Glycated Haemoglobin (HbA1c) Variations in Nondiabetics With Nutritional Anemia

Pilla, Rakesh; Palleti, Sujith K; Rayana, Renuka; Skss, Satish Reddy; Razzack, Aminah Abdul; Kalla, Sruti

doi:10.7759/cureus.11479

Cited by 11 publications

(22 citation statements)

References 18 publications

(25 reference statements)

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“…Sickle trait and G6PD defciency would have had the tendency to raise MBG relative to HbA1c [32]. While iron, folate, and B12 defciencies potentially would lower observed MBG relative to HbA1c [33][34][35]. Te prevalence of these various conditions in our study patient population might contribute to the between-population diferences in the relationship of HbA1c versus MBG.…”

Section: Discussionmentioning

confidence: 80%

Can HbA1c Alone Be Safely Used to Guide Insulin Therapy in African Youth with Type 1 Diabetes?

et al. 2023

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Introduction. The relationship of HbA1c versus the mean blood glucose (MBG) is an important guide for diabetes management but may differ between ethnic groups. In Africa, the patient’s glucose information is limited or unavailable and the management is largely guided by HbA1c. We sought to determine if the reference data derived from the non-African populations led to an appropriate estimation of MBG from HbA1c for the East African patients. Methods. We examined the relationship of HbA1c versus MBG obtained by the continuous glucose monitoring in a group of East African youth having type 1 diabetes in Kenya and Uganda (n = 54) compared with the data obtained from A1c-derived average glucose (ADAG) and glucose management indicator (GMI) studies. A self-identified White (European heritage) population of youth (n = 89) with type 1 diabetes, 3–18 years old, living in New Orleans, LA, USA metropolitan area (NOLA), was studied using CGM as an additional reference. Results. The regression equation for the African cohort was MBG (mg/dL) = 32.0 + 16.73 × HbA1c (%), r = 0.55, p < 0.0001 . In general, the use of the non-African references considerably overestimated MBG from HbA1c for the East African population. For example, an HbA1c = 9% (74.9 mmol/mol) corresponded to an MBG = 183 mg/dL (10.1 mmol/L) in the East African group, but 212 mg/dL (11.7 mmol/L) using ADAG, 237 mg/dL (13.1 mmol/L) using GMI and 249 mg/dL (13.8 mmol/L) using NOLA reference. The reported occurrence of serious hypoglycemia among the African patients in the year prior to the study was 21%. A reference table of HbA1c versus MBG from the East African patients was generated. Conclusions. The use of non-African-derived reference data to estimate MBG from HbA1c generally led to the overestimation of MBG in the East African patients. This may put the East African and other African patients at higher risk for hypoglycemia when the management is primarily based on achieving target HbA1c in the absence of the corresponding glucose data.

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Section: Discussionmentioning

confidence: 80%

Can HbA1c Alone Be Safely Used to Guide Insulin Therapy in African Youth with Type 1 Diabetes?

et al. 2023

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“…Pilla et al also studied 100 patients with megaloblastic anemia before and after correcting their anemia. The baseline HbA1c was significantly higher in those with megaloblastic anemia compared to the control group, and correcting the anemia did decrease the HbA1c level significantly to the range of the control group [ 26 ]. It is worth mentioning that in their study, the hemoglobin level was significantly lower than in ours (6.1 g/dL vs. 11.3 g/dL), which could explain the different findings.…”

Section: Discussionmentioning

confidence: 99%

The effect of different types of anemia on HbA1c levels in non-diabetics

et al. 2023

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Background Diabetes mellitus is one of the most common diseases worldwide with significant morbidity and mortality. HbA1c remains one of the most important methods for diagnosis and monitoring of the disease. Since HbA1c is a reflection of the glucose attached to red blood cells, factors affecting hemoglobin and red blood cells’ half-life can influence HbA1c measurements. Objective This study aims to evaluate the effect of different types of anemia including iron deficiency anemia, sickle cell anemia, β -thalassemia trait, and megaloblastic anemia on HbA1c levels in a tertiary hospital over the past 6 years (2016–2022). Method This is a retrospective chart review study of 324 patients including those with one of the four types of anemia mentioned above and a control group. The control group were healthy adults with normal HbA1c and hemoglobin, who were not known to have diabetes or anemia. Patients with diabetes or prediabetes based on self-reporting or elevated fasting, random blood sugar, or 2 hours post-prandial blood glucose were excluded. Results The mean HbA1c levels were significantly higher in sickle cell anemia at 5.83% (95% CI = 5.39–6.28) and in iron deficiency anemia at 5.75% (95% CI = 5.68–5.82) when compared to the control group at 5.32% (95% CI = 5.22–5.41). However, the mean HbA1c levels in megaloblastic anemia were 5.38% (95% CI = 5.26–5.5) and 5.45% (95% CI = 5.21–5.69) in beta thalassemia trait, which were not significantly different when compared to the control group. HbA1c significantly decreased from 5.75 to 5.44% after treatment in the iron-deficient group with a p-value of < 0.001. Moreover, lower hemoglobin and higher red cell distribution width correlated with higher HbA1c levels in patients with sickle cell anemia. Conclusion This study found a significant increase in HbA1c levels in iron deficiency anemia and sickle cell disease in patients not known to have diabetes. However, there was no significant effect in those patients with β-thalassemia trait and megaloblastic anemia. Treatment of iron deficiency anemia significantly decreased the HbA1c level, bringing it back to normal.

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“…In a recent study, 100 IDA patients and 100 patients with vitamin B12 deficiency anemia were compared with 100 healthy controls before and after 3-month treatment, and similarly, it was found that HbA1c decreased significantly after vitamin B12 deficiency anemia and IDA treatment [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Anemia and DM are diseases that are common in the society and constitute a public health problem, and they are highly likely to be seen together in the same patient [ 12 ]. Studies showed that the HbA1c level decreases with the treatment of vitamin B12 deficiency anemia [ 13 – 15 ]. However, there is no study examining how much of the increase in Hgb level after treatment leads to a decrease in HbA1c.…”

Section: Highlight Key Pointsmentioning

confidence: 99%

Relationship Between Glycosylated Hemoglobin and Vitamin B12 Deficiency Anemia

Aydın¹

2022

North Clin Istanbul

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Glycated Haemoglobin (HbA1c) Variations in Nondiabetics With Nutritional Anemia

Cited by 11 publications

References 18 publications

Can HbA1c Alone Be Safely Used to Guide Insulin Therapy in African Youth with Type 1 Diabetes?

Can HbA1c Alone Be Safely Used to Guide Insulin Therapy in African Youth with Type 1 Diabetes?

The effect of different types of anemia on HbA1c levels in non-diabetics

Relationship Between Glycosylated Hemoglobin and Vitamin B12 Deficiency Anemia

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