Fetal hemoglobin levels are related to metabolic control in diabetic subjects

Abstract

We have investigated the relationship between fetal hemoglobin (HbF) levels and metabolic control in subjects with insulin-dependent (N = 79) and non-insulin-dependent diabetes mellitus (N = 242). HbF and hemoglobin A1c (HbA1c) levels were increased in subjects with type 1 and type 2 diabetes as compared to levels in nondiabetic individuals (P<0.0001), and were significantly higher in type 1 than in type 2 diabetes subjects. Lower levels of HbA1c and HbF were observed in type 2 diabetes subjects treated by diet, intermediate levels in those treated with oral hypoglycemic agents, and higher levels in those treated with insulin. HbF and HbA1c levels were correlated in type 1 diabetes (R 2 = 0.57, P<0.0001) and type 2 diabetes (R 2 = 0.58, P<0.0001) subjects. Following intense treatment, twelve diabetic patients showed significant improvement both in HbA1c and HbF values. We conclude that increased HbF levels reflect poor metabolic control in subjects with diabetes mellitus.

Associations between Enhanced Fetal Hemoglobin Levels and Ineffective Reticulocyte Production in Diabetics

“…Our results were different from the previous report where elevated HbF was associated with poor glycemic control [7,8], but our data were consistent with the result that HbF was not associated with HbA1c levels [9]. These discrepancies may be derived from the differences in the quantification method of HbF and the characteristics of subject populations, such as severity of disease and the nutritional status including anemia and negative iron balance.…”

“…A wide heterogeneity of the results was reported concerning the reappearance of fetal-type erythropoiesis in diabetics. Several investigators suggested that increased prevalence of elevated HbF may be associated with poor glycemic control [7,8]. On the other hand, another group of researchers reported that no significant differences were observed in glycemic control and the duration of diabetes between patients with high or low HbF levels [9].…”

The Relationship between Erythrocytes and Diabetes Mellitus

“…Generally, HbF is increased in some hemoglobinopathies, hypoplastic anemia, pernicious anemia, and leukemia [46]. However, HbF has been reported to increase in DM erythrocytes [47]. To compensate for the above changes, HbF binds to oxygen with a greater affinity and releases oxygen at a much lower partial pressure.…”

Fetal hemoglobin and hemoglobin A1c level among pediatric patients with type 1 diabetes

“…It may be increased in children under 2 years.. For this reason, HbA1c level measurement in this group of patients can be inadequate. Moreover hemoglobinopathy and genetic variants of hemoglobin gene (BCL11A and HBS1L-MYB) may influenceon the level of HbF (7)(8)(9). The main goal of this study is to evaluate the variability of the HbF level among Polish children with diabetes and examine how it may affect the HbA1c level measurement.…”