Glucose-6-Phosphate Dehydrogenase Deficiency Diagnosed in an Adolescent with Type 1 Diabetes Mellitus and Hemoglobin A1c Discordant with Blood Glucose Measurements

Danzig, Jennifer A.; Moser, Joanne T.; Belfield, P.M.; Alter, Craig A.

doi:10.1016/j.jpeds.2010.12.012

Cited by 10 publications

(5 citation statements)

References 15 publications

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“…The HbA1c level at any point in time is contributed to by all the circulating erythrocytes, from the oldest (120 days old) to the youngest [15]. Falsely low HbA1c has been reported in glucose-6-phosphate dehydrogenase deficiency due to increased red cell turn over [15] and reduced exposure time of hemoglobin to glucose [16]. Hence, HbA1C levels may not be a reliable indicator of adequate glycemic control in a patient with type 1 diabetes mellitus with underlying G6PD deficiency.…”

Section: Discussionmentioning

confidence: 99%

Manifestation of glucose-6-phosphate dehydrogenase deficiency in the wake of new-onset type 1 diabetes mellitus: a case report

Govindarajan

Zamir

Bagewadi³

et al. 2022

J Med Case Reports

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Background Diabetes mellitus is the most common metabolic disease globally, while glucose-6-phosphate dehydrogenase deficiency, an X-linked inherited disorder, is the most common erythrocyte enzyme defect. The association between the two in children has been infrequently reported. Case presentation We report the case of a 10-year-old boy of Iraqi descent who presented to our emergency department with new-onset type 1 diabetes mellitus without Diabetic Keto Acidosis. He was treated with subcutaneous insulin and discharged. Eleven days after hospitalization, he was found to be jaundiced during his home visit. Hence, he was referred to the pediatric unit, and his hemoglobin had declined from 130 g/L at the previous admission to 81 g/L. Blood tests revealed low haptoglobin, and his peripheral blood film showed anisocytosis, polychromasia, and occasional red cell fragments suggestive of acute hemolysis. His glucose-6-phosphate dehydrogenase activity was very low, and his subsequent genetic tests confirmed Mediterranean-type glucose-6-phosphate dehydrogenase deficiency. Conclusion Glucose-6-phosphate dehydrogenase deficiency in people with diabetes mellitus has been underreported in the literature so far, and screening of glucose-6-phosphate dehydrogenase deficiency should be considered on diagnosis of diabetes mellitus, especially in boys of African, Mediterranean, or Asian descent.

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Section: Discussionmentioning

confidence: 99%

Manifestation of glucose-6-phosphate dehydrogenase deficiency in the wake of new-onset type 1 diabetes mellitus: a case report

Govindarajan

Zamir

Bagewadi³

et al. 2022

J Med Case Reports

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“…In disorders causing a decrease in RBC survival (e.g., recovery period after acute blood loss, hemolytic anemia), the time of encounter with glucose is reduced, therefore, hemoglobin exposed to glycation has a lower percentage and causes a false decrease in test results regardless of the method [6,7]. Considering that a shortened RBC life span [8]. When interpreting HbA1c results (especially when unexpected results are encountered), it should be checked whether the patient carries the factors that can affect measurements (such as hemoglobinopathy, hemolysis, uremia) [9].…”

Section: Discussionmentioning

confidence: 99%

CONTRIBUTION OF LABORATORY CLINICAL CONSULTATION FOR EXCESSIVELY LOW HbA1c RESULTS TO THE DIAGNOSIS

Sutasir¹

2020

Int J Med Biochem

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“…Falsely low HbA1c has been reported in cases of hereditary spherocytosis,3 autoimmune haemolytic anaemia4 and glucose-6-phosphate dehydrogenase deficiency 5. HbA1c has also been suggested as a screening test for haemolysis 6…”

Section: Discussionmentioning

confidence: 99%

Immeasurable glycosylated haemoglobin: a marker for severe haemolysis

et al. 2013

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Glycosylated haemoglobin (HbA1c) is a measurement commonly performed in patients with diabetes. Factors causing a change in the life span of the red blood cell (RBC) can affect the measurement of HbA1c. Thus haemolysis is an important factor that may affect the HbA1c level determination. Haemolysis has been shown to cause a falsely low HbA1c. A 62-year-old man with a history of autoimmune haemolytic anaemia was admitted for severe haemolytic anaemia and an Hb of 2.9 g/dL. HbA1c tested during hospitalisation was unrecordable due to the extremely low Hb. The patient was treated with intravenous steroids, immunoglobulin, fluids and RBC transfusions but continued to haemolyse and eventually expired. We emphasise that an extremely low HbA1c level can serve as a marker of haemolysis and an unrecordable HbA1c level may point towards fatal haemolysis.

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Glucose-6-Phosphate Dehydrogenase Deficiency Diagnosed in an Adolescent with Type 1 Diabetes Mellitus and Hemoglobin A1c Discordant with Blood Glucose Measurements

Cited by 10 publications

References 15 publications

Manifestation of glucose-6-phosphate dehydrogenase deficiency in the wake of new-onset type 1 diabetes mellitus: a case report

Manifestation of glucose-6-phosphate dehydrogenase deficiency in the wake of new-onset type 1 diabetes mellitus: a case report

CONTRIBUTION OF LABORATORY CLINICAL CONSULTATION FOR EXCESSIVELY LOW HbA1c RESULTS TO THE DIAGNOSIS

Immeasurable glycosylated haemoglobin: a marker for severe haemolysis

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