Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia

Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, which is caused by impaired insulin secretion, insulin action, or both. Four complications of DM have been identified – diabetes microangiopathy including nephropathy, retinopathy and polyneuropathy and diabetes macroangio...

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Main Authors: Yordanov E., Hristov E., Parvova I., Petkova V., Andreevska K.
Format: Article
Language:English
Published: Sciendo 2020-09-01
Series:Acta Medica Bulgarica
Subjects:
Online Access:https://doi.org/10.2478/amb-2020-0027
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spelling doaj-abd4559b7f674f209ed27438e35b3d282021-09-06T19:41:08ZengSciendoActa Medica Bulgarica0324-17502020-09-01473131710.2478/amb-2020-0027Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and ThalassemiaYordanov E.0Hristov E.1Parvova I.2Petkova V.3Andreevska K.4Faculty of Chemistry and Pharmacy, Sofia University “Sveti Kliment Ohridski” – Sofia, BulgariaFaculty of Chemistry and Pharmacy, Sofia University “Sveti Kliment Ohridski” – Sofia, BulgariaClinic of Rheumatology, Department of Internal Medicine, Medical University – Sofia, BulgariaFaculty of Pharmacy, Medical University – Sofia, BulgariaFaculty of Chemistry and Pharmacy, Sofia University “Sveti Kliment Ohridski” – Sofia, BulgariaDiabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, which is caused by impaired insulin secretion, insulin action, or both. Four complications of DM have been identified – diabetes microangiopathy including nephropathy, retinopathy and polyneuropathy and diabetes macroangiopathy. DM is diagnosed on the basis of one of the following criteria: 1. Presence of typical symptoms – polyuria, polyphagia, polydipsia, weight loss and accidental plasma glucose value ≥ 11.1 mmol/l. 2. Fasting plasma glucose level ≥ 7.0 mmol/l. 3. Oral Glucose Tolerance Test (OGTT) – 2-hour blood glucose level ⩾ 11.1 mmol/l. 4. Test for glycated hemoglobin HbA1c⩾6.5%. Regular monitoring of blood glucose is crucial for good control of diabetes. Two are the most commonly available methods for glycemic monitoring – 1) home self-assessment; 2) HbA1c test. In this paper we discuss the diagnostic and prognostic value of HbA1c in comorbid patients with DM and diseases, where there are deviations in hemoglobin and erythrocyte values. In the scientific literature, single reports are available that give scarce guidance on how to manage these patients. It is mentioned that anemia should be treated individually, however no data could be found on what should be the standard behavior in such patients. According to the American Diabetes Association, only the blood glucose should be used when the relationship between HbA1c and glycemia is altered. Because of the diverse gene pool of the US population, different variants of hemoglobin may interfere with HbA1c measurements, although tests in the USA are standardized. Discrepancies between HbA1c and plasma glucose should suggest that testing for HbA1c may not be reliable for a particular patient. We present a clinical case of a comorbid patient with DM and thalassemia minor, whose glycemic control with glycated hemoglobin HbA1c is unreliable.https://doi.org/10.2478/amb-2020-0027diabetes mellitusblood glucoseglycated hemoglobinhemolytic anemiathalassemia
collection DOAJ
language English
format Article
sources DOAJ
author Yordanov E.
Hristov E.
Parvova I.
Petkova V.
Andreevska K.
spellingShingle Yordanov E.
Hristov E.
Parvova I.
Petkova V.
Andreevska K.
Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia
Acta Medica Bulgarica
diabetes mellitus
blood glucose
glycated hemoglobin
hemolytic anemia
thalassemia
author_facet Yordanov E.
Hristov E.
Parvova I.
Petkova V.
Andreevska K.
author_sort Yordanov E.
title Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia
title_short Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia
title_full Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia
title_fullStr Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia
title_full_unstemmed Diagnostic and Prognostic Value of Glycated Hemoglobin (HbA1c) in Patients with Diabetes Mellitus and Thalassemia
title_sort diagnostic and prognostic value of glycated hemoglobin (hba1c) in patients with diabetes mellitus and thalassemia
publisher Sciendo
series Acta Medica Bulgarica
issn 0324-1750
publishDate 2020-09-01
description Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, which is caused by impaired insulin secretion, insulin action, or both. Four complications of DM have been identified – diabetes microangiopathy including nephropathy, retinopathy and polyneuropathy and diabetes macroangiopathy. DM is diagnosed on the basis of one of the following criteria: 1. Presence of typical symptoms – polyuria, polyphagia, polydipsia, weight loss and accidental plasma glucose value ≥ 11.1 mmol/l. 2. Fasting plasma glucose level ≥ 7.0 mmol/l. 3. Oral Glucose Tolerance Test (OGTT) – 2-hour blood glucose level ⩾ 11.1 mmol/l. 4. Test for glycated hemoglobin HbA1c⩾6.5%. Regular monitoring of blood glucose is crucial for good control of diabetes. Two are the most commonly available methods for glycemic monitoring – 1) home self-assessment; 2) HbA1c test. In this paper we discuss the diagnostic and prognostic value of HbA1c in comorbid patients with DM and diseases, where there are deviations in hemoglobin and erythrocyte values. In the scientific literature, single reports are available that give scarce guidance on how to manage these patients. It is mentioned that anemia should be treated individually, however no data could be found on what should be the standard behavior in such patients. According to the American Diabetes Association, only the blood glucose should be used when the relationship between HbA1c and glycemia is altered. Because of the diverse gene pool of the US population, different variants of hemoglobin may interfere with HbA1c measurements, although tests in the USA are standardized. Discrepancies between HbA1c and plasma glucose should suggest that testing for HbA1c may not be reliable for a particular patient. We present a clinical case of a comorbid patient with DM and thalassemia minor, whose glycemic control with glycated hemoglobin HbA1c is unreliable.
topic diabetes mellitus
blood glucose
glycated hemoglobin
hemolytic anemia
thalassemia
url https://doi.org/10.2478/amb-2020-0027
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