<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, which is caused by impaired insulin secretion, insulin action, or both. Four complications of DM have been identified – diabetes microangiopathy including nephropathy, retinopathy and polyneuropathy and diabetes macroangiopathy. DM is diagnosed on the basis of one of the following criteria: 1. Presence of typical symptoms – polyuria, polyphagia, polydipsia, weight loss and accidental plasma glucose value ≥ 11.1 mmol/l. 2. Fasting plasma glucose level ≥ 7.0 mmol/l. 3. Oral Glucose Tolerance Test (OGTT) – 2-hour blood glucose level ⩾ 11.1 mmol/l. 4. Test for glycated hemoglobin HbA1c⩾6.5%. Regular monitoring of blood glucose is crucial for good control of diabetes. Two are the most commonly available methods for glycemic monitoring – 1) home self-assessment; 2) HbA1c test. In this paper we discuss the diagnostic and prognostic value of HbA1c in comorbid patients with DM and diseases, where there are deviations in hemoglobin and erythrocyte values. In the scientific literature, single reports are available that give scarce guidance on how to manage these patients. It is mentioned that anemia should be treated individually, however no data could be found on what should be the standard behavior in such patients. According to the American Diabetes Association, only the blood glucose should be used when the relationship between HbA1c and glycemia is altered. Because of the diverse gene pool of the US population, different variants of hemoglobin may interfere with HbA1c measurements, although tests in the USA are standardized. Discrepancies between HbA1c and plasma glucose should suggest that testing for HbA1c may not be reliable for a particular patient. We present a clinical case of a comorbid patient with DM and thalassemia minor, whose glycemic control with glycated hemoglobin HbA1c is unreliable.</p></abstract>

Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, which is caused by impaired insulin secretion, insulin action, or both. Four complications of DM have been identified – diabetes microangiopathy including nephropathy, retinopathy and polyneuropathy and diabetes macroangiopathy. DM is diagnosed on the basis of one of the following criteria: 1. Presence of typical symptoms – polyuria, polyphagia, polydipsia, weight loss and accidental plasma glucose value ≥ 11.1 mmol/l. 2. Fasting plasma glucose level ≥ 7.0 mmol/l. 3. Oral Glucose Tolerance Test (OGTT) – 2-hour blood glucose level ⩾ 11.1 mmol/l. 4. Test for glycated hemoglobin HbA1c⩾6.5%. Regular monitoring of blood glucose is crucial for good control of diabetes. Two are the most commonly available methods for glycemic monitoring – 1) home self-assessment; 2) HbA1c test. In this paper we discuss the diagnostic and prognostic value of HbA1c in comorbid patients with DM and diseases, where there are deviations in hemoglobin and erythrocyte values. In the scientific literature, single reports are available that give scarce guidance on how to manage these patients. It is mentioned that anemia should be treated individually, however no data could be found on what should be the standard behavior in such patients. According to the American Diabetes Association, only the blood glucose should be used when the relationship between HbA1c and glycemia is altered. Because of the diverse gene pool of the US population, different variants of hemoglobin may interfere with HbA1c measurements, although tests in the USA are standardized. Discrepancies between HbA1c and plasma glucose should suggest that testing for HbA1c may not be reliable for a particular patient. We present a clinical case of a comorbid patient with DM and thalassemia minor, whose glycemic control with glycated hemoglobin HbA1c is unreliable.

Diagnostic and Prognostic Value of Glycated Hemoglobin (<italic>HbA1c</italic>) in Patients with Diabetes Mellitus and Thalassemia

Sofia University “Sveti Kliment Ohridski” – Sofia

Acta Medica Bulgarica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Diagnostic and Prognostic Value of Glycated Hemoglobin () in Patients with Diabetes Mellitus and Thalassemia

Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, which is caused by impaired insulin secretion, insulin action, or both. Four...

Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia

Published Online: Oct 14, 2020

Page range: 13 - 17

Accepted: Apr 08, 2020

DOI: https://doi.org/10.2478/amb-2020-0027

Keywords
Diabetes mellitus, blood glucose, glycated hemoglobin, hemolytic anemia, thalassemia

© 2020 E. Yordanov et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia

Published Online: Oct 14, 2020

Page range: 13 - 17

Accepted: Apr 08, 2020

DOI: https://doi.org/10.2478/amb-2020-0027

KeywordsDiabetes mellitus, blood glucose, glycated hemoglobin, hemolytic anemia, thalassemia

© 2020 E. Yordanov et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Diabetes mellitus, blood glucose, glycated hemoglobin, hemolytic anemia, thalassemia