Epinex attended the 69th AACC Annual Scientific Meeting & Clinical Lab Expo, which took place July 30 through August 3 2017 at the San Diego convention center. One of the highlights of this expo was the “Beyond Hemoglobin A1c” symposium that took place in the afternoon of August 1. Close to 200 attendees were at this symposium, where three speakers; David Sacks, Cyrus Desouza, and Paul J. Thornalley, discussed the challenges associated with Hemoglobin A1c (HbA1c) and explored alternatives such as Glycated Albumin (GA) and Fructosamine.
During his presentation, David Sacks stated that HbA1c was well standardized and the most widely used marker of chronic glycemia. Sacks explained how Fructosamine and GA reflect extracellular protein glycation independent of Red Blood Cells (RBCs). Of these two alternative markers, Sacks talked about how there are efforts being made to standardize GA. He mentioned that there is an entire committee in Japan working to standardize GA. The paper on glycated albumin published by this committee has cited the article written by Epinex Scientific Advisory Board member Dr. Vern Roohk.
Cyrus Desouza highlighted the clinical utility of GA with five main points. The first is that GA can be an intermediate glycemic control marker. The second is that GA can be used for Chronic Kidney Disease (CKD). Third, it can be used during pregnancy for gestational diabetes mellitus (GDM) and diabetes mellitus (DM). Fourth, it can be used for insulin titration and medication changes. Lastly, it can be used for any condition that shortens erythrocyte survival (i.e. anemia and hemoglobinopathy).
Some of the key takeaways from Desouza’s presentation include how GA is better at detecting variability, hyperglycemia and short-term fluctuations as compared to A1c. Another main point was that when GA is expressed as a ratio of albumin concentration, it’s more reliable and cost effective compared to A1c. He also said that GA is a good indicator for detecting the future risk of developing diabetes complications and that that it is clinically useful in titrating insulin, during pregnancy and in the setting of Chronic Kidney Disorder (CKD).
The last speaker, Paul J. Thornalley focused his presentation on the role of advanced glycation end products (AGEs) in diabetes.
Epinex has been at the forefront in advocating a role for Glycated Albumin for early detection, screening and monthly monitoring of diabetes. Epinex has a patented rapid test, G1A, for Glycated Albumin and is working towards developing this test for clinical trials. This G1A tests measures total albumin and glycated albumin exclusively (not fructosamine), similar to what Desouza described, in a hand held device as a POCT (Point of Care Test for doctors’ offices and clinics and as an OTC (Over The Counter) test for general public use.
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