[Restatment. Biological management of diabetes for patients with hemoglobinopathy]

For a better biological management of diabetes for patients with hemoglobinopathy. Glycated hemoglobin, HbA1c, as a cumulative retrospective marker of glycemic control in diabetic patients could be faulty in patients with hemoglobinopathy. Abnormal hemoglobin could introduce bias analytically during HbA1c measure but also due to its physiopathology by altering the lifespan of red blood cells and/or the normal glycation process. The aim of this communication is to raise awareness of physicians on some important elements for an appropriate interpretation of HbA1c levels so that these patients are better diagnosed and balanced. This review enlightens the practitioner on the HbA1c assay methods (separatives) to prioritize. It provides him critical situations where inconsistent HbA1c results should lead him to suspect hemoglobinopathy, what to do in terms of additional investigations and follow-up. It also offers a pragmatic solution for relevant personalized follow-up. Clinico-biological collaboration will help determine the HbA1c target to be reached.