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Plasma glucose and HbA1c discrepancy may indicate hemoglobinopathy: a case series

Gulru Birce Sonmezoz1

  • 1Department of Internal Medicine, Taksim Training and Research Hospital, Istanbul, Turkey.

Current Medical Research and Opinion
|September 10, 2025
PubMed

Insights

Discrepancies between plasma glucose (PG) and hemoglobin A1c (HbA1c) in diabetes patients may indicate hemoglobinopathies. Further testing like hemoglobin electrophoresis is crucial for accurate diabetes diagnosis and management.

Area of Science:

  • Endocrinology
  • Clinical Chemistry

Background:

  • Diabetes Mellitus is a chronic condition marked by high plasma glucose (PG).
  • Hemoglobin A1c (HbA1c) is a key diagnostic marker, but its accuracy can be limited.
  • Plasma glucose (PG) and self-monitoring blood glucose (SMBG) are alternatives when HbA1c is unreliable.

Purpose of the Study:

  • To highlight the importance of considering both HbA1c and PG/SMBG in diabetes evaluation.
  • To present cases with discrepancies between PG and HbA1c levels.
  • To emphasize the role of hemoglobin electrophoresis in diagnosing hemoglobinopathies.

Main Methods:

  • Case series of three patients with diabetes.
  • Analysis of discrepancies between PG and HbA1c levels.
  • Hemoglobin electrophoresis to identify hemoglobin variants.

Main Results:

  • Three diabetic patients showed discordance between PG and HbA1c.
  • Hemoglobinopathies were identified in all three patients via electrophoresis.
  • Hematologic profiles varied, with one showing microcytosis and others being normal.

Conclusions:

  • Hemoglobinopathies can cause falsely low HbA1c, necessitating further investigation.
  • Hemoglobin electrophoresis is valuable for diagnosing hemoglobin variants in discordant cases.
  • Integrated use of HbA1c, PG, and SMBG optimizes diabetes management and reduces complication risks.
Abstract

Keywords:
Diabetes mellitusHbA1chemoglobinopathymicrocytosisnormal hemogram parametersplasma glucoseself-blood glucose monitoring

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