Anaemia and HbA1c?

[LittleGreyCat]

Following on from my other post about anaemia, does anyone know how a low red blood cell count can skew an HbA1c?

Trying to get my head around it.

Also tracking back, the estimated HbA1c from my Freestyle Libre is 5.9% and my latest result is 7.0%.

Edit:
https://www.diabetes.co.uk/news/201...ted-through-hba1c-due-to-anemia-97409751.html
Anaemia can cause a higher calculated HbA1c.
Investigating further.

 

[Honeyblossom]

A bit late replying to this one. I was diagnosed type 2 just over a year ago, low BMI, high blood sugar out of the blue, not taking any medication for diabetes but recently had some blood tests that need a repeat test and I suspect are due to low iron. Will be interesting to see how this works out. Will let you know in a few weeks!

 

[Goonergal]

Following on from my other post about anaemia, does anyone know how a low red blood cell count can skew an HbA1c?

Trying to get my head around it.

Also tracking back, the estimated HbA1c from my Freestyle Libre is 5.9% and my latest result is 7.0%.

Edit:
https://www.diabetes.co.uk/news/201...ted-through-hba1c-due-to-anemia-97409751.html
Anaemia can cause a higher calculated HbA1c.
Investigating further.

I know @Bluetit1802 did a lot of research into HbA1c and results that don’t tally with blood glucose testing, as did @Mbaker

Try as I might I haven’t been able to find the helpful links that Bluetit gave me (it was at least a couple of years ago). However, while I haven’t read them, but have found these studies:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336595/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933917/

Editing to say, just found this post in which Bluetit lists many helpful links: https://www.diabetes.co.uk/forum/th...e-with-some-chat.22272/page-1891#post-1945168

 

[Oldvatr]

RBC can skew the hematocrit value, and most home meters are sensitive to this affecting their accuracy The HbA1c is not so affected,

I use two meters and one of them seems that it may be skewed because my hematocrit is low. Since the HbA1c is an assayed value done on venous blood, I would consider it to be more accurate than home testing.

 

[Mbaker]

I know @Bluetit1802 did a lot of research into HbA1c and results that don’t tally with blood glucose testing, as did @Mbaker

Try as I might I haven’t been able to find the helpful links that Bluetit gave me (it was at least a couple of years ago). However, while I haven’t read them, but have found these studies:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336595/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933917/

Editing to say, just found this post in which Bluetit lists many helpful links: https://www.diabetes.co.uk/forum/th...e-with-some-chat.22272/page-1891#post-1945168

Oh I pushed this to my limit:

• 6 different blood glucose monitors (a couple perfectly in sync with professional units used by my surgery)
• Countless readings per day
• Freestyle Libre - some estimates for HbA1c at 22
• A1cNow+ - many results between 30 and 31 (my wife non-diabetic read a 32 when I read 31)

At best I was getting 3.8 mmol/L fasting bg, with a normal of 4.3 / 4.4, adhoc of around 4.7 (just tested 15:56 at 5.0, on no exercise as went to City today, so on the train). What was strange is that despite dropping between 0.8 and 1 point for fbg my HbA1c stayed the same at around 38-39.
Post postprandial never above 6.0, apart from an Apple test at 6.2.

I used the Libres many times and noticed a improvement on these as well in terms of lower averages and no spiking (which I thought I might have been missing with regular tests to push up the A1c). Still no budge in the HbA1c read at Ipswich hospital. I did private tests on 2 different assays, one read 39 and other 35.5. I then read that ethic groups can get differing readings to say Europeans, so now I just focus on occasional fbg, random tests and post postprandial from time to time.

 

[LittleGreyCat]

Update: tests show that I have adequate Ferritin (which means that I am not iron deficient).
Stool test indicates that I am not bleeding into my gut (which is a relief).
Now trying to work out what it can be.

https://www.niddk.nih.gov/health-information/blood-diseases/anemia-inflammation-chronic-disease lists diabetes as possibly associated with anaemia.

https://www.niddk.nih.gov/health-in...s/anemia-inflammation-chronic-disease#chronic includes rheumatoid arthritis and I do have some arthritic joints, but then I have had on and off for years.

https://www.nhlbi.nih.gov/health-topics/hemolytic-anemia is an interesting one.
Red blood cells being recycled before their "sell by" date so production of new RBCs lags behind the rate of destruction.
This could well impact on HbA1c because the calculations are based on an assumed life time of RBCs.
I haven't yet worked out if only having new RBCs would make an HbA1c higher or lower.

 

[MrsA2]

Interesting topic. Please carry on researching and reporting back here