Hereditary Spherocytosis and HbA1c

[primmers]

I have Hereditary Spherocytosis (HS), which is a form of haemolysing anaemia (the red blood cells are a different shape and the spleen destroys them before they are actually defunct leaving the patient with anaemia) It is often treated by removing the spleen - splenectomy. My spleen was removed over 30 years ago. As is my way, when I have anything odd in my health I do a google check for links with the disorder and HS. I found this 2007 report in the Journal of The American Board of Family Medicine

http://www.jabfm.org/cgi/content/full/20/1/93

The gist of it is that because the red cells are destroyed prematurely in HS the HbA1c is not a reliable indicator of blood sugar levels over the past three months (which is the normal lifespan of a red blood cell)

The report does not specify whether the patient described had had a splenectomy or not. I think it's probable that she had not as I think that the splenectomy generally resolves the matter, BUT it is possible that HS patients who have had a splenectomy might still have shorter lived red cells which would interfere with how the HbA1c should be interpreted. I don't know for sure but I think it's quite important I do

If there are any haeomotologists out there who could answer that one that would be fabby, otherwise I'm going to ask a pal, who works at a high risk maternity clinic where a haematologist attends, if she could check it out with the haematologist for me.

As a matter of interest, are there any other HS bods out there? I don't really fit the risk profile for Type 2 diabetes but have it anyway, if there's a lot of us in that boat it might be an interesting research question. HS does have all sorts of knock on effects, funny blood fats, increased risk of heart disease and an increased susceptibility to malaria to name but three so this might be another as yet unsuspected one.

 

[louiseb]

I do not know the answer to your question but I suffer from frequent bouts of iron deficiant anemia.
infact I am taking ferous sulphate at the minute to treat low iron levels that has have NOT reached anemia stage yet, and my subsequent hba1c is 4.4 :shock: if that is correct its fantastic however I take minimal metfromin 2x500g per day and I have to say I have been rather bad with my diet of late and have been consuming ALOT of carbs.
the doctor had told before that anemia can give you falsely low hba1c but seeing as I have not actually reached the anemic state yet just low iron levels this surprisingly low hba1c was abit baffling to me, I didnt qestion the doctor on it becuase for one I didnt really ant to admit to my poor diet lately.

 

[Blue_Dog]

I too have hereditary spherocytosis and am a type 2 diabetic. I have not had my spleen out (though I have many family members including my mother and sister who have had there spleen out). My A1C is consistently very low so its not a good indicator for me. My total cholesterol is also very low in the 130 to 135 total cholesterol range, which I understand is also due to the HS. My mother's cholesterol was also very low until she had her spleen out when it went up a lot. My triglycerides tend to be high, my HDL tends to be low, but I can't say that is due to the HS. My understanding is that if I had my spleen out, then my A1C would be a better indicator, but I don't know this for a fact, just based on conversations with my doctors and endos over the years. I'm 48 and only I and an uncle in his 70s have not had our spleens out (among those family members who have been diagnosed with HS). Oh and my children (14 and 16) have both been diagnosed, but not had their spleens out. They both had an anemia crisis when they got fifth disease a few years back.

Not sure how helpful that information is, but at least you know you're not alone.

 

[davidhowardmuhn]

I was diagnosed Type 1 Diabetic at the age of 13 and luckily found out a year later about my Spherocytosis. At 14 my spleen was removed, I have had many Doctors tell me the Spherocytosis should not effect me after the Splenectomy but I become Anemic like clock work as the Red Blood Cells change. Sad to say it took me using a Microscope and making slides of my own blood to show how this blood disorder works. It is difficult in the States to find an Endocrinologist who can look at both diseases and treat them together. When the Red Blood Cells change my Blood Sugar drops, 2 + 2 = what. Oddly enough I had an irregular Heartbeat and they thought it must be Heart Disease... NO... it was my Red Blood Cells and it was just in the lower chambers when highly stressed. Not Heart Disease, once my Blood cells went back to normal my Heart beat was fine. 7 different EKG's later they thought it must be Heart disease only to find out Spherocytosis was the cause. I am the only one in my family with Spherocytosis and one other person with Type 1 Diabetes, my family has been in the states for over 150 years and are of German Decent. I was Jaundice at birth and given a transfusion, but otherwise a healthy baby until the age of 13.

 

[davidhowardmuhn]

I have Hereditary Spherocytosis (HS), which is a form of haemolysing anaemia (the red blood cells are a different shape and the spleen destroys them before they are actually defunct leaving the patient with anaemia) It is often treated by removing the spleen - splenectomy. My spleen was removed over 30 years ago. As is my way, when I have anything odd in my health I do a google check for links with the disorder and HS. I found this 2007 report in the Journal of The American Board of Family Medicine

I was diagnosed with Type 1 Diabetes at the age of 13 & the next year they diagnosed me with Spherocytosis , no one in my family has the blood disorder so its Congenital Spherocytosis for me (1 in 14 people). My spleen was removed the same year. My blood sugar is affected by the anemia, everything can affect it but like anything I just roll with it, I am 50 years old so people can live quite well with the two diseases. I live in the United States & was lucky to find the right doctors when needed.

 

[DCUKMod]

David, this is a very old thread, so not sure any of the original folks will be around to read it. If you want to chat about your condition more, perhaps a new thread could get more visibility?

 

[Theonlystone]

David, this is a very old thread, so not sure any of the original folks will be around to read it. If you want to chat about your condition more, perhaps a new thread could get more visibility?

I'm interested in this thread,

 

[Theonlystone]

I'm interested in this thread.
I've recently been diagnosed with type 1 diabetes.
My HS was evident at birth and I have had my spleen out.
I suffer from awful fatigue, could this be linked?

 

[Theonlystone]

I also have HS and have recently found out that I have type 1 diabetes.
I suffer with awful fatigue and wonder if there is any research or any help out there for me?