Impact of haemoglobin variants on the use of haemoglobin A1c for the diagnosis and monitoring of diabetes: a contextualised review

Liddy, Anne Marie; Grundy, Stephan; Sreenan, Séamus; Tormey, William

doi:10.1007/s11845-022-02967-2

Cited by 5 publications

(3 citation statements)

References 48 publications

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“…The total Hb values vary between individuals, and hence measurement of HbA1c alone results in errors in the diagnosis of diabetes, especially in anemic individuals [ 107 ]. Therefore, it becomes necessary to measure both total Hb and HbA1c levels in individuals for error-free diagnosis.…”

Section: Challenges In Diagnosis Based On Hba1c Measurementsmentioning

confidence: 99%

Trends in Quantification of HbA1c Using Electrochemical and Point-of-Care Analyzers

Mandali

Prabakaran

Annadurai

et al. 2023

Sensors

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Glycated hemoglobin (HbA1c), one of the many variants of hemoglobin (Hb), serves as a standard biomarker of diabetes, as it assesses the long-term glycemic status of the individual for the previous 90–120 days. HbA1c levels in blood are stable and do not fluctuate when compared to the random blood glucose levels. The normal level of HbA1c is 4–6.0%, while concentrations > 6.5% denote diabetes. Conventionally, HbA1c is measured using techniques such as chromatography, spectroscopy, immunoassays, capillary electrophoresis, fluorometry, etc., that are time-consuming, expensive, and involve complex procedures and skilled personnel. These limitations have spurred development of sensors incorporating nanostructured materials that can aid in specific and accurate quantification of HbA1c. Various chemical and biological sensing elements with and without nanoparticle interfaces have been explored for HbA1c detection. Attempts are underway to improve the detection speed, increase accuracy, and reduce sample volumes and detection costs through different combinations of nanomaterials, interfaces, capture elements, and measurement techniques. This review elaborates on the recent advances in the realm of electrochemical detection for HbA1c detection. It also discusses the emerging trends and challenges in the fabrication of effective, accurate, and cost-effective point-of-care (PoC) devices for HbA1c and the potential way forward.

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Section: Challenges In Diagnosis Based On Hba1c Measurementsmentioning

confidence: 99%

Trends in Quantification of HbA1c Using Electrochemical and Point-of-Care Analyzers

Mandali

Prabakaran

Annadurai

et al. 2023

Sensors

View full text Add to dashboard Cite

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“…This has enabled a direct comparison of the analytical performance for HbA1c (as measured by imprecision, expressed as a coefficient of variation, CV), in the QAAMS Program versus Australasian laboratories. To enable clinically significant changes in serial patient HbA1c measurements to be detected and not be masked by poor-quality test performance, imprecision goals of 3% (desired) and 2% (optimal) have been set by professional bodies and expert panels [12,13].…”

Section: Surveillance Of Analytical Qualitymentioning

confidence: 99%

Pathology Testing at the Point of Patient Care: Transformational Change for Rural Communities

Shephard¹,

Matthews²,

Markus³

et al. 2023

Rural Health - Investment, Research and Implications

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Point-of-care (POC) testing is an innovative and revolutionary in vitro diagnostic (IVD) technology that enables the real-time conduct of pathology testing during a patient consultation, facilitating immediate clinical action. When conducted under a quality-assured framework, POC testing is an essential diagnostic tool, and is now well embedded, in primary health care settings in rural communities around the world. POC testing helps bridge the gap in health equity access that exists in geographically isolated rural communities and empowers patients to invest in understanding and improving their own health literacy. Using POC testing networks for chronic, acute and infectious diseases that are currently operating in rural and remote Australia, this chapter explores the operational, clinical and economic benefits that POC testing can deliver, and the lessons learned that have contributed to continuously improved quality of POC testing service delivery. Investment in POC testing and infrastructure by Australian governments, both federal and state, has reaped significant rewards for patients in rural communities. Additionally, translational research in this field has provided insight into how POC testing can be successfully scaled up for broad application in low- and middle-income countries.

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“…31 Measurement of HbA1c depends on a normal erythrocyte life span 32 , and hemoglobinopathies have varying effects on HbA1c concentrations. 32,33 Unlike people homozygous for hemoglobin S variant (HbS), people with sickle cell trait may have normal erythrocyte survival, and HbA1c can be used to assess their glycemic status as long as HbS does not interfere with the assay method or glucose binding. 32 HbS does not interfere with the immunoassay method used in our study, 34 but it affects HPLC methods.…”

Section: Pre-analytical Factors Including Sample Freezing and Storage...mentioning

confidence: 99%

Measuring Hemoglobin A1C with Frozen Packed Cell and Frozen Whole Blood Samples in an Epidemiologic Study: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Mukaz,

Tison,

Long

et al. 2023

Preprint

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IntroductionHemoglobin A1c (HbA1c) measurement in epidemiology studies could be increased if reliability of measurements in frozen stored samples was known. In the REasons for Geographic and Racial Differences in Stroke, a longitudinal study of 30,239 Black and White U.S. adults, we investigated reliability of HbA1c measurements for two types of samples stored at -80°C for up to 14 years.MethodsAmong 917 participants without diabetes, HbA1c was measured in 2017 in frozen packed cells from the first visit (2003-07) and in frozen whole blood samples from the second visit (2013-16). To study reliability, associations between HbA1c and glycemia-related characteristics were examined.ResultsEach 10mg/dL greater fasting glucose was associated with 0.08% (95%CI: 0.05-0.11%) greater HbA1c in frozen packed cells (visit 1) and 0.10% (95%CI: 0.08-0.12%) greater HbA1c in whole blood (visit 2). HbA1c was also similarly higher with both methods with increasing age, gender, systolic blood pressure, body mass index, high-density lipoprotein, triglycerides, C-reactive protein, and hemoglobin. Using both methods, ≤3.5% were classified with diabetes based on HbA1c ≥6.5%.ConclusionsIn REGARDS participants without diabetes, HbA1c measurement appeared reliable in frozen packed cells or whole blood under long-term storage, suggesting acceptability for study of the epidemiology of HbA1c.

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Impact of haemoglobin variants on the use of haemoglobin A1c for the diagnosis and monitoring of diabetes: a contextualised review

Cited by 5 publications

References 48 publications

Trends in Quantification of HbA1c Using Electrochemical and Point-of-Care Analyzers

Trends in Quantification of HbA1c Using Electrochemical and Point-of-Care Analyzers

Pathology Testing at the Point of Patient Care: Transformational Change for Rural Communities

Measuring Hemoglobin A1C with Frozen Packed Cell and Frozen Whole Blood Samples in an Epidemiologic Study: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

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