Is HbA1c an ideal biomarker of well-controlled diabetes?

Postgrad Med J. 2021 Jun;97(1148):380-383. doi: 10.1136/postgradmedj-2020-138756. Epub 2020 Sep 10.

Abstract

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.

Keywords: Anaemia; Diabetes & endocrinology; General diabetes; Haematology.

Publication types

  • Review

MeSH terms

  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring
  • COVID-19 / complications*
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Predictive Value of Tests

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A