Hemoglobin A1C in Home Parenteral Nutrition

Abstract

Hemoglobin A_1C or glycosylated hemoglobin has been described as being effective in monitoring long-term glucose control in diabetics. The usefulness of HbA_1C in reflecting glucose homeostasis during chronic hypertonic dextrose infusions in 6 patients receiving cyclic home TPN was studied at monthly intervals. Grouped data for the 34 values representing study periods of 5 to 10 months averaged 7.5 ± 0.2% (Mean ± SEM) indicating that HbA_1C levels were not elevated above normal (4-8%) in these patients while receiving a dextrose based diet. Final values of HbA _1C (7.3 ± 0.4%, mean ± SEM) although lower than early values (8.7 ± 0.6%, mean ± SEM) were not significantly different ( p > 0.05, Student's paired t-test). The change in HbA_1C that occurred in these patients probably reflects the response to an altered glucose load infused by the patient.

HbA_1C is a convenient and apparently accurate method of evaluating chronic glucose tolerance in patients receiving home TPN and may be used as an alternate method for monitoring glucose tolerance on an outpatient basis.