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March 7, 2006

A1c (Glycohemoglobin, HgbA1c), Other

Question from Liberty Township, Ohio, USA:

When looking through records from my daughter's early years with diabetes, we see the following comment from her endocrinologist: "Her A1c remains high probably because of the presence of fetal hemoglobin." What does this mean? My daughter was diagnosed at the age of 24 months and these comments are on her quarterly exam reports for the first 16 months she had diabetes.

Answer:

Fetal hemoglobin looks on many laboratory tests like hemoglobin A1c and, so, produces a higher than expected A1c test on some assays. Fetal hemoglobin usually disappears after several months, but occasionally lasts a bit longer. So, I would expect that the diabetologist was rather clever and realized that this produced falsely high readings and correctly “interpreted” the results to be better than the actual A1c reading. It is a perfectly normal physiologic variation and nothing to be concerned about since it self-corrects virtually all of the time.

SB