What is HbA1c?
- Hb1Ac is an important indicator of glycemic control in diabetic patients.
- It reflects average plasma glucose over the previous eight to 12 weeks.
- It can be performed anytime of the day and does not require special preparation such as fasting.
- Although HbA1c is in general a robust marker of glycemia, the result can be unreliable under certain condition.
- Lists of concomitant disease and conditions that may alter HbA1c result is as listed below.
Increase
|
Decrease
|
Variable
|
Longer red blood cell life span
(May occur due to aplastic anemia, iron or vitamin B12 deficiency)
|
Shortened red blood cell life span.
(May occur with splenomegaly, G6PD deficiency)
|
Fetal haemoglobin
|
Hyperbilirubinemia
|
Hyperlipidemia
|
Methemoglobin
|
Uremia
|
Sickle-cell disease
|
Certain hemoglobinopathies
|
Chronic renal failure
|
Any other condition that could result in premature red blood cell
death/blood loss
|
Alcoholism
|
Diabetic and non diabetic pregnant women
|
- Lists of concomitant drugs that may alter HbA1c with its proposed mechanism is as listed below.
Reference :
- Speeckaert,
M., Van Biesen, W., Delanghe, J., Slingerland, R., Wiecek, A., Heaf, J., …
European Renal Best Practice Guideline Development Group on Diabetes in
Advanced CKD, for the E. R. B. P. G. D.
G. on D. in A. (2014). Are there better alternatives than haemoglobin A1c to
estimate glycaemic control in the chronic kidney disease population? Nephrology,
Dialysis, Transplantation : Official Publication of the European Dialysis and
Transplant Association - European Renal Association, 29(12), 2167–77.
http://doi.org/10.1093/ndt/gfu006
- Sultanpur, C.
M., & Kumar, Sv. (2010). Comprehensive Review on HB1AC in Diagnosis of
Diabetes Mellitus. International Journal of Pharmaceutical Sciences Review
and Research, 3(2).
- Unnikrishnan, R., Anjana, R. M., & Mohan, V. (2012). Drugs affecting HbA1c levels. Indian Journal of Endocrinology and Metabolism, 16(4), 528–31. http://doi.org/10.4103/2230-8210.98004
- http://www.leicestershospitals.nhs.uk/EasysiteWeb/getresource.axd?
- http://www.who.int/diabetes/publications/report-hba1c_2011.pdf
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