Diagnostic and prognostic value of glycated hemoglobin (HbA1c) in patients with diabetes mellitus and thalassemia

Title

Poster

Description

Emanuil Yordanov1, Emil Hristov1, Iva Parvova2, Valentina Petkova3, Kalina Andreevska1
1Faculty of Chemistry and Pharmacy, Sofia University “Saint Kliment Ohridski”, Sofia, Bulgaria
2Clinic of Rheumatology, Department of Rheumatology, Medical University - Sofia, Bulgaria
3Faculty of Pharmacy, Medical University - Sofia, Sofia, Bulgaria

Subject

Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia results from impaired insulin secretion, insulin action, or both. Four complications of DM were identified - microangiopathy, nephropathy, polyneuropathy and macroangiopathy. DM is diagnosed with: 1.The presence of typical simptoms - polyuria, polyphagia, polydipsia, weight reduction and accidental plasma glucose ≥11.1 mmol/l. 2.Fasting glucose test ≥ 7,0 mmol/l. 3.Oral Glucose Tolerance Test (OGTT) - blood sugar above 11.1 mmol/l at 2 hours. 4.Test for glycated hemoglobin HbA1c ≥6.5%. Regular monitoring of blood glucose is crucial for good control: 2 methods are available - 1)Home self-control; 2) Assessment of HbA1c. What is the diagnostic and prognostic value of HbA1c in comorbid patients with DM and diseases where there are deviations in hemoglobin and erythrocyte values? In the scientific literature, single reports such as case report and case series are found, it is mentioned that anemia should be treated individually, however we do not find data on standard behavior even in the guides of leading scientific organizations. According to the American Diabetes Association, only the blood glucose should be used when the relationship between HbA1c and glycemia is altered. Because of the diverse gene pool of the US population, different variants of hemoglobin may interfere with HbA1c measurements, although tests in the US are standardized. Discrepancies between HbA1c and plasma glucose should suggest that testing for HbA1c may not be reliable for a particular patient. We present a clinical case of a comorbid patient with DM and thalassemia minor, in whom the control of DM with glycated hemoglobin HbA1c is unreliable.
Keywords: Diabetes mellitus, blood sugar, glycated hemoglobin, thalassemia