ANAEMIA & BLOOD DISORDERS CAN DISTORT HBA1C DIABETES TEST RESULTS

NEWS: A recent study warns that anaemia and certain blood disorders can distort HbA1c values, leading to misdiagnosis or delayed diagnosis, especially in South Asia and India

ABOUT

• HbA1c (glycated haemoglobin) is widely used to diagnose and monitor Type 2 Diabetes (T2D).
• Reflects average blood glucose levels over the past 2– 3 months.

Population specific biological factors that affect HbA1c accuracy:

• High prevalence of anaemia: Iron-deficiency anaemia is widespread due to–> Poor nutrition, poverty, gender and regional disparities
  • Anaemia alters the lifespan of red blood cellsàfalsely raises or lowers HbA1c.
• Genetic blood disorders (haemoglobinopathies)–> Common in India: Sickle cell disease, Thalassaemia, G6PD deficiency
  • These conditions change: Structure of haemoglobin–> Survival of red blood cells. Result: HbA1c no longer accurately reflects blood glucose.

Key findings of the study

• Sole reliance on HbA1c in India is clinically unsafe.
• HbA1c readings can be misleading, especially in: Anaemic individuals, those with undiagnosed blood disorders
• Diabetes diagnosisà may be delayed by up to 4 years, increasing risk of complications

Experts recommend

• Instead of HbA1c alone, doctors should use: Oral Glucose Tolerance Test (OGTT), fasting / post-prandial blood glucose, self-monitoring of blood glucose
• Check for: Anaemia, blood disorders–>important in primary healthcare and resourcelimited settings.

Public health significance for India

• India is the diabetes capital of the world and also has: High anaemia burden
• Using a one-size-fits-all diagnostic tool can: Exclude vulnerable populations, worsen health inequality
• Reinforces the need for context specific healthcare strategies