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Hemoglobin A1c and the Estimated Average Glucose



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Hemoglobin Variants

Slide 14

July 2009

In the United States, hemoglobin S is the most common variant, followed by hemoglobin C, then hemoglobin E, and hemoglobin D (Punjab/Los Angeles).  Worldwide, hemoglobin variants follow this similar trend except hemoglobin E is more common than hemoglobin C.  Many, but not all, HbA1c methods are unaffected by the presence of some or all of these variants.  For patients who have no hemoglobin A, such as homozygous S or C patients, hemoglobin A1c measurement will be inaccurate and it is recommended that an alternate form of glycemia be used such as fructosamine.  In these patients a shortened red blood cell lifespan is typically encountered, which leads to a falsely low hemoglobin A1c.

Hemoglobin Variants

 


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