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November 9, 2003

A1c (Glycohemoglobin, HgbA1c)

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Question from Manila, the Philippines:

We have a one month old boy in our hospital with persistent hyperglycemia and increased random blood sugar, now being treated with insulin. Can a hemoglobin A1c be done despite the young age of the patient?

Answer:

From: DTeam Staff

The DCA 2000 (which is the most common device, at least in the USA) for measuring hemoglobin A1c requires only about 2 microliters of blood which could easily be obtained from an infant. Lets hope that this child has the transient form of diabetes, something that might be confirmed by looking for uniparental disomy on chromosome 6.

DOB

[Editor’s comment: A hemoglobin A1c certainly can be done, but since this child is so young, I would be concerned about the presence of hemoglobin F interfering with the assay. Its presence will cause falsely elevated A1c values. Therefore, it would be important to make sure whatever method is used corrects for abnormal hemoglobins.

In addition, I’m not sure what the value of measuring A1c would be. If this infant is only a month old, what would be the purpose? It seems to me that if he has persistent hyperglycemia, treatment should be continued.

SS]