell disease,…) preventing HbA1c reporting in the absence of HbA.

The HbA1c measurement is done by using the exact same calculation formula as the one used by the IFCC reference method for the worldwide assay standardization: HbA1c/(HbA1c+HbA0), thus ensuring reliable results in all circumstances.

SEBIA assays available for this pathology

CAPILLARYS 3 Hb A1c 

CAPILLARYS Hb A1c 

MINICAP Hb A1c