Inaccurate Hemoglobin A1C Levels in Patients with Type 1 Diabetes and Hereditary Persistence of Hemoglobin F

Felner, Eric I.; McGrath, Maureen

doi:10.1016/j.jpeds.2008.01.024

Cited by 16 publications

(8 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As HbA 1C level is calculated by dividing the measured HbA 1C by the whole Hb, the level appears to be low in blood samples containing a large amount of components other than HbA. 23 Neonatal blood contains a large amount of HbF, whereas HbA accounts for only 10 to 20%. For this reason, HbA 1C levels are determined extremely low and such data cannot be used in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Measurement of glycated hemoglobin and glycated albumin in umbilical cord: evaluation of the glycemic control indicators in neonates

et al. 2010

View full text Add to dashboard Cite

Objective: As neonatal blood contains a high proportion of fetal hemoglobin (HbF), it is difficult to use high-performance liquid chromatography (HPLC) method, latex-immunoturbidimetry (LA) method and enzymatic methods, which determine hemoglobin A 1C (HbA 1C ) in order to provide the glycemic control indicators of neonates. In this study, we evaluated glycated hemoglobin (GHb) and glycated albumin (GA) as appropriate indicators of the glycemic control in the neonatal period.Study Design: Umbilical cord blood samples collected during delivery were subjected to measurements of GHb (HPLC methods using two different instruments, LA method, enzymatic method and affinity method) and serum GA.Result: HbA 1C levels determined by the HPLC method, the LA method and the enzymatic method were as low as <3.0% in all the cases. Although GHb determined by the affinity method was 3.6 ± 0.2%, this method may not measure accurately the values of glycated HbF plus glycated HbA. Serum GA was 9.4 ± 1.1%. Conclusion:We speculate that serum GA, but not GHb, could be used as glycemic control indicators in neonates.

show abstract

Section: Discussionmentioning

confidence: 99%

Measurement of glycated hemoglobin and glycated albumin in umbilical cord: evaluation of the glycemic control indicators in neonates

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Thus, HbA 1c levels may not accurately reflect glycaemic control in these situations [8]. In addition to variant haemoglobin, some assays and calculation methods for estimating HbA 1c indicate that HbA 1c levels appear low when fetal haemoglobin (HbF) levels are high [9,10]. HbF is the main haemoglobin present during the fetal period and accounts for 80-90% of haemoglobin just after birth, whereas haemoglobin A (HbA) accounts for only 10-20% [11].…”

Section: Introductionmentioning

confidence: 99%

Glycated albumin but not HbA1c reflects glycaemic control in patients with neonatal diabetes mellitus

et al. 2011

View full text Add to dashboard Cite

Aims/hypothesis It is difficult to use HbA 1c as an indicator of glycaemic control in patients with neonatal diabetes mellitus (NDM) because of high levels of fetal haemoglobin (HbF) remaining in the blood. In this study, glycated albumin (GA), which is not affected by HbF, and HbA 1c were compared to evaluate whether they reflect glycaemic control in patients with NDM. Methods This study included five patients with NDM. Age at diagnosis was 38±20 days. Insulin therapy was started in all patients, and levels of GA, HbA 1c and HbF were measured monthly for 6 months. One-month average preprandial plasma glucose (aPPG) was calculated using self-monitoring of blood glucose. Results Plasma glucose and GA were elevated (29.7± 13.1 mmol/l [n=5] and 33.3±6.9% [n=3], respectively) but HbA 1c was within normal limits (5.4±2.6% [35.5± 4.9 mmol/mol]; n=4) at diagnosis. With diabetes treatment, aPPG (r=−0.565, p=0.002), GA (r=−0.552, p=0.003) and HbF (r=−0.855, p<0.0001) decreased with age, whereas HbA 1c increased (r=0.449, p=0.004). GA was strongly positively correlated with aPPG (r=0.784, p<0.0001), while HbA 1c showed no correlation with aPPG (r=0.221, p=0.257) and was significantly inversely correlated with HbF (r=−0.539, p=0.004). Conclusions/interpretation GA is a useful indicator of glycaemic control in patients with NDM, whereas HbA 1c is influenced by age-related changes in HbF and does not accurately reflect glycaemic control.

show abstract

“…The currently used diagnostic criteria for FT1DM are mainly based on adult data [5], wherein proof of an abrupt onset depends on the lack of a substantial elevation in the value of HbA1c. However, in infant patients, the percentage of fetal hemoglobin (HbF) in the blood is estimated to be high, and a higher percentage of non-HbA1c, such as HbF, is associated with a lower level of HbA1c [15]. Therefore, in the present study, the true duration of high blood glucose status may have been underestimated by the relatively low HbA1c values.…”

Section: Discussionmentioning

confidence: 69%

Fulminant type 1 diabetes mellitus in Japanese children and adolescents: multi-institutional joint research of the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes

et al. 2018

View full text Add to dashboard Cite

Fulminant type 1 diabetes mellitus (FT1DM) is a subtype of type 1 diabetes mellitus characterized by a remarkably abrupt onset. In Japan, FT1DM accounts for approximately 20% of acute-onset adult type 1 diabetes mellitus cases; however, reports of pediatric-onset FT1DM are rare. We aimed to determine the frequency and clinical characteristics of FT1DM in Japanese children and adolescents by conducting a 2-phase questionnaire survey among the members of the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes (JSGIT) regarding their clinical experience with FT1DM. Responses were obtained from 54 of the 79 participating hospitals (68.4%). Of these, 8 hospitals managed a total of 15 pediatric patients with FT1DM (4 patients in each of 2 hospitals, 2 patients in 1 hospital, and 1 patient in each of 5 hospitals). The distribution of patient age was biphasic, with peaks in children younger than 5 years and older than 8 years of age. The clinical characteristics of FT1DM in this population (such as the duration from onset of symptoms to diagnosis, severity of symptoms, preceding flu-like episodes, and abnormal laboratory data) did not differ from those of patients with adult-onset FT1DM. The frequency of pediatric-onset FT1DM is low compared with that of adult-onset FT1DM. The genetic background and susceptibility patterns of pediatric patients with FT1DM may differ from those typical of adults with FT1DM, but both age groups share similar clinical characteristics.

show abstract

Inaccurate Hemoglobin A1C Levels in Patients with Type 1 Diabetes and Hereditary Persistence of Hemoglobin F

Cited by 16 publications

References 9 publications

Measurement of glycated hemoglobin and glycated albumin in umbilical cord: evaluation of the glycemic control indicators in neonates

Measurement of glycated hemoglobin and glycated albumin in umbilical cord: evaluation of the glycemic control indicators in neonates

Glycated albumin but not HbA1c reflects glycaemic control in patients with neonatal diabetes mellitus

Fulminant type 1 diabetes mellitus in Japanese children and adolescents: multi-institutional joint research of the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes

Contact Info

Product

Resources

About