随時血糖とHbA1cに乖離があったなら/クラフトコーラ気になる
・血糖がたかくてHbA1cが正常、もしくは異常でもそう高くない場合は、急性に発症した糖尿病を考えることにしていますが、その外にも考えるべきことがあるようで、異常へモグロビン症なんかもそうみたいですね。↓のようなレポートがありました。
HbA1c偽高値から見つかった非糖尿病異常ヘモグロビンHbCの日本人高齢者の1例
石井 宏明, 樋端 恵美子, 村山 秀喜, 小林 則善, 小林 龍彦, 床尾 万寿雄
糖尿病/64 巻 (2021) 3 号
【抄録】
HbA1cの測定方法は,高速液体クロマトグラフィ(HPLC)法のほか,免疫法,酵素法など複数存在する.本邦では従来多くの施設でHPLC法が用いられてきたが,近年酵素法や免疫法による測定が増えている.今回,免疫法でHbA1c偽高値を示した異常ヘモグロビンHbCの1症例を経験した.HPLC法では異常低値を示し,酵素法では基準値内,グリコアルブミンは基準値内であった.遺伝子解析で,βグロビン鎖のミスセンス変異によるHbCと診断した.HbCはアフリカに多い異常ヘモグロビン症で,日本人の報告としては非常に稀であるが,国際化に伴って日本でも症例数が増えることが予想される.HbA1cと血糖値に乖離を疑った際には,複数の方法によるHbA1cの測定,グリコアルブミンによる評価等を含めた慎重な対応が必要である.
・私、どうしても血糖よりHbA1cを重視してしまいますが、血糖がそう高くないときは要注意ですね。
あっという間に以下日記
・本日4/30(土)は、6時8分起床。布団の中でゴソゴソして6時半前に寝床から出ました。朝食摂って、朝勉しました。午前中はある会議というか懇談会(?)、午後は勉強、事務作業、夕方医療生協の新聞と浅口市の広報をくばりました。その後草刈り。そして入浴、夕食。アルコールをいただいております。録画の『マツコの知らない世界』でクラフトコーラというのがあるのを知りました。こりゃーカクテルに使えるのではないかと思い、これから気を付けてお店を診てみようと思います。まずは、カルディーや成城石井チェックですね。
2022-04-30 21:54
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