Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients

Clauden Louis

doi:doi:10.11648/j.ijde.20170201.12

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Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients

Clauden Louis

Published in International Journal of Diabetes and Endocrinology (Volume 2, Issue 1)

Received: 2 January 2017 Accepted: 18 January 2017 Published: 15 March 2017

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Abstract

To assess the evidence underlying Hemoglobin A1c (HbA1c) in patients with hemoglobinopathy and the use of this modality to evaluate confounders, sources of error, upcoming developments and reach evidence-based conclusions on their optimal use in patients who require tight glucose control. This was a retrospective chart review of 7 patients with data collected between the years 2004 - 2009. Participants were selected based on the criteria that they were 1) diagnosed with Type 2 Diabetes Mellitus; 2) patients of the North Florida Thyroid Center for at least one year; and 3) had hemoglobinopathy. These patients were selected using electronic medical records (EMR). Researchers were blinded of patients’ gender, race and any other personal identifiers. A random search was performed for hemoglobinopathy within physician patient database. Assessing glycemia in diabetics can be a challenge, in particular subgroup patients with hemoglobinopathies face several pitfalls that can implicate glycemia assessment rather difficult. Our results suggest there may be a discrepancy between mean blood glucose and A1C levels of individuals with a hemoglobinopathy in small cohorts at risk of cardiovascular demise.

Published in	International Journal of Diabetes and Endocrinology (Volume 2, Issue 1)
DOI	10.11648/j.ijde.20170201.12
Page(s)	5-9
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Cardiovascular, Diabetes, Glycemic, Hemoglobinopathy, HbA1c, Cardiothoracic

References

[1]	Adekanmbi J, Higgins T, Rodriguez-capote K, et al. Erroneous HbA1c results in a patient with elevated HbC and HbF. Clin Chim Acta. 2016; 462: 153-157.
[2]	Behan KJ, Mbizo J, Johnston MA. Is the Correlation of HbA1c to Average Glucose Predictable in Individuals With Sickle Cell Trait? J Diabetes Sci Technol. 2015; 10 (1): 236-7.
[3]	DCCT Research Group. The Diabetes Control and Complications Trial (DCCT). Design and methodologic considerations for the feasibility phase. Diabetes. 1986; 35: 530-545.
[4]	Bry L, Chen PC, Sacks DB. Effects of hemoglobin variants and chemically modified derivatives on assays for glycohemoglobin. Clinical Chemistry. 2001; 47 (2): 153–163.
[5]	Dorland, W. A. (1965). Dorland s medical dictionary. Kentucky: APH.
[6]	Greer JP, Arber DA, Rodgers GM. Wintrobe's Clinical Hematology. Amirsys; 2014. Disorders of red cells, 4 (33), 856-857
[7]	Herman, W. H., Ma, Y., Uwaifo, G., Haffner, S., Kahn, S. E., Horton, E. S., et al. (2007). Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care, 30 (10), 2453-2457.
[8]	Melmed S, Williams RH. Williams Textbook of Endocrinology. Saunders; 2011. Type 2 Diabetes, 31 (6), 1404-1405
[9]	Saudek, C. D., Derr, R. L., & Kalyani, R. R. (2006). Assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin A1c. JAMA: The Journal of the American Medical Association, 295 (14), 1688-1697.
[10]	Smaldone, A. (2008). Glycemic control and hemoglobinopathy: When A1C may not be reliable. Diabetes Spectrum, 21 (1), 46-49.
[11]	Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights. 2016; 11: 95-104.
[12]	Subramaniam B, Lerner A, Novack V, et al. Increased glycemic variability in patients with elevated preoperative HbA1C predicts adverse outcomes following coronary artery bypass grafting surgery. Anesth Analg. 2014; 118 (2): 277-87.
[13]	Tran, H., Silva, D., & Petrovsky, N. (2004). Case study: Potential pitfalls of using hemoglobin A1C as the sole measure of glycemic control. Clinical Diabetes, 22 (3), 141-143.

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APA Style

Clauden Louis. (2017). Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients. International Journal of Diabetes and Endocrinology, 2(1), 5-9. https://doi.org/10.11648/j.ijde.20170201.12

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ACS Style

Clauden Louis. Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients. Int. J. Diabetes Endocrinol. 2017, 2(1), 5-9. doi: 10.11648/j.ijde.20170201.12

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AMA Style

Clauden Louis. Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients. Int J Diabetes Endocrinol. 2017;2(1):5-9. doi: 10.11648/j.ijde.20170201.12

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@article{10.11648/j.ijde.20170201.12,
  author = {Clauden Louis},
  title = {Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients},
  journal = {International Journal of Diabetes and Endocrinology},
  volume = {2},
  number = {1},
  pages = {5-9},
  doi = {10.11648/j.ijde.20170201.12},
  url = {https://doi.org/10.11648/j.ijde.20170201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20170201.12},
  abstract = {To assess the evidence underlying Hemoglobin A1c (HbA1c) in patients with hemoglobinopathy and the use of this modality to evaluate confounders, sources of error, upcoming developments and reach evidence-based conclusions on their optimal use in patients who require tight glucose control. This was a retrospective chart review of 7 patients with data collected between the years 2004 - 2009. Participants were selected based on the criteria that they were 1) diagnosed with Type 2 Diabetes Mellitus; 2) patients of the North Florida Thyroid Center for at least one year; and 3) had hemoglobinopathy. These patients were selected using electronic medical records (EMR). Researchers were blinded of patients’ gender, race and any other personal identifiers. A random search was performed for hemoglobinopathy within physician patient database. Assessing glycemia in diabetics can be a challenge, in particular subgroup patients with hemoglobinopathies face several pitfalls that can implicate glycemia assessment rather difficult. Our results suggest there may be a discrepancy between mean blood glucose and A1C levels of individuals with a hemoglobinopathy in small cohorts at risk of cardiovascular demise.},
 year = {2017}
}

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TY  - JOUR
T1  - Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients
AU  - Clauden Louis
Y1  - 2017/03/15
PY  - 2017
N1  - https://doi.org/10.11648/j.ijde.20170201.12
DO  - 10.11648/j.ijde.20170201.12
T2  - International Journal of Diabetes and Endocrinology
JF  - International Journal of Diabetes and Endocrinology
JO  - International Journal of Diabetes and Endocrinology
SP  - 5
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PB  - Science Publishing Group
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UR  - https://doi.org/10.11648/j.ijde.20170201.12
AB  - To assess the evidence underlying Hemoglobin A1c (HbA1c) in patients with hemoglobinopathy and the use of this modality to evaluate confounders, sources of error, upcoming developments and reach evidence-based conclusions on their optimal use in patients who require tight glucose control. This was a retrospective chart review of 7 patients with data collected between the years 2004 - 2009. Participants were selected based on the criteria that they were 1) diagnosed with Type 2 Diabetes Mellitus; 2) patients of the North Florida Thyroid Center for at least one year; and 3) had hemoglobinopathy. These patients were selected using electronic medical records (EMR). Researchers were blinded of patients’ gender, race and any other personal identifiers. A random search was performed for hemoglobinopathy within physician patient database. Assessing glycemia in diabetics can be a challenge, in particular subgroup patients with hemoglobinopathies face several pitfalls that can implicate glycemia assessment rather difficult. Our results suggest there may be a discrepancy between mean blood glucose and A1C levels of individuals with a hemoglobinopathy in small cohorts at risk of cardiovascular demise.
VL  - 2
IS  - 1
ER  -

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Author Information

Clauden Louis

Department of Cardiothoracic Surgery, University of Rochester Medical Center, Rochester, New York, USA

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Plain Text BibTeX RIS

APA Style

Clauden Louis. (2017). Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients. International Journal of Diabetes and Endocrinology, 2(1), 5-9. https://doi.org/10.11648/j.ijde.20170201.12

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ACS Style

Clauden Louis. Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients. Int. J. Diabetes Endocrinol. 2017, 2(1), 5-9. doi: 10.11648/j.ijde.20170201.12

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AMA Style

Clauden Louis. Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients. Int J Diabetes Endocrinol. 2017;2(1):5-9. doi: 10.11648/j.ijde.20170201.12

Copy | Download

@article{10.11648/j.ijde.20170201.12,
  author = {Clauden Louis},
  title = {Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients},
  journal = {International Journal of Diabetes and Endocrinology},
  volume = {2},
  number = {1},
  pages = {5-9},
  doi = {10.11648/j.ijde.20170201.12},
  url = {https://doi.org/10.11648/j.ijde.20170201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20170201.12},
  abstract = {To assess the evidence underlying Hemoglobin A1c (HbA1c) in patients with hemoglobinopathy and the use of this modality to evaluate confounders, sources of error, upcoming developments and reach evidence-based conclusions on their optimal use in patients who require tight glucose control. This was a retrospective chart review of 7 patients with data collected between the years 2004 - 2009. Participants were selected based on the criteria that they were 1) diagnosed with Type 2 Diabetes Mellitus; 2) patients of the North Florida Thyroid Center for at least one year; and 3) had hemoglobinopathy. These patients were selected using electronic medical records (EMR). Researchers were blinded of patients’ gender, race and any other personal identifiers. A random search was performed for hemoglobinopathy within physician patient database. Assessing glycemia in diabetics can be a challenge, in particular subgroup patients with hemoglobinopathies face several pitfalls that can implicate glycemia assessment rather difficult. Our results suggest there may be a discrepancy between mean blood glucose and A1C levels of individuals with a hemoglobinopathy in small cohorts at risk of cardiovascular demise.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Assessment of Glycemic Control and Hemoglobinopathy: When HbA1c Testing Is Unreliable in High Risk Cardiovascular Patients
AU  - Clauden Louis
Y1  - 2017/03/15
PY  - 2017
N1  - https://doi.org/10.11648/j.ijde.20170201.12
DO  - 10.11648/j.ijde.20170201.12
T2  - International Journal of Diabetes and Endocrinology
JF  - International Journal of Diabetes and Endocrinology
JO  - International Journal of Diabetes and Endocrinology
SP  - 5
EP  - 9
PB  - Science Publishing Group
SN  - 2640-1371
UR  - https://doi.org/10.11648/j.ijde.20170201.12
AB  - To assess the evidence underlying Hemoglobin A1c (HbA1c) in patients with hemoglobinopathy and the use of this modality to evaluate confounders, sources of error, upcoming developments and reach evidence-based conclusions on their optimal use in patients who require tight glucose control. This was a retrospective chart review of 7 patients with data collected between the years 2004 - 2009. Participants were selected based on the criteria that they were 1) diagnosed with Type 2 Diabetes Mellitus; 2) patients of the North Florida Thyroid Center for at least one year; and 3) had hemoglobinopathy. These patients were selected using electronic medical records (EMR). Researchers were blinded of patients’ gender, race and any other personal identifiers. A random search was performed for hemoglobinopathy within physician patient database. Assessing glycemia in diabetics can be a challenge, in particular subgroup patients with hemoglobinopathies face several pitfalls that can implicate glycemia assessment rather difficult. Our results suggest there may be a discrepancy between mean blood glucose and A1C levels of individuals with a hemoglobinopathy in small cohorts at risk of cardiovascular demise.
VL  - 2
IS  - 1
ER  -

Copy | Download