HbA1c can be a useful glycemic control marker for patients with neonatal diabetes mellitus older than 20 weeks of age.
BACKGROUND
The accuracy of most HbA1c analysis methods is affected by the presence of increased fetal hemoglobin (HbF). The objective of this study was to investigate the age at which HbA1c measurements become useful for monitoring glycemic control in patients with neonatal diabetes mellitus (NDM).


METHODS
We retrospectively analyzed the data of 5 NDM patients diagnosed at 38±20 days of age, who each had several available HbA1c measurements during the first year of life, with a control group of HbA1c values over the course of 1 year for 13 patients with type 1 diabetes mellitus (T1DM). Mean blood glucose (MBG) levels derived from premeal or premeal plus bedtime blood glucose measurements prior to HbA1c measurements were compared to HbA1c values.


RESULTS
The NDM patients' age at which the difference in the HbA1c/MBG ratios became not significant between the NDM patients and the T1DM patients was 21 weeks of age and over. Even after the HbA1c was adjusted for HbF, this ratio was significantly lower in the NDM patients at <21 weeks of age than in the T1DM patients.


CONCLUSIONS
HbA1c can be a useful glycemic control marker for NDM patients >20 weeks of age.
Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan.
Akiko
A
Furuya
Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan. Electronic address: shige5p@asahikawa-med.ac.jp.
Shigeru
S
Suzuki
Department of Internal Medicine, Kawanishi City Hospital, Japan.
Masafumi
M
Koga
Department of Pediatrics, Sapporo Tokushukai Hospital, Japan.
Miho
M
Oshima
Department of Pediatrics, Sapporo Tokushukai Hospital, Japan.
Satoshi
S
Amamiya
Department of Neonatology, Japanese Red Cross Medical Center, Japan.
Atsushi
A
Nakao
Department of Pediatrics, Bell Land General Hospital, Japan; Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Japan.
Keiko
K
Wada
Department of Pediatrics, Tenshi Hospital, Japan.
Koji
K
Okuhara
Department of Pediatrics, Anjo Kosei Hospital, Japan.
Satoshi
S
Hayano
Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan.
Kumihiro
K
Matsuo
Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan.
Yusuke
Y
Tanahashi
Department of Pediatrics, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa 078-8510, Japan.
Hiroshi
H
Azuma
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin
Fetal hemoglobin; Glycemic control; HbA1c; Neonatal diabetes mellitus