• J Am Board Fam Med · Jan 2007

    Case Reports

    Delay in diagnosis of diabetes mellitus due to inaccurate use of hemoglobin A1C levels.

    • Jason G Arnold and Howard J McGowan.
    • US Air Force, Medical Corps, 78th Medical Group, Warner-Robbins Air Force Base, GA, USA.
    • J Am Board Fam Med. 2007 Jan 1; 20 (1): 939693-6.

    AbstractTesting 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 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.

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