Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (860 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Products of non-enzymatic reactions between glucose and hemoglobin (occurring as a minor fraction of the hemoglobin of erythrocytes.) It generally refers to glycated hemoglobin A. Hemoglobin A1c (Hb A1c) is hemoglobin A with glycation on a terminal valine of the beta chain. Glycated hemoglobin A is used as an index of the average blood sugar level over a lifetime of erythrocytes.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Hemoglobin, Glycated; Glycohemoglobin; Glycohemoglobins; Glycated Hemoglobins; Hemoglobins, Glycated; Hemoglobin, Glycosylated; Glycosylated Hemoglobin; Hb A1a-2.
Where it fits in the MeSH classification
- Broader topics
- Glycated Serum Proteins; Hemoglobins
Related concepts
- Glucose
- Hemoglobin
- Erythrocytes
- Glycation
- Valine
Research landscape
PubMed indexes 50,964 records tagged with the MeSH heading “Glycated Hemoglobin” (counts retrieved 2026-10-31). 15,838 of them (31.1%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 19,940 records.
Reviews account for 4,765 records (9.3%) and meta-analyses for 1,901. Randomized controlled trials number 7,214 (14.2%) as a share of all records on the topic. Randomized trials make up a comparatively large share of this literature, which means many treatment questions have been tested directly.
Show the data
| Period | Records |
|---|---|
| through 1999 | 6,083 |
| 2000-2009 | 9,103 |
| 2010-2019 | 19,940 |
| 2020 onward | 15,838 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 4,765 | 9.3% |
| Meta-analyses | 1,901 | 3.7% |
| Randomized controlled trials | 7,214 | 14.2% |
Method: PubMed query "Glycated Hemoglobin"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.
Reading the evidence in drugs and chemicals
Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
Impact of glucometabolic status on type 4a myocardial infarction in patients with non-ST-segment elevation myocardial infarction: the role of stress hyperglycemia ratio [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundType 4a myocardial infarction (MI) is a relevant complication in non-ST-segment elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI).
- Closing excerpt
- 42; p ConclusionsSHR emerged as a strong predictor of type 4a MI in NSTEMI patients undergoing PCI, outperforming other glucometabolic markers.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (222 words)
BackgroundType 4a myocardial infarction (MI) is a relevant complication in non-ST-segment elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI). While glucometabolic status has been linked to type 4a MI in chronic coronary syndromes, data in the acute setting are lacking. This study aimed to assess the association of glucometabolic parameters-admission blood glucose (ABG), glycated hemoglobin (HbA1c) and stress hyperglycemia ratio (SHR)-with type 4a MI in NSTEMI patients undergoing PCI and evaluate their independent predictive role.MethodsConsecutive NSTEMI patients undergoing PCI from the AMIPE multicenter prospective registry (NCT03883711) with stable or falling pre-procedural cardiac troponin levels were analyzed. The optimal glucometabolic predictor of type 4a MI among ABG, HbA1c and SHR was identified using receiver operating characteristic analysis. The best cut-off for each parameter was derived using Youden's index. Regression analysis and Kaplan-Meier curves were performed to identify independent predictors of type 4a MI and their prognostic implications.ResultsThe study population included 1005 patients (mean age 70.3 ± 12.5 years, 25.5% females), with 45.9% having diabetes mellitus. SHR showed a significantly higher accuracy (AUC 0.69, 95% CI 0.65-0.73) in predicting type 4a MI compared with ABG and HbA1c (p 1.14 was independently associated with type 4a MI (aOR = 2.73; 95% CI 1.70-4.42; p ConclusionsSHR emerged as a strong predictor of type 4a MI in NSTEMI patients undergoing PCI, outperforming other glucometabolic markers.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41076534 · DOI · PMC12514836
Managing discordance between HbA1c and glucose management indicator [2]
Abstract reading summary — source excerpts
- Opening excerpt
- AimsThe assessment of haemoglobin A1c (HbA1c) continues to play an essential role in diabetes care; however, major advances in new technologies widen the armament available to clinicians to further refine treatment for their patients.
- Closing excerpt
- ConclusionsGMI will likely continue to be used in the upcoming years by both persons with diabetes and their health care providers, and so it is important for users of CGM devices to be equipped with the knowledge to understand the potential causes of discordance between GMI and HbA1c values.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (238 words)
AimsThe assessment of haemoglobin A1c (HbA1c) continues to play an essential role in diabetes care; however, major advances in new technologies widen the armament available to clinicians to further refine treatment for their patients. Whilst HbA1c remains a critical glycaemic marker, advances in technologies such as Continuous Glucose Monitoring (CGM) now offer real-time glucose monitoring, allowing a more instant assessment of glycaemic control. Discrepancies between laboratory-measured HbA1c and Glucose Management Indicator (GMI) values are a significant clinical issue. In this article, we present a checklist of potential sources of error for both GMI and HbA1c values and provide suggestions to mitigate these sources in order to continue to improve diabetes care.MethodsWe identified key literature pertaining to GMI measurement, HbA1c measurement, and potential factors of discordance between the two. Using these sources, we explore the potential factors leading to discordance and how to mitigate these when found.ResultsWe have constructed a quick reference checklist covering the main sources of discordance between HbA1c and GMI, with accompanying narrative text for more detailed discussion. Discordance can arise due to various factors, including CGM accuracy, sensor calibration, red blood cell turnover and other physiological conditions.ConclusionsGMI will likely continue to be used in the upcoming years by both persons with diabetes and their health care providers, and so it is important for users of CGM devices to be equipped with the knowledge to understand the potential causes of discordance between GMI and HbA1c values.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40123266 · DOI · PMC12080991
Association of hemoglobin glycation index with all-cause and cardio-cerebrovascular mortality among people with metabolic syndrome [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundResearch on the association between blood glucose-related biomarkers and mortality has gained increasing attention.
- Closing excerpt
- ConclusionThis cohort study of the American metabolic syndrome population highlighted a U-shaped association of HGI with all-cause and cardio-cerebrovascular mortality.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (224 words)
BackgroundResearch on the association between blood glucose-related biomarkers and mortality has gained increasing attention. However, the association of hemoglobin glycation index (HGI) with all-cause and cardio-cerebrovascular mortality among people with metabolic syndrome has never been investigated. The objective of this study was to examine the association through a cohort study of the American population.MethodsIn this study, 8,267 participants were included. We utilized multivariable Cox regression analyses to explore the relationship between HGI and outcomes. The dose-response relationship between HGI and mortality was explored with restricted cubic splines. Recursive algorithms and segmented linear regression models were used to calculate the inflection points and assess the effect relationships before and after the inflection points.ResultsIn the model adjusting for all covariates, our analysis did not reveal a statistically significant association between HGI and mortality. Intriguingly, subsequent explorations of non-linear relationships unearthed a U-shaped correlation between HGI and both all-cause mortality and cardio-cerebrovascular mortality among American adults with metabolic syndrome. Before and after the inflection point, the HRs (95%CIs) for the association between HGI and all-cause mortality were 0.72 (0.63, 0.82) and 1.30 (1.17, 1.44), respectively. For cardio-cerebrovascular mortality, similar opposite relationships were found. The metabolic syndrome population with HGI levels at T2 had a lower rate of mortality.ConclusionThis cohort study of the American metabolic syndrome population highlighted a U-shaped association of HGI with all-cause and cardio-cerebrovascular mortality.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39678188 · DOI · PMC11637851
The Predictive Value of Hemoglobin Glycation Index and Clonal Hematopoiesis of Indeterminate Potential Among AMI Patients-A Prospective Registry Study [4]
Abstract reading summary — source excerpts
- Opening excerpt
- AimsThe objective of this research is to explore the combined effect of hemoglobin glycation index (HGI) and clonal hematopoiesis of indeterminate potential (CHIP) on all-cause mortality among patients diagnosed with acute myocardial infarction (AMI).
- Closing excerpt
- Kaplan-Meier analysis in the high-HGI group confirmed that carriers of any CHIP (p ConclusionsOur study reveals that HGI significantly modifies CHIP-related all-cause mortality risk, which provides a way for refined risk stratification in patients with AMI.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (176 words)
AimsThe objective of this research is to explore the combined effect of hemoglobin glycation index (HGI) and clonal hematopoiesis of indeterminate potential (CHIP) on all-cause mortality among patients diagnosed with acute myocardial infarction (AMI).MethodsThe presence of CHIP in peripheral blood cells was detected using deep targeted sequencing. AMI patients were divided into groups based on the median value of HGI and assessed for the effect of CHIP on all-cause mortality using multivariable Cox regression and Kaplan-Meier analysis.ResultsMultivariable Cox regression indicated that among patients with HGI above the median value, CHIP carriers exhibited a significantly higher all-cause mortality (any CHIP, adjusted HR: 2.06 95% CI: 1.10-3.85; p = 0.023), with analysis of specific mutations identifying particularly high risks for TET2 (adjusted HR: 3.72, 95% CI: 1.37-10.09; p = 0.010) and TET2/ASXL1 co-mutations (adjusted HR: 2.61, 95% CI: 1.08-6.30; p = 0.033). Kaplan-Meier analysis in the high-HGI group confirmed that carriers of any CHIP (p ConclusionsOur study reveals that HGI significantly modifies CHIP-related all-cause mortality risk, which provides a way for refined risk stratification in patients with AMI.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41699200 · DOI · PMC12909099
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus [5]
- Research article Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control [6]
- Research article Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials [7]
- Research article Glycated haemoglobin A1c as a risk factor of cardiovascular outcomes and all-cause mortality in diabetic and non-diabetic populations: a systematic review and meta-analysis [8]
- Research article Progression rates from HbA1c 6.0-6.4% and other prediabetes definitions to type 2 diabetes: a meta-analysis [9]
- Research article Efficacy and safety of empagliflozin for type 2 diabetes: a systematic review and meta-analysis [10]
References
- Armillotta M, Bergamaschi L, Angeli F, Belmonte M, Casuso Alvarez M, Sansonetti A, et al.. Impact of glucometabolic status on type 4a myocardial infarction in patients with non-ST-segment elevation myocardial infarction: the role of stress hyperglycemia ratio. . 2025. PMID 41076534 · DOI · PMC12514836
- Lenters-Westra E, Fokkert M, Kilpatrick ES, Schleicher E, Pilla S, English E, et al.. Managing discordance between HbA1c and glucose management indicator. . 2025. PMID 40123266 · DOI · PMC12080991
- Zhao L, Li C, Lv H, Zeng C, Peng Y. Association of hemoglobin glycation index with all-cause and cardio-cerebrovascular mortality among people with metabolic syndrome. . 2024. PMID 39678188 · DOI · PMC11637851
- Xue L, Dong W, Li J, Chen R, Li N, Liu C, et al.. The Predictive Value of Hemoglobin Glycation Index and Clonal Hematopoiesis of Indeterminate Potential Among AMI Patients-A Prospective Registry Study. . 2026. PMID 41699200 · DOI · PMC12909099
- Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, et al.. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med. 2004. PMID 15381515 · DOI
- Chrvala CA, Sherr D, Lipman RD. Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Educ Couns. 2016. PMID 26658704 · DOI
- Faruque LI, Wiebe N, Ehteshami-Afshar A, Liu Y, Dianati-Maleki N, Hemmelgarn BR, et al.. Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials. CMAJ. 2017. PMID 27799615 · DOI · PMC5334006
- Cavero-Redondo I, Peleteiro B, Álvarez-Bueno C, Rodriguez-Artalejo F, Martínez-Vizcaíno V. Glycated haemoglobin A1c as a risk factor of cardiovascular outcomes and all-cause mortality in diabetic and non-diabetic populations: a systematic review and meta-analysis. BMJ Open. 2017. PMID 28760792 · DOI · PMC5642750
- Morris DH, Khunti K, Achana F, Srinivasan B, Gray LJ, Davies MJ, et al.. Progression rates from HbA1c 6.0-6.4% and other prediabetes definitions to type 2 diabetes: a meta-analysis. Diabetologia. 2013. PMID 23584433 · DOI
- Liakos A, Karagiannis T, Athanasiadou E, Sarigianni M, Mainou M, Papatheodorou K, et al.. Efficacy and safety of empagliflozin for type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab. 2014. PMID 24766495 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-31.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.