Is HbA1c an ideal biomarker of well-controlled diabetes?

• Published in: Postgraduate medical journal Vol. 97; no. 1148; pp. 380 - 383
• Main Authors: Kaiafa, Georgia, Veneti, Stavroula, Polychronopoulos, George, Pilalas, Dimitrios, Daios, Stylianos, Kanellos, Ilias, Didangelos, Triantafyllos, Pagoni, Stamatina, Savopoulos, Christos
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-06-2021
• Subjects: Anemia; Biomarkers; Biomarkers - blood; Blood Glucose - metabolism; Blood Glucose Self-Monitoring; Chromatography; COVID-19 - complications; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetic retinopathy; Erythrocytes; Glucose; Glycated Hemoglobin - metabolism; Hemoglobin; Humans; Hypoglycemia; Laboratories; Mortality; Patients; Predictive Value of Tests; Review; Severe acute respiratory syndrome coronavirus 2; Haematology; Anaemia; General diabetes; Diabetes & endocrinology
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/postgradmedj-2020-138756

HbA1c is a biomarker with a central role in the diagnosis and follow-up of patients with diabetes, although not a perfect one. Common comorbidities encountered in patients with diabetes mellitus, such as renal insufficiency, high output states (iron deficiency anaemia, haemolytic anaemia, haemoglobinopathies and pregnancy) and intake of specific drugs could compromise the sensitivity and specificity of the biomarker. COVID-19 pandemic poses a pressing challenge for the diabetic population, since maintaining optimal blood glucose control is key to reduce morbidity and mortality rates. Alternative methods for diabetes management, such as fructosamine, glycosylated albumin and device-based continuous glucose monitoring, are discussed.