A discrepancy between plasma glycated albumin and HbA1c levels in a patient with steroid-induced diabetes mellitus

Abstract

A 57-year-old man was admitted for the treatment of steroid-induced diabetes mellitus (DM). He also had interstitial pneumonia and, to treat it, 20 mg prednisolone had been started in April 2014. Although glycated haemoglobin (HbA1c) level was 7.8% (62 mmol/mol), his glycated albumin (GA) level was normal (13.9%) and the ratio of GA to HbA1c (GA:HbA1c) was lower than that of normal participants and patients with type 2 DM. Plasma GA and GA:HbA1c levels became persistently lower. In September 2015, HbA1c levels measured by HPLC and immunoprecipitation methods were almost the same (6.8% (51 mmol/mol) and 6.7% (50 mmol/mol), respectively), but GA (10.2%) and GA:HbA1c (1.6) were much lower. We report the case of a patient with DM where steroid administration may have caused a decrease in plasma GA and GA:HbA1c levels via increased albumin turnover.

Differing Effects of Body Size on Circulating Lipid Concentrations and Hemoglobin A1c Levels in Young and Middle-Aged Japanese Women

“…Thus, additional detailed information should be collected in the future to evaluate the effect of menopause on circulating lipid concentrations. Moreover, HbA1c may be affected by anemia, pregnancy, abnormal hemoglobin levels, and steroid treatment [35][36][37]. HbA1c reflects glucose tolerance better than occasional blood glucose measurements at the population level.…”