Specialists say that reliance on HbA1c alone in India is constrained by a number of scientific and organic elements. |Photograph courtesy: Getty Photos/iStockphoto
Glycated hemoglobin (HbA1c) is a typical diabetes check generally used to diagnose and monitor kind 2 diabetes (T2D), particularly in South Asia, the place it’s used to diagnose anemia, hemoglobinopathies (e.g., sickle cell illness, thalassemia), and glucose-6-phosphate dehydrogenase (G6PD). This may result in deceptive analysis and monitoring within the Indian inhabitants, the place the prevalence of the deficiency is excessive, notes an article printed on-line. Lancet Regional Well being: Southeast Asia.
The overview, led by Anoop Misra, corresponding writer and chairman of the Fortis C-DOC Heart of Excellence for Diabetes, questions the reliance on HbA1c as the only real diagnostic or monitoring software for kind 2 diabetes in South Asia.
The article provides that poorly standardized HbA1c assay strategies complicate interpretation of HbA1c values. “Total, relying solely on HbA1c in India is constrained by a number of scientific and organic elements. A multiparameter danger stratification strategy that integrates oral glucose tolerance testing, self-monitoring of blood glucose, and steady blood glucose monitoring the place potential, along with related hematological assessments, is crucial to extend the accuracy of analysis and monitoring and inform acceptable remedy selections, particularly in major care and resource-limited settings,” Dr. Misra stated.
Any situation that impacts the quantity, construction, or longevity of hemoglobin, similar to anemia, hemoglobinopathies, and different pink blood cell issues, can skew HbA1c values and result in deceptive estimates of common blood sugar ranges, the Viewpoint article factors out.
Co-author Shashank Joshi of the Joshi Clinic in Mumbai defined that in some components of India, individuals are malnourished and endure from iron-deficiency anemia, which may skew HbA1c measurements.
“This has implications for each analysis and monitoring, and may mislead clinicians. Counting on HbA1c alone can delay analysis by as much as 4 years in males with undetected G6PD deficiency, probably growing the danger of issues,” Dr. Joshi stated.
On this article, we defined that in sufferers with kind 1 diabetes, there’s proof of a nonlinear relationship between imply blood glucose ranges and HbA1c. Commenting on the article, diabetologist V. Mohan stated that though HbA1c is the gold normal for understanding diabetes administration, it can’t be the one check to diagnose diabetes, and this isn’t new data.
Rajeev Jayadevan, former president of the Indian Medical Affiliation Cochin, stated, “Indian research have proven that correcting anemia reduces HbA1c ranges. Prognosis of diabetes can’t be made based mostly on a single HbA1c stage; the complete scientific image must be thought-about.”
