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1. Title Subtitle

3. Neonatal complications of DM

4. Monitoring glycaemic control in DM

5. Potential to measure glycated fetal Hb Roberts et al (2001) evaluated ESI-MS for the analysis of HbA1c Technique enables assessment of glycation of ? and ? chains of Hb and any other Hb variant ? Potential to measure glycation and acetylation of HbF

6. Aim of study To assess the relationship between glycated and acetylated haemoglobin in the neonate and glycated haemoglobin in the mother

7. Methods 1 Quattro Ultima mass spectrometer (Waters, Ltd) 10 ?L aliquot of whole blood (F EDTA) was diluted in 490 ?L of deionised water 20 ?L aliquot of above diluted with: 40 ?L of 10 mL/L formic acid 40 ?L of deionised water 100 ?L of acetonitrile Samples desalted with AG 50-X8 resin (BioRad Laboratories).

8. Methods 2 HbA1c analysis - Menarini-Arkay HA-8160 HPIEC system (Menarini Diagnostics) Glucose analysis - Roche D modular unit glucose oxidase method (Roche Diagnostics) Statistical analysis of data done using Astute (Microsoft Excel® [version 5])

9. Samples used in study

10. Results

11. Results

12. Calculating the level of GHb and acetylated Haemoglobin GHb (%) = 50([?g/(?+?g)] + [*g/(*+*g)]) * = ? or ? chain intensity Acetylated HbF (%) = 100[?a/? + ?a]

13. Is there a relationship between GHb in the mother and neonate?

14. Mean level (? 1 SD) of glucose and GHb observed in diabetic and non diabetic pregnant women and their offspring.

15. Mean level (? 1 SD) of glucose and GHb observed in diabetic and non diabetic pregnant women and their offspring.

16. Mean level (? 1 SD) of glucose and GHb observed in diabetic and non diabetic pregnant women and their offspring.

17. Mean level (? 1 SD) of glucose and GHb observed in diabetic and non diabetic pregnant women and their offspring.

18. Distribution of GHb (%) observed in non diabetic and diabetic women and their offspring

20. Distribution of acetylated Hb levels (%) in neonates born to non diabetic and diabetic women

21. Conclusions Preliminary data suggest that there may be a significant correlation between maternal and neonatal GHb levels in the diabetic group. Absence of a significant difference between maternal GHb levels suggests good long term glycaemic control in diabetic individuals during pregnancy

22. Future work Collect more samples from diabetic women and their respective neonate to allow a more reliable assessment of the relationship between GHb levels in the mother and neonate

23. Acknowledgements Norman Roberts (Consultant Biochemist, RLBUH) Anthony Stott (Consultant Biochemist, RLBUH) Steve Walkinshaw (Consultant Obstetrician, LWH) Lorna Wood (Diabetes Nurse Specialist, LWH) Brian Green (Researcher, Waters)

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