Pitfalls in Hemoglobin A1c Measurement: When Results may be Misleading

Measurement of Hemoglobin A1c

Evaluation of glycemia is used for the diagnosis and management of patients with diabetes. Glucose and hemoglobin A1c (HbA1c) provide complementary information and both are used to assess an individual’s glycemic status. The concentration of glucose in the blood indicates the subject’s glycemia at the time of blood sampling. However, blood glucose concentrations are modified by numerous factors...

Unexpected hemoglobin A1c results.

A 52-year-old woman with a medical history of hepatitis B, hyperlipidemia, hypertension, anemia, and depression presented to the internal medicine clinic for a routine visit. Laboratory tests 3 months previously had revealed an impaired fasting glucose concentration of 5.9 mmol/L (106 mg/dL) [reference interval, 3.9 –5.6 mmol/L (70 –100 mg/dL)]. Therefore, a hemoglobin (Hb) A1c analysis was per...

Confidence Intervals On Subsets May Be Misleading

Hemoglobin A1c May Be an Inadequate Diagnostic Tool for Diabetes Mellitus in Anemic Subjects

BACKGROUND Recently, a hemoglobin A1c (HbA1c) level of 6.5% has been determined to be a criterion for diabetes mellitus (DM), and it is a widely used marker for the diagnosis of DM. However, HbA1c may be influenced by a number of factors. Anemia is one of the most prevalent diseases with an influence on HbA1c; however, its effect on HbA1c varies based on the variable pathophysiology of anemia. ...

Pulmonary actinomycosis and Hodgkin's disease: when FDG-PET may be misleading.

We present a patient with advanced Hodgkin's disease treated with escalated BEACOPP chemotherapy. The result from the interim fluorodeoxyglucose positron emission tomography with CT (PET-CT) after two cycles of chemotherapy is crucial for treatment guidance for the clinical trial HD18 from the German Hodgkin Study Group. An increase in size and standard uptake value (SUV) of a pulmonary lesion ...