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[When HbA1c fails]

Mads Bisgaard Bengtsen1,2, Esben Søndergaard1

  • 1Steno Diabetes Center Aarhus, Aarhus Universitetshospital.

Ugeskrift for Laeger
|June 20, 2025
PubMed

Insights

Recognize potential HbA1c measurement errors. Vigilance is key for discrepancies between continuous glucose monitoring (CGM) and venous HbA1c, especially for managing type 2 diabetes in primary care.

Area of Science:

  • Clinical Chemistry
  • Endocrinology
  • Diabetes Management

Background:

  • Continuous glucose monitoring (CGM) is increasingly used for diabetes management.
  • Accurate HbA1c measurements are crucial for assessing long-term glycemic control.
  • Discrepancies between CGM-estimated HbA1c and laboratory values can impact clinical decisions.

Purpose of the Study:

  • To highlight potential pitfalls in HbA1c measurement.
  • To emphasize the importance of vigilance regarding discrepancies between CGM-estimated HbA1c and venous HbA1c.
  • To inform physicians managing diabetes, particularly in primary care settings.

Main Methods:

  • Case report.
  • Comparison of HbA1c values derived from continuous glucose monitoring (CGM) and traditional venous blood draws.
  • Analysis of potential sources of measurement error.

Main Results:

  • Potential for significant discrepancies between CGM-estimated HbA1c and laboratory-measured HbA1c.
  • Identification of factors contributing to measurement errors.
  • Clinical relevance of these discrepancies in diabetes management.

Conclusions:

  • Physicians must be aware of and vigilant for HbA1c measurement errors.
  • Discrepancies necessitate careful interpretation of glycemic control data.
  • Proactive identification and management of measurement errors are essential for optimal patient care, especially with rising CGM adoption.

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