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October 5, 2006

A1c (Glycohemoglobin, HgbA1c)

Question from New Jersey, USA:

My six year old son was diagnosed with diabetes almost two years ago. He also has sickle cell trait (Mediterranean descendent). His A1c usually runs between 6.2 to 7.5. Are these numbers are biased by the trait? If yes, how? I then read about Validation by a Mass Spectrometric Reference Method of Use of Boronate Affinity Chromatography to Measure Glycohemoglobin in the Presence of Hemoglobin S and C Traits. Is it necessary to ask for a more elaborate test then the regular A1c to assess his diabetes management? Are there any additional risks associated with having both of these conditions?

Answer:

Any condition which changes the red blood cell hemoglobin concentrations for any reason produces a spurious A1c result. Therefore, you can use the fructosamine test which gives “average glucose readings” without hemoglobin information being needed. Please discuss this with your diabetes team so that they can give you more specific information.

SB