1. Field of the Invention
The present invention relates to a process for the determination of the amount of irreversibly glycated hemoglobin, or HbA1c, present in a sample of blood, relative to the amount of total hemoglobin. In particular, the invention incorporates in the method an electrochemical, enzyme-catalyzed reaction or reactions.
2. Background Information
HbA1c is a glycated hemoglobin formed by a binding reaction between an amine group of hemoglobin and the glucose aldehyde group, for example between the amine group of the N-terminal valine of the β-chain of hemoglobin and the glucose aldehyde group. The binding reaction first forms a Schiff's base and then a stable ketoamine by Amadori rearrangement. The percentage of HbA1c (i.e. the amount of glycated hemoglobin relative to total hemoglobin in the blood) has come to be taken as a measure of the level of blood glucose control a diabetic patient has maintained for a period of two or three months prior to the measurement. As such, percentage HbA1c has become an important measurement by which health care providers can assist diabetic patients in their care.
There are many known assays that can be used to determine HbA1c percentage. In recent years research efforts have focused on creating assays that are both highly accurate and fast. However, known HbA1c assays typically require a substantial number of time-consuming steps wherein the blood components must be separated and treated.
In the health care context, a diabetic patient is typically guided by a physician to obtain an HbA1c measurement when the physician realizes that there is a need for such information during an office visit. The patient then provides a blood sample to a laboratory and results are returned to the physician hours or days later. Typically, the lab will use a table top analyzer of the type presently available commercially. This time lag between the patient's visit and the result of the test requires that the physician review the result long after the patient has left the office. If the physician believes that further consultation with the patient is required in light of the test result, the patient must be contacted again.
Currently, there is a device sold under the name “A1c NOW” by Metrika, Inc. of Sunnyvale, Calif. This handheld and disposable device (based on technology described in U.S. Pat. No. 5,837,546 entitled “Electronic Assay Device and Method,” incorporated herein by reference) is said to provide an HbA1c test result in eight minutes using a relatively small sample of blood. The A1c NOW device is an example of the market demand for a fast method of providing an HbA1c result for either home or doctor's office use. However, the A1c NOW device is not as accurate as some laboratory assays. Thus, research has continued to focus on finding a highly accurate HbA1c assay that is also fast enough and simple enough to permit a diabetic and his or her doctor to take a blood sample during an office visit and have a trustworthy HbA1c measurement available for discussion in the same visit.