title: A falling HbA1c is not necessarily an indicator of improving diabetes control.
abstract: The finding of a very low haemoglobin A1c (HbA1c) (1.4%) in a diabetic patient with fairly high plasma glucose levels prompted haematological investigations, which revealed auto-immune haemolysis and a Hb concentration of 7.7 g/L. Following treatment, both Hb and HbA1c concentrations increased roughly in parallel until, 4 months later, Hb was 13.8 g/L, HbA1c 5.2% and plasma glucose was 6.8 mmol/L. This case illustrates that a falling HbA1c cannot always be attributed to improving glucose control in diabetic patients.
authors.affiliation: Department of Clinical Biochemistry, North Manchester General Hospital, UK. Keith.Wiener@mail.nmanhc-tr.nwest.nhs.uk
authors.forename: K
authors.initials: K
authors.lastname: Wiener
mesh_terms: D015415:Biomarkers / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D005260:Female; D005475:Flupenthixol / Q000031:analogs & derivatives / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000032:analysis*; D006454:Hemoglobins / Q000032:analysis; D006461:Hemolysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007037:Hypothyroidism / Q000097:blood / Q000150:complications / Q000188:drug therapy; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D016584:Panic Disorder / Q000097:blood / Q000150:complications / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D015203:Reproducibility of Results; D013974:Thyroxine / Q000627:therapeutic use; D013997:Time Factors; D014149:Tranquilizing Agents / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D005475:Flupenthixol; D006442:Glycated Hemoglobin; D006454:Hemoglobins; D007004:Hypoglycemic Agents; D008687:Metformin; D011239:Prednisolone; D013974:Thyroxine; D014149:Tranquilizing Agents; C007761:flupenthixol decanoate