Third, what are the factors affecting the measurement of glycosylated hemoglobin? 1, glycated hemoglobin (HbA1c) false elevation (that is, was not high, but the measured value is high) Any factors to extend the life of red blood cells or reduce the exposure time of red blood cells in a high-sugar environment can be caused by an increase in the level of glycated hemoglobin, iron deficiency anemia is the most common cause of increased glycated hemoglobin factors. Severe hypertriglyceridemia (concentration >19 mmol/L), severe hyperbilirubinemia (concentration >342 ummol/L), and uremia can cause pseudo-elevation of glycated hemoglobin. In addition, many drugs can also cause false elevation of glycosylated hemoglobin, including salicylates and opioids. 2.Glycosylated hemoglobin (HbA1c) pseudo-reduced (that is, originally high, but the measured value is low) Any factors that can shorten the life expectancy of red blood cells or reduce the exposure time of red blood cells in a high-sugar environment, increase the turnover of red blood cells can be caused by a reduction in the level of glycated hemoglobin, and these factors, such as acute or chronic blood loss, hemolytic anemia, splenomegaly and so on, can cause pseudo-decrease in the results of glycated hemoglobin. . In addition, some drug medications including vitamin E, viroxicam and alpha-interferon can also cause a false decrease in hemoglobin. In addition, some studies have shown that for every 1 year increase in age, the glycosylated hemoglobin value can rise by 0.03%. After checking glycosylated hemoglobin, do I still need to check fasting and two-hour postprandial blood glucose? The answer is yes. Daily blood glucose monitoring is used to guide the adjustment of daily treatment program. Glycated hemoglobin does not reflect the immediate blood glucose level at a certain point in time, therefore, it cannot replace daily blood glucose monitoring. Sometimes there are inconsistencies between the two, which are to be determined by an endocrine specialist. There are two scenarios: 1. Normal blood glucose but high glycosylated hemoglobin test result: This is because a single blood glucose result does not reflect the true long-term blood glucose control, while glycosylated hemoglobin can reflect the average blood glucose level over the past 2-3 consecutive months. In this case, it is often because the number of times of testing blood glucose is small, for example, checking the fasting blood glucose is normal, but not checking the postprandial blood glucose, you can not find postprandial hyperglycemia. 2, high blood glucose but normal results of glycated hemoglobin: This is because the blood glucose meter detects blood glucose value only reflects the blood glucose value at a certain point of the day (e.g., fasting, pre-meal, postprandial or bedtime, etc.). If there is often both hypoglycemia and hyperglycemia over a period of time, it is entirely possible that the glycosylated hemoglobin value will remain in the normal range. In this case, there may be frequent hypoglycemia that goes undetected. If there have been several recent episodes of markedly elevated immediate blood glucose with normal glycosylated hemoglobin values, this suggests that the blood glucose level has only recently changed. Therefore, popularizing the knowledge of diabetes, updating the concept of treatment, monitoring and keeping the glycated hemoglobin up to the target, and using glucose-lowering drug therapy earlier and more rationally are especially important for controlling the development of diabetic complications. Glycated hemoglobin should be checked every 3 months when diabetic patients’ glycemic control does not reach the target or after the adjustment of the treatment plan; after glycemic control reaches the target, glycemic hemoglobin should be checked at least twice a year.