title: Delay in diagnosis of diabetes mellitus due to inaccurate use of hemoglobin A1C levels.
abstract: Testing of hemoglobin A(1C) (HbA(1C)) levels has become widespread in the management of patients with diabetes mellitus. Since the 1980s, it has proven to be an invaluable tool correlating with a patient's average blood glucose levels as well as with their disease morbidity. Clinicians often base treatment decisions and make adjustments depending on a patient's HbA(1C) level. As useful as the HbA(1C) is, it does have notable limitations. A number of conditions can lead to a falsely elevated or a falsely low HbA(1C) level. When one of these conditions is present, it is important to recognize the inaccuracy of the HbA(1C) test to prevent a delay or error in the diagnosis or care of patients with diabetes mellitus. It is also important to be aware of alternative methods of monitoring a patient's diabetes such as a fructosamine assay or home and office blood glucose measurements. Presented is the case of a patient with diabetes mellitus and hereditary spherocytosis, a condition that interfered with her HbA(1C) value and resulted in a delay in her care.
authors.affiliation: US Air Force, Medical Corps, 78th Medical Group, Warner-Robbins Air Force Base, GA, USA.
authors.forename: Jason G
authors.initials: JG
authors.lastname: Arnold
authors.forename: Howard J
authors.initials: HJ
authors.lastname: McGowan
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000175:diagnosis*; D003951:Diagnostic Errors; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D014481:United States
chemical_list: D006442:Glycated Hemoglobin