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The importance of the measurement of glycosylated haemoglobin as a quantitative index reflecting metabolic control in diabetics during the preceeding four to six weeks is now well established. The suitability of the colorimemc method of Fluckiger and Winterhalter as a technique adaptable for developing countries has been evaluated. Incubation with oxalic acid for one hour indicated good precision with coefficient of variation within assay of 3.19 (n=20) and between assay of 2.8% (n=15) for normals and 1.8% for diabetics. 0-D-fructose was also used in addition to 5-hydroxy methyl furfuraldehyde (HMF) as standards. This gives a measure of efficiency of the reaction. The non-specific blank value for all samples were a constant. Whole blood sam les could be stored at room temperature (30 f 3'~) for 5 8 days and for nine days at 4 C. Haemolysates were stable at 4'~ for 5 days and for 30 days at -20'~. A good correlation coefficient of r = 0.92 was obtained with a microcolumn test kit (n=20, p < 0.001). The normal mean (SD) for glycosylated haemoglobin (HbA1) for Sri Lanka was found to be 5.85% f 0.79 for males (n=70) and 5.88% f 0.79 for females (n=30). A significant difference was not observed between males and females. The overall mean for normals was 5.9% 2 0.79 (or 0.39% f 0.05 /&I HMF/g Hb). Mean for non-insulin dependent diabetics was 10.83% f 3 (or 0.68 k 0.20 /.&I HMF/g Hb). The mean %HbA1 for pregnant women (n=15) in the 3rd trimester of pregnancy was 7.0% f 0.7 The colorimetric method meets many of the criteria for an ideal laboratory test. It proves to be the most suitable method for the measurement of glycosylated haemoglobin in developing countries.

An evaluation of a colorimetric procedure for the estimation of glycosylated haemoglobin and the establishment of reference values for Sri Lanka