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[IP] HgB A1c

Gina is correct.  Once the hemoglobin has been glycosylated there are 2
changes which take place.  One is a reversible change where the free amino
groups of hemoglobin form a schiff base intermediate (major Organic Chemistry
there) with the aldehyde group of the glucose molecule.  This is then followed
by an irreversible rearrangement.  It is this irreversible rearrangement which
allows the measurement to be taken.  So it is a 2 step process which might
explain why occasion but not consistent BG spikes do not effect the test.

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