Question

1. Distinguish between reactive and spontaneous hypoglycemia.
2. Describe the three commonly encountered methods of glycosylated hemoglobin.
3. Describe the use of glycosylated hemoglobin in the long-term monitoring of diabetes.

Answer 1

Reactive hypoglycemia refers to low blood sugar that occurs after a meal which is the result of too much insulin released by pancreas following a large carbohydrate-based meal.

Spontaneous hypoglycemia is hypoglycemia that occurs outside the setting of diabetes management; i.e not iatrogenic.

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Glycosylated hemoglobin means hemoglobin to which glucose is bound. Glycosylated hemoglobin is tested to monitor the long-term control of diabetes mellitus.

The methods of estimation og glycosylated hemoglobin are :

Knauer–HPLC - a device designed based on affinity chromatography.

Biosystem - kit containing chromatographic columns accompanied with chemical reagent. It is based on spectrophotometer ion exchange.

Diazyme - kit containing chemical reagents and buffers used in autoanalyzers. It is based on enzyme reactions.

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The level of glycosylated hemoglobin is increased in the red blood cells of persons with poorly controlled diabetes mellitus. Once a hemoglobin is glycosylated, it remains in the RBC for about 120 days (lifespan of RBC). So glycosylated hemoglobin measures the average control of blood sugar over the preceding 2 to 3 months.