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Effect Of Low Hemoglobin On A1c

Iron: How This Supplement Could Impact Your A1c

Iron: How This Supplement Could Impact Your A1c

We need iron. Without enough iron, we’ll get sick. But too much iron can kill us. As with so many things relating to our health, it’s a balancing act. Most people who eat meat get sufficient iron. Some foods these days are also supplemented with iron. The chocolate syrup Bosco was designed to get children to consume more iron. Cooking in iron pots, especially cooking acid foods, adds iron to our diet. Multivitamins designed for younger people contain iron (especially those for pregnant women, as the fetus consumes a lot of iron). Hence nonpregnant Western people who aren’t vegetarians usually get enough iron from their diet. People in Third World countries who don’t get much meat, however, are often iron deficient. Heme iron, or the iron that is in hemoglobin, the oxygen-carrying molecule in red blood cells, is absorbed even more efficiently than the nonheme iron that you get when you eat vegetables or take an iron-containing multivitamin pill. So eating meat, especially red meat and liver, should ensure that you get enough iron. Vitamin C will increase the absorption of iron, and large amounts of calcium or whole grains will decrease it. Those of us over 60 probably remember all those ads for “tired blood” in the 1950s and 1960s that implied that older people were tired because they didn’t have enough iron and needed to supplement with Geritol. So should we all try to get as much iron as possible? Nope. There is some evidence that high iron levels contribute to heart disease, and most “senior vitamins,” designed for people who are at an age at which heart disease is more likely, don’t have any added iron. Some people think that losing blood every month helps to protect younger women from heart disease. This protection is lost after menopause. Iron l Continue reading >>

Factors That Interfere With Hba1c Test Results

Factors That Interfere With Hba1c Test Results

Information for physicians and patients regarding HbS, HbC, HbE and HbD traits More about hemoglobin variants and HbA1c can also be found at the NIDDK web site: Sickle Cell Trait and Other Hemoglobinopathies and Diabetes: Important Information for Physicians For People of African, Mediterranean, or Southeast Asian Heritage: Important Information about Diabetes Blood Tests Factors that Interfere with HbA1c Measurement: Genetic variants (e.g. HbS trait, HbC trait), elevated fetal hemoglobin (HbF) and chemically modified derivatives of hemoglobin (e.g. carbamylated Hb in patients with renal failure) can affect the accuracy of HbA1c measurements. The effects vary depending on the specific Hb variant or derivative and the specific HbA1c method. Table 1 contains information for most of the commonly used current HbA1c methods for the four most common Hb variants, elevated HbF and carbamylated Hb. Interferences from less common Hb variants and derivatives are discussed in Bry, et al [1]. All entries in Table 1 are based on published information. In addition, if a product insert indicates clearly that there is inference from a particular factor, then the interference is entered as “yes” and the product insert is cited. When selecting an assay method, laboratories should take into consideration characteristics of the patient population served, (e.g. high prevalence of hemoglobinopathies or renal failure). Factors that affect interpretation of HbA1c Results: Any condition that shortens erythrocyte survival or decreases mean erythrocyte age (e.g., recovery from acute blood loss, hemolytic anemia) will falsely lower HbA1c test results regardless of the assay method used [2]. HbA1c results from patients with HbSS, HbCC, and HbSC must be interpreted with caution given the patholog Continue reading >>

Effect Of Iron Deficiency Anemia On The Levels Of Hemoglobin A1c In Nondiabetic Patients.

Effect Of Iron Deficiency Anemia On The Levels Of Hemoglobin A1c In Nondiabetic Patients.

Abstract The major form of glycohemoglobin is hemoglobin A1c (HbA1c). The HbA1c fraction is abnormally elevated in chronic hyperglycemic diabetic patients and correlates positively with glycemic control. Previous studies suggest that iron deficiency anemia (IDA) affects the levels of HbA1c. The aim of this study was to determine the effect of IDA on HbA1c levels in nondiabetic patients. The population studied consisted of 50 patients (30 women, 20 men, mean age 35.7 +/- 11.9 years) with IDA and 50 healthy subjects that were matched for age and sex. Patients who had glucose tolerance abnormalities (impaired glucose tolerance or diabetes mellitus), hemoglobinopathies, hemolytic anemia, chronic alcohol ingestion and chronic renal failure were excluded from the study. Hematologic investigations, fasting and postprandial glucose and HbA1c levels were measured in all subjects before iron therapy. All patients with IDA were treated with iron 100 mg/day for 3 months. We repeated the laboratory investigation after iron therapy. Before iron treatment, the mean HbA1c (7.4 +/- 0.8%) level in patients with IDA was higher than in a healthy group (5.9% +/- 0.5) (p < 0.001). In patients with IDA, HbA1c decreased significantly after iron treatment from a mean of 7.4% +/- 0.8 to 6.2% +/- 0.6 (p < 0.001). Iron deficiency must be corrected before any diagnostic or therapeutic decision is made based on HbA1c. Continue reading >>

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin (a blood pigment that carries oxygen) that is bound to glucose. The blood test for HbA1c level is routinely performed in people with type 1 and type 2 diabetes mellitus. Blood HbA1c levels are reflective of how well diabetes is controlled. The normal range for level for hemoglobin A1c is less than 6%. HbA1c also is known as glycosylated, or glycated hemoglobin. HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose. High HbA1c levels indicate poorer control of diabetes than levels in the normal range. HbA1c is typically measured to determine how well a type 1 or type 2 diabetes treatment plan (including medications, exercise, or dietary changes) is working. How Is Hemoglobin A1c Measured? The test for hemoglobin A1c depends on the chemical (electrical) charge on the molecule of HbA1c, which differs from the charges on the other components of hemoglobin. The molecule of HbA1c also differs in size from the other components. HbA1c may be separated by charge and size from the other hemoglobin A components in blood by a procedure called high pressure (or performance) liquid chromatography (HPLC). HPLC separates mixtures (for example, blood) into its various components by adding the mixtures to special liquids and passing them under pressure through columns filled with a material that separates the mixture into its different component molecules. HbA1c testing is done on a blood sample. Because HbA1c is not affected by short-term fluctuations in blood glucose concentrations, for example, due to meals, blood can be drawn for HbA1c testing without regard to when food was eaten. Fasting for the blood test is not necessary. What Are Continue reading >>

Effect Of Iron Deficiency Anaemia On Haemoglobin A1c Levels

Effect Of Iron Deficiency Anaemia On Haemoglobin A1c Levels

1Department of General Medicine, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, India 2Department of Family Medicine, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, India *Corresponding Author: Department of General Medicine Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, India Tel: 7269983216 E-mail: [email protected] Citation: Bhardwaj K, Sharma SK, Rajpal N, et al. Effect of Iron Deficiency Anaemia on Haemoglobin A1c Levels. Ann Clin Lab Res, 4: 4. doi: 10.21767/2386-5180.1000123 Visit for more related articles at Annals of Clinical and Laboratory Research Abstract Background: Iron deficiency anaemia is the most common form of anaemia in India. Haemoglobin A1c (HbA1c) is used in diabetic patients as an index to reflect glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected by presence of variant haemoglobin, haemolytic anaemia, nutritional anaemias, uremia, pregnancy and acute blood loss. However, reports on the effects of iron deficiency anaemia on HbA1c levels are inconsistent. We conducted a study to analyze the effects of iron deficiency anaemia on HbA1c levels and to assess whether treatment of iron deficiency anaemia affects HbA1c levels. Methods: Fifty patients confirmed to have iron deficiency anaemia were enrolled in the study. HbA1c levels of them were measured both at baseline and after 3 months of treatment of iron deficiency. These values were also compared with those in the control population. Results: The mean baseline HbA1c level in anaemic patients (6.60) was significantly higher than that of controls (5.48). However, after 3 months of treatment, significant decline from 6.60 to 5.74 was found in HbA1c levels. Conclusions: Our study proved that Iron Continue reading >>

Association Between Iron Deficiency And A1c Levels Among Adults Without Diabetes In The National Health And Nutrition Examination Survey, 1999–2006

Association Between Iron Deficiency And A1c Levels Among Adults Without Diabetes In The National Health And Nutrition Examination Survey, 1999–2006

OBJECTIVE Iron deficiency has been reported to elevate A1C levels apart from glycemia. We examined the influence of iron deficiency on A1C distribution among adults without diabetes. RESEARCH DESIGN AND METHODS Participants included adults without self-reported diabetes or chronic kidney disease in the National Health and Nutrition Examination Survey 1999–2006 who were aged ≥18 years of age and had complete blood counts, iron studies, and A1C levels. Iron deficiency was defined as at least two abnormalities including free erythrocyte protoporphyrin >70 μg/dl erythrocytes, transferrin saturation <16%, or serum ferritin ≤15 μg/l. Anemia was defined as hemoglobin <13.5 g/dl in men and <12.0 g/dl in women. RESULTS Among women (n = 6,666), 13.7% had iron deficiency and 4.0% had iron deficiency anemia. Whereas 316 women with iron deficiency had A1C ≥5.5%, only 32 women with iron deficiency had A1C ≥6.5%. Among men (n = 3,869), only 13 had iron deficiency and A1C ≥5.5%, and only 1 had iron deficiency and A1C ≥6.5%. Among women, iron deficiency was associated with a greater odds of A1C ≥5.5% (odds ratio 1.39 [95% CI 1.11–1.73]) after adjustment for age, race/ethnicity, and waist circumference but not with a greater odds of A1C ≥6.5% (0.79 [0.33–1.85]). CONCLUSIONS Iron deficiency is common among women and is associated with shifts in A1C distribution from <5.5 to ≥5.5%. Further research is needed to examine whether iron deficiency is associated with shifts at higher A1C levels. RESEARCH DESIGN AND METHODS We used data from the NHANES 1999–2006 conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention to assess the health and nutritional status of the U.S. population. The NHANES 1999–2006 included a nat Continue reading >>

Why Hemoglobin A1c Is Not A Reliable Marker

Why Hemoglobin A1c Is Not A Reliable Marker

i was recently tested for Hemoglobin A1c because i presented to an endocrinologist with extremely low blood glucose on lab test and some scary symptoms, not the ordinary hypoglycemia symptoms. My A1c was 4.7 which registered as low (L) on the lab print out–it was only slightly low. Does a low score on this suggest a possibility of short-lived RBCs? Does it have any relationship with extremely low blood glucose? my result at the lab, fasting, was 32mg/dL. Not long after that i got a home glucometer and i get the same kind of results on that as the lab got, in the 20s and 30s first thing in the morning, every day. did not know i had hypoglycemia until i had that lab test, though i had had one episode where i woke up with ataxia, i fell while walking to the bathroom first thing in the morning, i got up and immediately fell again. I soon found that i had very impaired coordination. i did not know why and i was very worried. Eventually i wanted to have breakfast but had great difficulty holding the measuring cup under the faucet, to get some water to heat, to make instant oatmeal, i lacked the coordination to get the water into the cup. I persisted and did make the instant oatmeal (pour hot water onto flakes and it’s done), and i got my lap top and was eating the oatmeal and i suddenly was aware that the symptoms were going away. Previously i had been unable to type. While eating the small amount of oatmeal, i realized i could type. That was about a month before the lab test. Since it only happened that once, i put it out of my mind. About 5 days after the lab test, i had the second episode, worse than the first, i woke falling out of bed to the floor, couldn’t use my arm to break the fall, i didn’t have the coordination. i sat on the floor, i could not get up and wa Continue reading >>

Pitfalls In Hemoglobin A1c Measurement: When Results May Be Misleading

Pitfalls In Hemoglobin A1c Measurement: When Results May Be Misleading

Go to: DESCRIPTION OF HEMOGLOBIN A1C Hemoglobin is the iron-containing oxygen transport metalloprotein in the red blood cells. Hemoglobin’s structure consists of a tetramer of two pairs of protein molecules: two α globin chains and two non–α globin chains. The α globin genes are HbA1 and HbA2, whereas the non–α globin genes include β, γ, δ.5 The normal adult hemoglobin molecule (HbA) consists of two α and two β chains (α2β2), and makes up about 97 % of most normal human adult hemoglobin.6 Other minor hemoglobin components may be formed by posttranslational modification of HbA. These include hemoglobins A1a, A1b, and A1c. Of these, A1c is the most abundant minor hemoglobin component. A1c is formed by the chemical condensation of hemoglobin and glucose which are both present in high concentrations in erythrocytes. This process occurs slowly and continuously over the life span of erythrocytes, which is 120 days on average. Furthermore, the rate of A1c formation is directly proportional to the average concentration of glucose within the erythrocyte during its lifespan.6 Hence, as levels of chronic hyperglycemia increase, so does the formation of A1c. This makes it an excellent marker of overall glycemic control during the time frame of the 120-day lifespan of a normal erythrocyte. Results of the DCCT and UKPDS studies verified the close relationship between glycemic control measured by A1c and the risk for diabetes-related complications. A1c has been widely accepted as the standard used to measure glycemic control over the previous 3 month period and correlates with patients’ risk for developing diabetes-related complications.7 It is important to remember that A1c represents a weighted mean of glucose levels during the preceding 3 month time period. In ot Continue reading >>

Low Hemoglobin A1c In Nondiabetic Adults

Low Hemoglobin A1c In Nondiabetic Adults

Abstract OBJECTIVE To identify predictors of low hemoglobin A1c (HbA1c) (<5.0%) and to investigate the association of low HbA1c with cause-specific mortality and risk of liver disease hospitalization. RESEARCH DESIGN AND METHODS Prospective cohort study of 13,288 participants in the Atherosclerosis Risk in Communities Study. Logistic regression was used to identify cross-sectional correlates of low HbA1c, and Cox proportional hazards models were used to estimate the association of low HbA1c with cause-specific mortality. RESULTS Compared with participants with HbA1c in the normal range (5.0 to <5.7%), participants with low HbA1c were younger, less likely to smoke, had lower BMI, lower white cell count and fibrinogen levels, and lower prevalence of hypercholesterolemia and history of coronary heart disease. However, this group was more likely to have anemia and had a higher mean corpuscular volume. In adjusted Cox models with HbA1c of 5.0 to <5.7% as the reference group, HbA1c <5.0% was associated with a significantly increased risk of all-cause mortality (hazard ratio [HR]: 1.32, 95% CI: 1.13–1.55) and of cancer death (1.47, 95% CI: 1.16–1.84). We also noted nonsignificant trends toward increased risk of death from cardiovascular causes (1.27, 95% CI: 0.93–1.75) and respiratory causes (1.42, 95% CI: 0.78–2.56). There was a J-shaped association between HbA1c and risk of liver disease hospitalization. CONCLUSIONS No single cause of death appeared to drive the association between low HbA1c and total mortality. These results add to evidence that low HbA1c values may be a generalized marker of mortality risk in the general population. Hemoglobin A1c (HbA1c) is the standard measure of glucose control in persons with diagnosed diabetes mellitus and is now recommended f Continue reading >>

Implications Of Iron Deficiency/anemia On The Classification Of Diabetes Using Hba1c

Implications Of Iron Deficiency/anemia On The Classification Of Diabetes Using Hba1c

Nonglycemic factors like iron deficiency (ID) or anemia may interfere with classification of diabetes and prediabetes using hemoglobin A1c (HbA1c). However, few population-based studies of diabetes in areas with endemic ID/anemia have been conducted. We aimed to determine how mutually exclusive categories of ID alone, anemia alone and iron-deficiency anemia (IDA) were each associated with prediabetes and diabetes prevalence using fasting blood glucose (FBG) versus HbA1c in a population-based study of adults with endemic ID/anemia. We used data from the China Health and Nutrition Survey, a longitudinal, population-based study across 228 communities within nine provinces of China. This analysis included 7308 adults seen in the 2009 survey aged 18–75 years. We used descriptive and covariate-adjusted models to examine relative risk of prediabetes and diabetes using FBG alone, HbA1c alone, HbA1c and FBG, or neither (normoglycemia) by anemia alone, ID alone, IDA or normal iron/hemoglobin. Approximately 65% of individuals with diabetes in our sample were concordantly classified with diabetes using both FBG and HbA1c, while 35% had a discordant diabetes classification: they were classified using either FBG or HbA1c, but not both. Fewer participants with ID alone versus normal iron/hemoglobin were classified with diabetes using HbA1c only. From covariate-adjusted, multinomial regression analyses, the adjusted prevalence of prediabetes using HbA1c only was 22% for men with anemia alone, but 13% for men with normal iron/hemoglobin. In contrast, the predicted prevalence of prediabetes using HbA1c only was 8% for women with ID alone, compared with 13% for women with normal iron/hemoglobin. These findings suggest potential misclassification of diabetes using HbA1c in areas of endem Continue reading >>

Artefactually Low Hemoglobin A1c In A Patient With Hemolytic Anemia

Artefactually Low Hemoglobin A1c In A Patient With Hemolytic Anemia

Hemoglobin A1C (HbA1C) is widely used for the monitoring and management of diabetes mellitus. Shortened red cell survival may result in artefactually low HbA1C values. In patients with hemoglobin variants or chemically-modified derivatives of hemoglobin, falsely decreased or increased HbA1C results may be found depending on the particular assay method. Although in most such cases, HbA1C can be reported if the appropriate methodology is selected. In diabetic patients with shortened red cell survival and in a small number of patients with certain hemoglobin variants, alternate approaches such as frequent glucose measurements and/or self glucose monitoring and fructosamine should be used to assess glycemic control. In diabetic patients with these conditions, HbA1C as the preferred diagnostic test for diabetes is not valid. Prekallikrein (Fletcher factor), a precursor of blood plasma kallikrein, is a glycoprotein consisting of 619 amino acid residues. Prekallikrein is synthesized in hepatocytes as a single polypeptide.1,2 Deficiencies of prekallikrein, factor XII (Hageman factor), high-molecular-weight (HMW) kininogen, and factor XI (plasma thromboplastin antecedent) affect the contact phase of coagulation. Despite abnormalities in coagulation tests including markedly prolonged activated partial thromboplastin time (aPTT), only factor XI deficiency is clinically relevant with a bleeding tendency, and a possible thrombophilia has been reported for factor XII deficiency.3–5 According to anecdotal reports, prekallikrein-deficient patients do not experience spontaneous or excessive injury-related bleeding; however, the marked prolongation of aPTT may be a diagnostic and management challenge for pathologists, hematologists, and surgeons with patients who undergo surgical proce Continue reading >>

Low Hemoglobin A1c And Risk Of All-cause Mortality Among Us Adults Without Diabetes

Low Hemoglobin A1c And Risk Of All-cause Mortality Among Us Adults Without Diabetes

Abstract Background— Among individuals without diabetes, elevated hemoglobin A1c (HbA1c) has been associated with increased morbidity and mortality, but the literature is sparse regarding the prognostic importance of low HbA1c. Methods and Results— National Health and Nutrition Examination Survey III (NHANES III) participants, 20 years and older, were followed up to 12 years (median follow-up, 8.8 years) for all-cause mortality. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association between HbA1c levels and all-cause mortality for 14 099 participants without diabetes. There were 1825 deaths during the follow-up period. Participants with a low HbA1c (<4.0%) had the highest levels of mean red blood cell volume, ferritin, and liver enzymes and the lowest levels of mean total cholesterol and diastolic blood pressure compared with their counterparts with HbA1c levels between 4.0% and 6.4%. An HbA1c <4.0% versus 5.0% to 5.4% was associated with an increased risk of all-cause mortality (HR, 3.73; 95% CI, 1.45 to 9.63) after adjustment for age, race-ethnicity, and sex. This association was attenuated but remained statistically significant after further multivariable adjustment for lifestyle, cardiovascular factors, metabolic factors, red blood cell indices, iron storage indices, and liver function indices (HR, 2.90; 95% CI, 1.25 to 6.76). Conclusions— In this nationally representative cohort, low HbA1c was associated with increased all-cause mortality among US adults without diabetes. Additional research is needed to confirm these results and identify potential mechanisms that may be underlying this association. Introduction Elevated hemoglobin A1c (HbA1c) is associated with an increased risk of c Continue reading >>

Effect Of Iron Deficiency Anemia On Hemoglobin A1c Levels

Effect Of Iron Deficiency Anemia On Hemoglobin A1c Levels

Go to: Abstract Background Iron deficiency anemia is the most common form of anemia in India. Hemoglobin A1c (HbA1c) is used in diabetic patients as an index of glycemic control reflecting glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected by the presence of variant hemoglobins, hemolytic anemias, nutritional anemias, uremia, pregnancy, and acute blood loss. However, reports on the effects of iron deficiency anemia on HbA1c levels are inconsistent. We conducted a study to analyze the effects of iron deficiency anemia on HbA1c levels and to assess whether treatment of iron deficiency anemia affects HbA1c levels. Fifty patients confirmed to have iron deficiency anemia were enrolled in this study. HbA1c and absolute HbA1c levels were measured both at baseline and at 2 months after treatment, and these values were compared with those in the control population. The mean baseline HbA1c level in anemic patients (4.6%) was significantly lower than that in the control group (5.5%, p<0.05). A significant increase was observed in the patients' absolute HbA1c levels at 2 months after treatment (0.29 g/dL vs. 0.73 g/dL, p<0.01). There was a significant difference between the baseline values of patients and controls (0.29 g/dL vs. 0.74 g/dL, p<0.01). Conclusions In contrast to the observations of previous studies, ours showed that HbA1c levels and absolute HbA1c levels increased with treatment of iron deficiency anemia. This could be attributable to nutritional deficiency and/or certain unknown variables. Further studies are warranted. Keywords: Iron deficiency anemia, Hemoglobin A1c, HbA1c, Glycated hemoglobin Go to: INTRODUCTION Hemoglobin A1c (HbA1c) is a glycated hemoglobin that can be used as an indicator of a patient's glycemic stat Continue reading >>

When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?

When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?

Faculty Peer Reviewed Hemoglobin A1C (HbA1c) is an invaluable tool for monitoring long-term glycemic control in diabetic patients. However, many clinicians managing diabetics have encountered the problem of HbA1c values that do not agree with fingerstick glucose logs. Before suspecting an improperly calibrated glucometer or poor patient record keeping, it is useful to consider the situations in which HbA1c may be spuriously elevated or depressed. These issues are best understood after reviewing how HbA1c is defined and measured–topics fraught with considerable confusion. Glycosylation is a non-enzymatic, time-dependent chemical reaction in which glucose binds to the amino groups of proteins.[1] Historically, and long before its precise chemistry was discovered, glycosylated Hb was defined as an area of an elution chromatogram containing hemoglobin glycosylation products. This elution peak was labeled as HbA1, in keeping with the existing nomenclature (HbA, HbA2, HbF, etc. had been identified previously). Later it was recognized that the chromatographic HbA1 region is not homogeneous and consists of several component peaks, designated A1a, A1b and A1c, with HbA1c being the dominant one.[1] The HbA1c fraction also turned out to correlate best with mean serum glucose concentrations, ie, to be a better index of long-term glycemia. Relatively recently HbA1c was redefined chemically: now glycohemoglobin refers to hemoglobin glycosylated at any of its amino groups, while HbA1c is defined as glycohemoglobin with glucose bound specifically to the terminal valine of the beta-globin chain. Consequently, the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) has developed a standard reference method for HbA1c in which hemoglobin is cleaved with a specif Continue reading >>

Type 2 Diabetes Diagnosis Distorted Through Hba1c Due To Anemia

Type 2 Diabetes Diagnosis Distorted Through Hba1c Due To Anemia

New research shows that anemia could lead to a false diagnosis of type 2 diabetes if HbA1c is used as the diagnostic method. In the UK, HbA1c is advocated by the World Health Organisation (WHO) for diagnosing type 2 diabetes at a value of 6.5 per cent (48 mmol/mol). Anemia is a common condition in which a lack of iron in the body leads to decreased red blood cell count or hemoglobin in patients. An estimate from 2011 found that 29 per cent of non-pregnant women had anemia, while the latest WHO figures suggest this figure is 13 per cent in men. Researchers at the University of Nottingham investigated studies between 1990 and 2014 in which HbA1c and glucose were measured, as well as an index of anemia involving non-pregnant women not diagnosed with diabetes. 12 studies found that iron deficiency with or without anemia resulted in increased HbA1c values, while no corresponding blood glucose rise occurred. Subsequently, a diagnosis of diabetes would require further testing. The researchers recommend that when glucose and HbA1c levels differ in diabetic patients, anemia or iron deficiency should be considered. If these abnormalities are identified, correction of high hemoglobin levels should be corrected before HbA1c is again used for diagnosis or monitoring. "HbA1c is likely to be affected by iron deficiency and iron deficiency anaemia with a spurious increase in HbA1c values. This may lead to confusion when diagnosing diabetes using HbA1c," the authors say. "This review clearly identifies the need for more evidence, especially in identifying the types and degrees of anaemia likely to have significant impact on the reliability of HbA1c." Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being in Continue reading >>

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