Insights into the Progression of Labile Hb A to Stable Hb A a Mechanistic Assessment of 2,3-Bisphosphoglycerate Facilitation of the Slow Nonenzymatic Glycation Process.

Nonenzymatic glycation (NEG) of human hemoglobin (Hb A) consists of initial non covalent, reversible steps involving glucose and amino acid residues, which may also involve effector reagent(s) in the formation of labile Hb A (the conjugate acid of the Schiff base). Labile Hb A can then undergo slow, largely irreversible, formation of stable Hb A (the Amadori product). Stable Hb A is measured to assess diabetic progression after labile Hb A removal.