The Hemoglobin Wayne Variant and Association With Falsely Elevated HbA_1c

The objective of this work is to explain the effect of the clinically silent hemoglobinopathy hemoglobin Wayne (Hb Wayne) variant on glycated hemoglobin A_1c (HbA_1c) assay. This variant can result in falsely high HbA_1c values among euglycemic individuals without diabetes mellitus (DM). We discuss 3 patients who were diagnosed with type 2 DM based on spuriously high HbA_1c values due to the presence of Hb Wayne. All 3 patients were found to have elevated HbA_1c values that did not correlate with other glycemic parameters such as capillary blood sugar, 2-hour oral glucose tolerance test, and fructosamine levels. Hemoglobin electrophoresis revealed that each patient had a rare hemoglobinopathy called Hb Wayne variant. These patients were reassured that they did not have DM and were able to avoid unnecessary treatment. These cases emphasize the importance of clinical judgment in recognizing the limitations and caveats of the HbA_1c test. It is always necessary to investigate further any discordance between HbA_1c values and the clinical picture or other glycemic parameters.