Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Relationship between glycosylation of haemoglobin and the duration of diabetes: A study during the third trimester of pregnancy

  • 93 Accesses

  • 20 Citations


The relationship between blood glucose and glycosylated haemoglobin (HbA1c) has been investigated during an 8 week period in 53 Type 1 (insulin-dependent) diabetic women studied during the third trimester of pregnancy. Blood glucose estimations (fasting and 2 h post-prandially) were made an average of 41 times in each patient during this period and HbA1c was determined once at the end of the study. There was a significant correlation between both the mean blood glucose over the preceding 8 weeks and the standard deviation of the fasting blood glucose with HbA1c (r=0.69, p<0.001; r=0.46, p<0.001, respectively). A ‘glycosylation index’ was calculated for each patient (HbA1c divided by the mean blood glucose value). There was a significant correlation between the ‘glycosylation index’ and duration of diabetes (r=0.68, p<0.001). In contrast, there was no correlation between red cell 2,3-diphosphoglycerate and HbA1c or ‘glycosylation index’. These findings suggest that increasing duration of diabetes influences the post-translational formation of HbA1c and that isolated HbA1c values need to be interpreted with caution in the pregnant diabetic.


  1. 1.

    Bunn HF, Gabbay KH, Gallop PM (1978) The glycosylation of hemoglobin: Relevance to diabetes mellitus. Science 200:21–27

  2. 2.

    Bunn HF, Haney DN, Kamin S, Gabbay KH, Gallop PM (1976) The biosynthesis of human hemoglobin A1c: Slow glycosylation of hemoglobin in vivo. J Clin Invest 57:1652–1659

  3. 3.

    Koenig RJ, Peterson CM, Jones RL, Saudek C, Lehrmann M, Cerami A (1976) Correlation of blood glucose regulation and hemoglobin A1c in diabetes mellitus. N Engl J Med 295:417–420

  4. 4.

    Gabbay KH, Hasty K, Breslow JL, Ellison RC, Bunn HF, Gallop PM (1977) Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus. J Clin Endocrinol 44:859–864

  5. 5.

    Kjærgaard J-J, Ditzel J (1979) Hemoglobin A1c as an index of long-term blood glucose regulation in diabetic pregnancy. Diabetes 28:694–696

  6. 6.

    Haney DN, Bunn HF (1976) Affinity labeling of hemoglobin by glucose-6-phosphate. Proc Natl Acad Sci USA 73:3534–3538

  7. 7.

    Madsen H, Ditzel J, Hansen P, Hahnemann N, Andersen OP, Kjærgaard J-J (1981) Hemoglobin A1c determinations in diabetic pregnancy. Diabetes Care 4:541–546

  8. 8.

    White P (1971) Pregnancy in diabetes. In: Marble A, White P, Bradley RF, Krall LP (eds) Joslin's Diabetes mellitus, 11th edit. Lea and Febiger, Philadelphia, pp 581–598

  9. 9.

    Pedersen J (1977) The pregnant diabetic and her newborn, 2nd edit. Munskgaard, Copenhagen

  10. 10.

    Trivelli LA, Ranney HM, Lai HJ (1971) Hemoglobin components in patients with diabetes mellitus. N Engl J Med 284:353–357

  11. 11.

    Schwartz HC, King KC, Schwartz AL, Edmunds D, Schwartz R (1976) Effects of pregnancy on hemoglobin A1c in normal, gestational diabetic and diabetic women, Diabetes 25:1118–1122

  12. 12.

    Banauch D, Brummer W, Ebeling W, Metz H, Rindfrey H, Lang H, Leybold K, Rick W (1975) Eine Glucose-dehydrogenase für die Glucose-Bestimmung in Körperflüssigkeiten. Z Klin Chem Klin Biochem 13:101–107

  13. 13.

    Ericsson A, de Verdier CM (1972) A modified method for the determination of 2,3-diphosphoglycerate in erythrocytes. Scand J Clin Lab Invest 29:85–90

  14. 14.

    Widness JA, Royler-Brown TL, McGormick KL, Petzold KS, Susa JB, Schwartz HC, Schwartz R (1980) Rapid fluctuations in glycohemoglobin (hemoglobin A1c) related to acute changes in glucose. J Lab Clin Med 95:386–394

  15. 15.

    Ditzel J, Kjærgaard JJ, Reiko Kawahara, Østergaard GZ, Mourits-Andersen T (1981) Glycosylated hemoglobin in relation to rapid fluctuations in blood glucose in children with insulin-dependent diabetes. A comparison of methods with and without prior dialysis. Diabetes Care 4:551–555

  16. 16.

    Kjærgaard JJ, Hansen P, Madsen H, Ditzel J (1980) Hemoglobin A1c as an indicator of long term blood glucose levels in diabetics with special reference to diabetic pregnancy. Acta Endocrinologica 94 (Suppl 238):25–29

  17. 17.

    Goldstein DE, Walker B, Rawlings SS, Hess RL, England JD, Peth SB, Hewett JE (1980) Hemoglobin A1c levels in children and adolescents with diabetes mellitus. Diabetes Care 3:503–507

  18. 18.

    Ruchnagel DL, Chernoff AJ (1955) Immunologic studies of hemoglobin. III Fetal hemoglobin changes in the circulation of pregnant women. Blood 10:1092–1099

Download references

Author information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Madsen, H., Kjasrgaard, J.-. & Ditzel, J. Relationship between glycosylation of haemoglobin and the duration of diabetes: A study during the third trimester of pregnancy. Diabetologia 22, 37–40 (1982). https://doi.org/10.1007/BF00253867

Download citation

Key words

  • Haemoglobin A1c
  • duration of diabetes
  • diabetic pregnancy
  • glycosylation index
  • 2,3-diphosphoglycerate