Sobre Hemoglobina Glicada, no New England Journal of Medicine, que saiu no blog
CasesBlog. Mais um estudo de importante publicação demonstra que o teste para avaliação de diabetes em longo prazo é a hemoglobina glicada, embora outros testes estejam chegando à realidade médica, como o 1,5 anidroglucitol (1,5 AG), que promete ser muito útil.
As pessoas em geral entendem que a determinação de glicemia de jejum diz alguma coisa útil sobre o controle do diabetes. Isso, além de não ser verdade, é extremamente perigoso, porque pode causar no doente uma falsa sensação de controle glicêmico. Por enquanto, o que temos de rotina é HbA1c, e este teste tem de ser encarado com a importância que merece, no contexto de avaliação do controle glicêmico. Atualmente, alguns autores têm tentado utilizar este teste em não diabéticos, seja para o diagnóstico de diabetes, seja para a determinação de risco de doenças coronarianas, por exemplo.
Bom proveito:
Glycated hemoglobin as a diagnostic test for diabetes predicts mortality more accurately than fasting glucose: "
Fasting glucose is the standard measure used to diagnose diabetes in the United States. Recently, glycated hemoglobin was also recommended for this purpose.
The glycated hemoglobin value at baseline was associated with newly diagnosed diabetes and cardiovascular outcomes.
For glycated hemoglobin, values of less than 5.0%, 5.0-5.5%, 5.5-6.0%, 6.0-6.5%, and
6.5% or greater, the
hazard ratios for diagnosed diabetes were 0.52, 1.00, 1.86, 4.48, and
16.47, respectively.
For coronary heart disease, the hazard ratios were 0.96, 1.00, 1.23, 1.78, and 1.95, respectively. The hazard ratios for stroke were similar.
In contrast, glycated hemoglobin and death from any cause were found to have a J-shaped association curve.
The association between the fasting glucose levels and the risk of cardiovascular disease or death from any cause was not significant.
In this community-based population of nondiabetic adults, glycated hemoglobin was associated with a risk of diabetes and more strongly associated with risks of cardiovascular disease and death from any cause as compared with fasting glucose. These data add to the evidence supporting the use of glycated hemoglobin as a diagnostic test for diabetes.
References:
Image source: OpenClipArt.org, public domain.

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