In response to popular demand, this week is glycation week. In this
episode, I discuss the strengths and limitations of using Hba1c to
measure our cumulative recent exposure to blood glucose and diabetes
Many people will be familiar with the fact that variation in red
blood cell turnover confounds this measurement. Less well known is that variations in the deglycating enzyme fructosamine 3-kinase (FN3K) also confound the measurement.
Counter-intuitively, if you have a higher rate of this deglycating enzyme but a lower rate of downstream metabolism of 3-deoxyglucosone, your lower Hba1c could actually mean MORE
glycation. I conclude that Hba1c is a useful test, but only in the context of a bigger picture put together with more information.
If you'd like to share the public version of this episode with non-Masterpass holders, you can find it here