Accurate A1C Tests Essential for Diabetics with Sickle Cell Anemia

Reliable methods should be used to test hemoglobin A1c in people with diabetes who have sickle cell trait or other inherited forms of variant hemoglobin.

A new information campaign of the [U.S.] National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK; Bethesda, MD, USA), part of the National Institutes of Health (Bethesda, MD, USA), the
National Glycohemoglobin Standardization Program (NGSP) at the University of Missouri School of Medicine (Columbia, MO, USA) highlights the importance of testing diabetic patients for sickle cell disease, especially among people of African, Mediterranean, or Southeast Asian heritage.

Intensive control of blood glucose, blood pressure, and cholesterol reduces heart disease and the other complications of diabetes. The hemoglobin A1c (A1C) blood test is an essential tool in diabetes care because it shows a patient's average level of blood glucose control in the previous two to three months. Physicians base their treatment decisions mainly on the A1C test results.

If there is a significant discrepancy between a patient's A1C reading and the results of routine blood glucose monitoring, it is possible that the patient has a hemoglobin variant. In such cases it is advised to find out if the lab is using an accurate method to measure A1C.

The NGSP, supported by the NIDDK and [U.S.] Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA), is working to improve and standardize the measurement of A1C around the world. The NGSP website lists the test methods that accurately measure A1C in patients with hemoglobin variant S, also known as sickle cell trait, and variant C, another common variant in the United States.

"In the United States, more than 3,000 labs rely on 20 different methods to measure A1C in people with diabetes,” said Randie Little, Ph.D., who heads the NGSP. "However, six of these methods yield unreliable results in patients with sickle cell trait. Healthcare professionals caring for people with diabetes should know that specific A1C tests should be used in this group of patients.”


Related Links:
National Institute of Diabetes and Digestive and Kidney Diseases
National Glycohemoglobin Standardization Program
University of Missouri School of Medicine