How Relİable Hba1c Is In Anemic Patients? Two Different Perspectives
Özet
Both diabetes mellitus (DM) and anemia are prevalent around the world. The possibility of these two diseases co-existing is also very high. Glycosylated hemoglobin (HbA1c) is used to diagnosed and monitor DM. Incorrect measurements of HBA1c will cause patients to be misdiagnosed as DM or to follow-up DM patients incorrectly. Conditions affecting the turnover of erythrocytes may cause inaccurate HBA1c measurement. In this study, a case of a 33-year-old patient diagnosed with Type 1 DM due to hemolytic anemia, which was misdiagnosed due to falsely low HBA1c value, and an 18-year-old patient misdiagnosed as DM due to falsely high HBA1c value stemming from iron deficiency anemia are presented. The reliability of HBA1c in the diagnosis and follow-up of DM is discussed.
Referanslar
Krishnamurti U, Steeffes MW. Glycohemoglobin: A primary predictor of the development or reversal of complications of diabetes mellitus. Clin Chem 2001;47(7):1157-65.
Kassebaum NJ, Jasrasaria R, Naghavi M, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014;123(5):615-624.
Looker AC, Dallman PR, Carroll MD, et al. Prevalence of iron deficiency in the United States. JAMA 1997;,277:973–976.
Altay C, Gumruk F. Red cell glucose-6-phosphate dehydrogenase deficiency in Turkey.Turk JHematol 2008;25(1):1-7.
Vikøren TB, Berg JP, Berg TJ. Sources of error when using haemoglobin A1c. Tidsskr Nor Laegeforen 2014;134(4):417-21.
Hanas R, John G: International HBA1c Consensus Committee. 2010 consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care, 2010; 33: 1903-4.
Saudek CD, Rastogi R, Derr RL. Assesment of glycemia in diabetes mellitus: He-moglobin A1c. J Assoc Physicians India 2005;53(4):299-304.
Hellman R. When are HbA1c values misleading? AACE Clin Case Rep. 2016;2(4):377-79.
Soliman AT, De Sanctis V, Yasin M, Soliman N. Iron deficiency anemia and glucose metabolism. Acta Biomed. 2017; 88 (1): 112- 18.
Aydın B, Özçelik S, Kilit TP, Eraslan S, Çelik M, Onbaşı K. Relationship between glycosylated hemoglobin and iron deficiency anemia: A common but overlooked problem. Prim Care Diabetes. 2022;16(2):312-317.
Aydin B, Cansu GB, Ozlu C. Relationship between glycosylated hemoglobin and vitamin B12 deficiency anemia. North Clin Istanb. 2022;9(5):459-463. Published 2022 Oct 21.
International Expert Committee. International Expert Committee report on therole of A1C assay in the diagnosis of diabetes. Diabetes Care 2009;32:1327-34.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009 Jan;32 Suppl 1(Suppl 1):S627.