Many of us are aware that normal variations in red blood cell turnover can account for large variations in HbA1c test results from one person to another and introduce substantial uncertainty regarding estimated average blood glucose levels. Starting at 11:00 in this fascinating podcast
from Dr. Chris Masterjohn, he describes another significant factor affecting HbA1c levels - deglycation of HbA1c by fructosamine 3-kinase. He also explains the science that absolves HbA1c of responsibility for causing diabetes-related disease and highlights a couple of processes that do drive accumulation of advanced glycation end products (AGEs).
Regarding those AGE accumulation processes, I recommend his recent Examine.com article in which he explains why very low carbohydrate diets may not be optimal for most people. The title exemplifies a key reason that I love his work - with straightforward research-driven logic, he reminds me of nuance, U-shaped response curves, feedback loops, and what we don't know:Sugar is the ultimate antioxidant and insulin will make you younger: Appreciating a few poorly recognized but critical contributions of carbohydrate
Sometimes with biomarkers I feel like the guy searching for his keys under the lamp post. "Did you lose them near here?" "No, but this is where the light is." Masterjohn's podcast is a persuasive reminder that our bodies are much more complex than the tests that we sometimes obsess over.