What are the limitations of hemoglobin A1c testing?

Updated: Dec 26, 2018
  • Author: Gary L Horowitz, MD; Chief Editor: Thomas M Wheeler, MD  more...
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Answer

Answer

A short note is in order with respect to hemoglobin variants. As long as one normal beta chain exists (eg, sickle cell trait, or hemoglobin C trait), one can measure hemoglobin A1c. Even in some cases with no normal beta chains (eg, sickle cell disease, or SC disease), the abnormal beta chains are glycated and can be measured by some methods. In other cases (eg, hereditary persistence of fetal hemoglobin), no beta chains exist to glycate, so glycated hemoglobin is not present. In all of these cases, though, the RBC lifespan issue may take precedence over the ability (or the lack thereof) to measure glycated hemoglobin and must be kept in mind. As noted earlier, regular fingerstick glucose monitoring throughout the course of the day can provide reliable data in these situations. [8]


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