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The Sickle Effect: The Silent Titan Affecting Glycated Hemoglobin Reliability
Domonick K Gordon1,2, Madiha Hussain3, Prabhat Kumar1,4,5
1Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus
|September 14, 2020
Summary
Sickle cell trait (SCT) can affect Hemoglobin A1c (HbA1c) test accuracy for diabetes diagnosis. Combining HbA1c with other tests like fasting blood glucose is recommended for SCT patients.
Area of Science:
- Endocrinology
- Hematology
- Genetics
Background:
- Hemoglobin A1c (HbA1c) is crucial for diagnosing Type 2 diabetes.
- Hemoglobinopathies, like sickle cell trait (SCT), can interfere with HbA1c accuracy.
- SCT is a common genetic condition, particularly in individuals of African ancestry.
Purpose of the Study:
- To review how sickle cell trait (SCT) impacts HbA1c interpretation.
- To explore the implications of SCT on Type 2 diabetes diagnosis and management.
- To highlight the need for accurate HbA1c measurements in diverse populations.
Main Methods:
- Traditional literature review using PubMed and Google Scholar.
- Keywords included sickle cell trait, HbA1c, diabetes, and genetics.
- Analysis focused on observational studies and standardization program guidelines.
Main Results:
- SCT may affect HbA1c accuracy due to potential reduction in red blood cell lifespan.
- Individuals with SCT, often of African ancestry, may have differing HbA1c levels influenced by race and G6PD deficiency.
- Conflicting results exist regarding the impact of SCT on red blood cell lifespan.
Conclusions:
- Hemoglobinopathy screening is recommended before HbA1c measurement in populations with high African ancestry.
- SCT complicates HbA1c interpretation, necessitating awareness and patient notification.
- For SCT patients with suspected Type 2 diabetes, using HbA1c alongside other diagnostic tools is advised to prevent missed diagnoses.
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