Elsevier

Primary Care Diabetes

Volume 2, Issue 3, September 2008, Pages 155-157
Primary Care Diabetes

Brief reports
Falsely low HbA1c value due to a rare variant of hemoglobin J-Baltimore

https://doi.org/10.1016/j.pcd.2008.05.003Get rights and content

Abstract

HbA1c values are heavily relied on to assess glycemic control. Hemoglobin variants may interfere with measurements of HbA1c resulting in falsely low values. We present the first report of a rare variant of Hb in a patient with type 2 diabetes, which lead to a falsely low HbA1c.

Section snippets

Case report

A 55-year-old Caucasian man with a 10-year history of type 2 diabetes was referred to the diabetes clinic due to a recent deterioration of his glycemic control. He was not symptomatic; he had occasional nocturia but had no polydipsia or weight loss. He denied symptoms related to hypoglycemia. Home blood glucose monitoring (HBGM) showed values between 8.0 and 12.0 mmol/l (114 and 216 mg/dl). His 14- and 30-day average from his blood glucose meter was 9.0 mmol/l (162 mg/dl).

His past medical history

Discussion

HbA1c (hemoglobin glycated at the N-terminal valine of the β-chain) remains the gold standard for monitoring glycemic control in people with diabetes mellitus [5]. Two large, prospective, randomised clinical trials have demonstrated a strong relationship between hyperglycemia and the development of microvascular complications in type 1 and type 2 diabetes [16], [18]. Glycated hemoglobin (GHb) is formed in vivo by a reaction between glucose and the N-terminal region of Hb α or β chains. The

Conflict of interest

We declare we have no conflicts of interest. Dr. Dhatariya acts as the guarantor for this paper.

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