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Hemoglobin A1c And Anemia

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 >>

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 >>

Glycosylated Hemoglobin (hba1c) And Anemia - General Practice Notebook

Glycosylated Hemoglobin (hba1c) And Anemia - General Practice Notebook

glycosylated hemoglobin (HbA1c) and anemia HbA1c is characterized and defined as hemoglobin that is irreversibly glycated at the N-terminal valine of the -chain HbA1c is an index used in the management of patients with diabetes HbA1c measurements rely on a predictable effect of glucose concentration on hemoglobin (Hb) over a normal red blood cell (RBC) life span - however any condition that alters RBC survival may invalidate HbA1c as an accurate measure of glycaemic control risk of misdiagnosis in those with iron-deficiency anemia and increased red blood cell turnover (e.g., haemolytic anemia or major blood loss) (1) iron-deficiency anemia is associated with higher concentrations of HbA1c among pediatric patients with type 1 diabetes despite similar levels of glycemia (1) iron replacement therapy can also result in a substantial drop in HbA1c in both diabetic and non-diabetic subjects (1) samples containing variant Hb cause erroneous results in measurement of HbA1c comparative analyses of HbA1c in samples containing Hb variants have shown that different test systems may give different results measurements of HbA1c percentages in subjects with Hb variants or high percentages of Hb derivatives may be affected differently in different methods decreased exposure time of Hb to circulating glucose concentrations will lead to truly decreased percentages for HbA1c, with erroneous interpretation when the condition is not recognized (2,3) for example with respect to sickle cell disease data from methods by HPLC and electrophoresis were variable, ranging from 'not detectable' to increased 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 >>

Anemia And Hemoglobin A1c Level: Is There A Case For Redefining Reference Ranges And Therapeutic Goals?

Anemia And Hemoglobin A1c Level: Is There A Case For Redefining Reference Ranges And Therapeutic Goals?

Segun Adeoye, Sherly Abraham, Irina Erlikh, Sylvester Sarfraz, Tomas Borda and Lap Yeung. Abstract Background: Hemoglobin A1c (HbA1c) has been adopted by physicians as a surrogate for monitoring glycemic control. There exists concern that other factors beyond serum glucose concentration may affect glycation rates and by extrapolation HbA1c levels. Study Objectives: The study attempts to discern clinical differences in HbA1c levels in patients with anaemia compared to patients without anemia, quantifying and showing the direction of such differences. Study Design: Using a convenient sampling method and a set of inclusion and exclusion criteria, it examined (retrospectively) patterns in [Hb] and HbA1c in non-diabetics with and without anemia. Results: The study observed a statistically significant 0.4units (8%) difference in the mean HbA1c in anaemia vs. non-anaemic populations. Reference ranges of HbA1c for non-anaemic population and anaemia subtypes was computed. Computed ranges for anaemia group and its subgroups were significantly wider compared to non-anaemia population. Modest but statistically significant correction of anaemia did not result in significant changes in HbA1c. Discussion: i. The linear relationship between [Hb] and HbA1c holds true for anaemic and non-anaemia populations. ii. Non-diabetic, anaemic have a significantly lower mean HbA1c (5.3% vs. 5.7%), but a similar upper limit of reference range due to a higher variance. iii. The variance and proposed reference ranges for anaemia group and its subtypes was greater than in non-anaemia group, perhaps due to homogenization of clinically heterogeneous entities. iv. Modest correction anaemia did not cause significant change in HbAIc, perhaps the increase in [Hb] was too modest or persistence of correction 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 >>

Diabetes And Anemia: Are They Related?

Diabetes And Anemia: Are They Related?

Someone’s anemic if they have an abnormally low amount of red blood cells – and when there are too few red blood cells, body organs don’t get the oxygen they need. This not only strains and damages organs, but it also decreases a person’s quality of life by causing fatigue, weakness, and headaches. Red blood cells can transport oxygen because they’re full of a complex molecule called hemoglobin, which can grab, hold, and release oxygen as needed in different part of the body. A doctor may an anemic person as having “too little hemoglobin” or “a low hematocrit”. The first statement refers to the amount of concentration of hemoglobin molecules in your blood, and the second refers to the concentration of red blood cells in your blood. If that sounds redundant, you’re right! They’re both describing the same thing. That’s why it’s best to pay attention to one or the other (not both) to avoid confusion. Types of anemia There are quite a few different types of anemia (over 400 to be exact!). The most common ones are summarized below. It is very important to know the type of anemia and the cause. Without knowing the cause, you cannot treat the disease! Iron Deficiency. This is the most common type. It is caused by lack of absorption, intake, or by blood loss. Aplastic. This occurs when the body stops making new red blood cells. It is rare, but very serious. Hemolytic. This type happens when red blood cells are destroyed faster than they can be produced. Vitamin Deficiency. Poor nutrition, or impaired vitamin absorption causes this type. Pernicious. With this, the B-12 intake is okay, but the body cannot process it correctly. Fragile Red Cell. Some people inherit abnormal red blood cells that die earlier than normal, like in sickle cell or thalassemia. Continue reading >>

Influence Of Iron Deficiency Anemia On Hemoglobin A1c Levels In Diabetic Individuals With Controlled Plasma Glucose Levels

Influence Of Iron Deficiency Anemia On Hemoglobin A1c Levels In Diabetic Individuals With Controlled Plasma Glucose Levels

Go to: Introduction: Hemoglobin A1C (HbA1c) reflects patient’s glycemic status over the previous 3 months. Previous studies have reported that iron deficiency may elevate A1C concentrations, independent of glycemia. This study is aimed to analyze the effect of iron deficiency anemia on HbA1c levels in diabetic population having plasma glucose levels in control. Methods: Totally, 120 diabetic, iron-deficient anemic individuals (70 females and 50 males) having controlled plasma glucose levels with same number of iron-sufficient non-anemic individuals were streamlined for the study. Their data of HbA1c (Bio-Rad D-10 HPLC analyzer), ferritin (cobas e411 ECLIA hormone analyzer), fasting plasma glucose (FPG, Roche Hitachi P800/917 chemistry analyzer), hemoglobin (Beckman Coulter LH780), peripheral smear examination, red cell indices, and medical history were recorded. Statistical analysis was carried out by student’s t-test, Chi-square test, and Pearson’s coefficient of regression. Results: We found elevated HbA1c (6.8 ± 1.4%) in iron-deficient individuals as compared to controls, and elevation was more in women (7.02 ± 1.58%). On further classification on the basis of FPG levels, A1C was elevated more in group having fasting glucose levels between 100-126 mg/dl (7.33 ± 1.55%) compared to the those with normal plasma glucose levels (<100 mg/dl). No significant correlation was found between HbA1c and ferritin and hemoglobin. Conclusion: This study found a positive correlation between iron deficiency anemia and increased A1C levels, especially in the controlled diabetic women and individuals having FPG between 100-126 mg/dl. Hence, before altering the treatment regimen for diabetic patient, presence of iron deficiency anemia should be considered. Key Words: Iron defici 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 >>

Artefactually Low Hemoglobin A1c In A Patient With Hemolytic Anemia

Artefactually Low Hemoglobin A1c In A Patient With Hemolytic Anemia

Artefactually Low Hemoglobin A1C in a Patient with Hemolytic Anemia Laboratory Medicine, Volume 41, Issue 5, 1 May 2010, Pages 267270, Gifford Lum; Artefactually Low Hemoglobin A1C in a Patient with Hemolytic Anemia, Laboratory Medicine, Volume 41, Issue 5, 1 May 2010, Pages 267270, 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. diabetes , HbA1C , falsely low HbA1C , shortened red cell survival , hemolytic anemia The patient was an 84-year-old male who was admitted to the emergency room in April 2009 with the chief complaint of increased bilateral lower extremity edema, a 34-pound weight gain over the past month, and worsening anemia. The patient stated that his legs had been steadily swelling over the last month although he had been taking Lasix faithfully (20 mg Monday, Wednesday, and Friday). In the emergency room, the patient was in atrial fibrillation but was free of chest pain. He had significant lower extremity edema and was given IV Lasix and diuresed approximately 1 liter overnight. Past me 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 >>

Diabetes And Anemia:

Diabetes And Anemia:

There are lots of articles about diabetes, as well as all kinds of information about anemia. But what if you have both? About 25 percent of people with diabetes have some level of anemia. This article explains how the two conditions interact. What Is Anemia, and Why Is It Linked to Diabetes? In anemia, there are fewer red blood cells than normal, resulting in less oxygen being carried to the body’s cells. People with anemia often feel tired or weak and may have difficulty getting through activities of daily living. Other symptoms include paleness, poor appetite, dizziness, lightheadedness, rapid heartbeat, and shortness of breath. Because these symptoms can also be associated with diabetes, they are sometimes not recognized as evidence of anemia. Anemia may occur with diabetes because the hormone that regulates red blood cell production, erythropoietin (EPO), is produced by the kidneys. Kidney damage at several levels is a complication of diabetes, and one problem often leads to the other. Changes in the kidneys that occur with diabetes range from diabetic nephropathy all the way to chronic kidney disease. Early detection and treatment is essential to prevent or delay disease progression. Information in greater detail can be found at www.kidney.niddk.nih.gov. Other causes of anemia are low levels of iron or other vitamins, as well as prolonged illness. Diagnosing Anemia A simple blood test done during a doctor visit, called a complete blood count or CBC, is used to check for anemia. The two elements of the test that reveal anemia are hemoglobin and hematocrit. Hemoglobin is the part of red blood cells that carries oxygen to the cells. Hematocrit indicates the percentage of red blood cells in the blood. How Does Anemia Affect Your Diabetes Care? If you have anemia, you 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 >>

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.

Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients. @article{oban2004EffectOI, title={Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients.}, author={Erkan oban and Mustafa Kemal Ozdogan and Ayen Timuraaolu}, journal={Acta haematologica}, year={2004}, volume={112 3}, pages={126-8}} Erkan oban , Mustafa Kemal Ozdogan , Ayen Timuraaolu 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 andCONTINUE READING 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 >>

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