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January 8, 2003

A1c (Glycohemoglobin, HgbA1c)

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Question from Sugar Land, Texas, USA:

My 16 year old son, who has type 1 diabetes, usually has very good blood sugar levels and checks his glucose three to six or more times a day. The averages from his meter show that his A1c should be at the level we are attempting to achieve, but his A1cs are much higher (about 10.9%). My son has been accused of cheating and interrogated about monitoring/adjusting his glucose levels. We finally had a 72 hour glucose monitor put on him, and after the results came back, the doctor admitted that my son has been doing everything right. However, for some unknown reason, his A1C is still high.

It scares me to know that something else is wrong, and we don’t know what to do. The doctor has now asked that he do a fructosamine blood test for three months. Do you have any suggestions as to what to do? Has anyone else had this happen to them?

Answer:

From: DTeam Staff

It’s wise to check fructosamine. There could be a variant hemoglobin that does not cause any other medical problems but merely interferes with the hemoglobin A1c assay.

SB