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Delay in Diagnosis of Diabetes Mellitus Due to Inaccurate Use of Hemoglobin A1C Levels

J. G. Arnold, H. J. McGowan
2007 Journal of the American Board of Family Medicine  
Testing of hemoglobin A 1C (HbA 1C ) levels has become widespread in the management of patients with diabetes mellitus. Since the 1980s, it has proven to be an invaluable tool correlating with a patient's average blood glucose levels as well as with their disease morbidity. Clinicians often base treatment decisions and make adjustments depending on a patient's HbA 1C level. As useful as the HbA 1C is, it does have notable limitations. A number of conditions can lead to a falsely elevated or a
more » ... ely elevated or a falsely low HbA 1C level. When one of these conditions is present, it is important to recognize the inaccuracy of the HbA 1C test to prevent a delay or error in the diagnosis or care of patients with diabetes mellitus. It is also important to be aware of alternative methods of monitoring a patient's diabetes such as a fructosamine assay or home and office blood glucose measurements. Presented is the case of a patient with diabetes mellitus and hereditary spherocytosis, a condition that interfered with her HbA 1C value and resulted in a delay in her care. (J Am Board Fam
doi:10.3122/jabfm.2007.01.060086 pmid:17204741 fatcat:q4k5dpekobbglknwxmdcueoopi