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1259 GLYCOHEMOGLOBIN BY AFFINITY CHROMATOGRAPHY: A THIRTY MINUTE PROCEDURE IN CLINIC

The utility of glycohemoglobin (GHb) in the management of diabetes mellitus (DM) is undisputed. Clinical decisions frequently are deferred 3-5 days until the GHb results are available; hence, follow-up instructions must be given by telephone or letter. The delay and lack of personal attention may markedly reduce compliance; conversely, postponing new recommendations until the next evaluation may reduce the utility of GHb to a mere academic exercise. We evaluated affinity chromatography (AC) for the possibility of obtaining GHb results while the patients were in the clinic. From 23 children with insulin dependent DM, 25 ul of blood was collected by a fingerstick and GHb was measured by AC. Results for up to 5 specimens were available in 30 minutes. A venous blood specimen was collected simultaneously from the same 23 children and HbA1c was measured by high pressure liquid chromatography after removal of labile fraction (LF). A remarkable correlation was found between the two methods (r = 0.89). The study was repeated 2 months later and similar results were obtained (r = 0.91, n = 25). Even though LF was not removed in AC, the correlation between the two methods indicates that LF may only be an insignificant portion of total GHb. The AC was less expensive than the conventional methods and was more acceptable to the children as venipuncture was not required. We conclude that the utility of GHb may be improved in clinical practice utilizing AC, as prompt results can be obtained at less expense without the necessity of a venipuncture.