NAVIGATING GLYCEMIC CONTROL IN HEMOGLOBIN VARIANTS: A CASE OF UNDETECTABLE HbA1c IN A PATIENT WITH HbE TRAIT
Dr. Rahul Gopalakrishnan*, Dr. Vijayakumar P. G., Dr. Seethalakshmi S. and Dr. Lydia Jeris W.
ABSTRACT
Hemoglobin A1c (HbA1c) is a key marker for monitoring long-term glycemic control in diabetic patients, providing an average of blood glucose levels over 2-3 months. However, hemoglobinopathies, such as hemoglobin E (HbE), can interfere with the accuracy of HbA1c measurements, leading to diagnostic confusion. This case study discusses a 21-year-old female with an undetectable HbA1c result, despite normal glucose levels and no history of diabetes. Further investigation using hemoglobin electrophoresis revealed the presence of the HbE variant, confirming a heterozygous HbE trait. While the patient was asymptomatic, the discovery of HbE emphasized the need for careful interpretation of HbA1c in patients with hemoglobin variants. This case highlights the diagnostic challenges posed by HbE in diabetes management and the importance of alternative glycemic assessment methods, such as fructosamine or continuous glucose monitoring. Additionally, identifying the HbE trait is crucial for managing potential genetic risks, especially in regions with a high prevalence of hemoglobinopathies, and underscores the importance of genetic counseling for reproductive planning.
Keywords: Glycated hemoglobin, HbE heterozygous, Bio-Rad D10, Hb Electrophoresis.
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