[1] The document discusses various methods for monitoring blood glucose levels and glycemic control in patients with diabetes, including HbA1c, blood glucose monitoring, and glycation of hair. [2] It compares the advantages and limitations of HbA1c testing versus blood glucose monitoring and discusses factors that can influence HbA1c levels. [3] Correlations between HbA1c levels and average blood glucose are presented, showing HbA1c as a marker of long-term glycemic control over the preceding 120 days.

1. [email_address] Dr.R.V.S.N. Sarma, M.D., M.Sc., Paradigm shift in Diabetic care

5. [email_address] Haemoglobin Structure of Hb

11. HbA 1c is ‘weighted’ [email_address]

12. [email_address] Lowering Hb A1c reduces risk of complications How well it measures ?

15. [email_address] Correlation of MPG - HbA 1c Mean Plasma Glucose = (33.3 x HbA 1C% ) - 86 (Nathan et. al. NEJM, vol. 310, No 6, Feb 9, 1994) HbA 1C % 5 7 9 11 Mean BG mg % 80.5 147.1 213.7 280.3

17. Blood Glucose Monitoring [email_address] Type Frequency Sample Type 2 DM Monthly FPG / PPG Type 1 DM 4-6 times initially 6 th hourly to 4 th hourly Stabilized Twice a week. 3 samples Pregnancy Once a week. FPG / PPG Peri-operative 4-6 times a day 6 th hourly to 4 th hourly

18. [email_address] “ Blood Glucose 80 min . after breakfast correlates with MAGE ( Mean Amplitude of Glycaemic Excursions ) throughout the day” Molnar et. al. MAGE

20. [email_address] New era in monitoring control