Glycosylated hemoglobins and their relation to the control of juvenile diabetes mellitus.

Patients with juvenile diabetes mellitus were studied over a period of six months. During this time their metabolic control was classified and the relation between the blood concentration of the glycosylated hemoglobins Hb A1a + b + c and the degree of diabetic control was established. 12 out of 37 diabetic children were under good control, whereas 6 patients were poorly controlled. Well controlled children had low concentrations of glycosylated hemoglobins, within the range of non-diabetic subjects. Those under poor control showed an almost twofold increase of the concentration of these minor hemoglobins. Hb A1a + b + c levels of 8 newly diagnosed diabetics were also extremely elevated. Since the hemoglobin-sugar linkage is irreversible, these components remains much longer elevated than the blood glucose itself. It is concluded that the determination of Hb A1a + b + c levels is a valuable tool for the evaluation of the efficiency of diabetic therapy in addition to blood and urinary glucose measurements.