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Falsely Decreased HbA1c in a Type 2 Diabetic Patient Treated with Dapsone

Arti D Shah1, Rena K Fox2, Robert J Rushakoff1

  • 1Division of Endocrinology and Metabolism, University of California, San Francisco.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|August 8, 2014
PubMed

Insights

Dapsone therapy can cause falsely low hemoglobin A1c (HbA1c) levels in transplant patients. Monitoring blood glucose with other methods is crucial for accurate glycemic control assessment.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Transplantation

Background:

  • Hemoglobin A1c (HbA1c) is a standard measure for assessing long-term glycemic control in diabetic patients.
  • Transplant recipients often require multiple medications, increasing the potential for drug-induced alterations in laboratory values.

Observation:

  • A liver transplant patient on dapsone therapy exhibited a declining HbA1c despite concurrent hyperglycemia indicated by fingerstick glucose and fructosamine levels.
  • This discrepancy emerged after the initiation of dapsone treatment, suggesting a drug-related effect.

Findings:

  • Dapsone is implicated in causing falsely low HbA1c readings through various potential mechanisms.
  • Discontinuation of dapsone therapy led to the normalization of the patient's HbA1c levels.

Implications:

  • Clinicians must be aware of dapsone's interference with HbA1c measurements, particularly in transplant populations.
  • Alternative glycemic markers like fructosamine should be utilized when HbA1c may be unreliable to ensure appropriate diabetes management.
Abstract

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