What do you do when HbA1c does not reflect glycemia?
HbA1c is affected by altered red cell production, red cell life span and rate of
glycation. Clinically silent conditions altering red cell production, red cell life
span and glycation rates can be missed by laboratories and clinicians, resulting in
wrong patient care decisions and treatment delays.
Not all HbA1c methods are created equal. HPLC methods provide information on interference from hemoglobin variants in addition to HbA1c readings1. Safeguard your clinical decisions.
Request for information on any suspected presence of hemoglobin variants to be included in your test reports2,3,4,5.
HbA1c in Diabetes Care and Management:
Demystifying the
Unknowns by Dr. Richard Pang
Dr. Richard Pang, a former Scientific Officer at the Department of Pathology and Clinical Biochemistry in Queen Mary Hospital, Hong Kong, and Fellow of AACC, elaborates on situations in which A1c value may be misleading, and explains how labs using HPLC method for A1c analysis could provide you more information than just an A1c value.
References
1.Weykamp C. HbA1c: A Review of Analytical and Clinical Aspects. Ann Lab Med 2013;33:393-400.
2. Little RR, La’ulu SL, Hanson SE, et al. Effects of 49 different rare Hb variants on HbA1c measurement in eight methods. J Diabetes Sci Technol. 2015;9:849-856.
3. Saw S, Loh TP, Yin C, Sethi SK. Identification of hemoglobin variants in samples received for glycated hemoglobin testing. Clin Chim Acta 2013; 415: 173-175.
4. Higgins T. HbA1c–an analyte of increasing importance. Clin Biochem. 2012;45:1038-1045.
5. Lohmann TP. The impact of red blood cell lifespan on HbA1c measurement. In: Medical Lab Observer. 2019. Available at https://www.mlo-online.com/disease/diabetes/article/21085264/the-impact-of-red-blood-cell-lifespan-on-hba1c-measurement 5/13. Accessed July 5,2021.
Disclaimer: This is not to promote any product. This is only for HCP education on HbA1c.
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HbA1c
in Diabetes Care and Management:
Demystifying the Unknowns by Dr. Richard Pang