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Type 2 Diabetes Mellitus with HbJ trait: A management conundrum
Wan Natrah Wan Yaacob1, Lili Husniati Yaacob2, Nani Draman3
1MBBS (Manipal), MMed Fam Med (USM), Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Summary
Optimal glycaemic control is vital for diabetes mellitus (DM) management. Haemoglobin A1c (HbA1c) testing is unreliable in patients with haemoglobinopathies, necessitating alternative monitoring methods for accurate diabetes care.
Area of Science:
- Endocrinology
- Clinical Chemistry
Background:
- Optimal glycaemic control is essential for managing diabetes mellitus (DM) and preventing complications.
- Haemoglobin A1c (HbA1c) is a key biomarker for assessing long-term glycaemic control.
- Haemoglobinopathies can interfere with the accuracy of HbA1c measurements.
Observation:
- This case report details a patient with type 2 DM and a haemoglobin J (HbJ) trait.
- The patient exhibited erratic HbA1c values during routine follow-up.
- This unreliability highlights a challenge in managing DM in individuals with specific haemoglobin variants.
Findings:
- HbA1c testing is unreliable for assessing glycaemic control in patients with haemoglobinopathies, such as the HbJ trait.
- Erratic HbA1c readings can misguide diabetes management strategies.
- Alternative methods are crucial for accurate patient monitoring.
Implications:
- Relying solely on HbA1c for glycaemic control assessment is inadequate for patients with haemoglobinopathies.
- Self-blood glucose monitoring and other methods are vital for guiding DM management in these individuals.
- Clinical practice should adapt to accommodate patients with haemoglobin variants for precise diabetes care.
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