Artefactually low glycated haemoglobin is a potential pitfall in diabetes management: consider congenital haemolytic anaemias
✍ Scribed by Baynes, Kevin C.R. ;McIntosh, Colin ;Feher, Michael D.
- Book ID
- 104513180
- Publisher
- John Wiley and Sons
- Year
- 2001
- Tongue
- English
- Weight
- 97 KB
- Volume
- 18
- Category
- Article
- ISSN
- 1357-8170
- DOI
- 10.1002/pdi.165
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✦ Synopsis
Abstract
Measurement of glycated haemoglobin is widely used as an index of glycaemic control in the out‐patient management of diabetes mellitus. The glycated haemoglobin measurement most commonly reported by laboratories being the HbA~1c~. Prospective clinical trials using the HbA~1c~ as an index of glycaemia now indicate a benchmark for both the patient and clinician in assessing their efforts to improve glycaemic control. Glycated haemoglobins are formed by a non‐enzymatic reaction between carbohydrates and haemoglobin and a multiplicity of techniques to measure them exist. A number of conditions artefactually lower the HbA~1c~ measurement, which may lead to false reassurance that glycaemic control is good. These conditions include iron deficiency anaemia, haemoglobinopathies, chronic renal failure or recent blood transfusion. A case of congenital haemolytic anaemia is described, highlighting another potential cause of artefactually low HbA~1c~. If the glycated haemoglobin result is spuriously low, other methods to assess glycaemic control, including self blood glucose monitoring and fructosamine assays, should be adopted. Copyright © 2001 John Wiley & Sons, Ltd.