Blood Sugar, HbA1c, and Their Impact on Thalassemia

Blood glucose, glycated hemoglobin, and Mediterranean anemia?

Hello, I had a company health check before the New Year, and my hemoglobin A1c was 5.6 and my blood glucose was 86.
At the end of March, due to feeling unwell, I tested my postprandial blood glucose and it was 155.
The doctor arranged for me to have a fasting blood test, and my hemoglobin A1c was 6 and my blood glucose was 95, leading to a diagnosis of prediabetes.
I have thalassemia and did not inform my primary care physician; I am unsure if this will affect the blood test results.
If it does, will the numbers increase or decrease?

Xuan Shier, 40~49 year old female. Ask Date: 2022/04/12

Dr. Li Jian reply Internal Medicine

If there are concerns that hemoglobin A1c levels may be affected by anemia, glycated albumin can be tested; the impact of anemia on hemoglobin A1c levels is difficult to estimate.

Reply Date: 2022/04/12

More Info

Understanding the relationship between blood sugar levels, HbA1c (glycated hemoglobin), and thalassemia is crucial, especially for individuals with thalassemia who may have concerns about their blood glucose management.
Firstly, it's important to clarify what HbA1c and blood glucose levels indicate. HbA1c reflects the average blood sugar levels over the past two to three months. It is a critical marker for diagnosing and monitoring diabetes. Normal HbA1c levels are typically below 5.7%, while levels between 5.7% and 6.4% indicate prediabetes, and levels of 6.5% or higher suggest diabetes. Blood glucose levels, on the other hand, can fluctuate throughout the day and are influenced by recent meals, physical activity, and other factors.

In your case, your HbA1c levels have shown an increase from 5.6% to 6.0%, which indicates a progression towards prediabetes. The fasting blood glucose levels of 86 mg/dL and 95 mg/dL are within the normal range, but the postprandial (after meal) level of 155 mg/dL is concerning and suggests impaired glucose tolerance.

Now, regarding thalassemia, particularly beta-thalassemia, it can indeed affect HbA1c readings. Individuals with thalassemia may have altered red blood cell turnover and hemoglobin variants, which can lead to inaccuracies in HbA1c measurements. The presence of thalassemia can result in a lower HbA1c level than what would be expected based on blood glucose levels. This is because the lifespan of red blood cells is shorter in individuals with thalassemia, leading to less time for glucose to attach to hemoglobin. Therefore, if you have thalassemia, your HbA1c might not accurately reflect your average blood sugar levels.

In terms of whether your thalassemia would cause your numbers to increase or decrease, it generally means that your HbA1c could be underestimated. This means that while your HbA1c is showing a level of 6.0%, the actual average blood glucose levels might be higher than what the HbA1c indicates. Consequently, it is essential to communicate your thalassemia diagnosis to your healthcare provider, as they may need to consider this when interpreting your blood sugar results.

Additionally, it is crucial to monitor your blood sugar levels regularly, especially since you have been diagnosed with prediabetes. Lifestyle modifications, such as a balanced diet low in refined sugars and carbohydrates, regular physical activity, and weight management, can significantly help in managing blood sugar levels and preventing the progression to type 2 diabetes.

In conclusion, thalassemia can complicate the interpretation of HbA1c and blood glucose levels. It is essential to inform your healthcare provider about your condition so they can provide the most accurate assessment and management plan for your blood sugar levels. Regular monitoring and lifestyle changes are key components in managing your health effectively.

Similar Q&A

Does Anemia Affect Blood Sugar Diagnosis Standards? Understanding the Impact

Recently, my health check report showed a fasting blood glucose level of 101 and a hemoglobin A1c of 5.8. I am very concerned about diabetes, but I have thalassemia. Does this condition affect blood glucose levels or the standards for hemoglobin A1c? Additionally, I would like to...

Dr. Lin Jianliang reply Internal Medicine
Hello: Mediterranean anemia can affect the binding of glucose to hemoglobin, which in turn can impact the levels of glycated hemoglobin.

Understanding Fluctuations in HbA1c Levels: A Month of Concerns

Hello Doctor: Thank you for taking the time to answer my questions despite your busy schedule. In my family, aside from my parents, my aunts, uncles, and both sets of grandparents have diabetes, so I am particularly concerned about blood sugar levels. Since mid-August, I have los...

Dr. Ye Qianyu reply Family Medicine
Hello! First, you should understand that glycated hemoglobin (HbA1c) is an indicator of average blood glucose levels over the past three months, so testing on different dates reflects average blood glucose status during different periods. Any factors that affect calorie intake an...

Conflicting Diabetes Advice: Who Should You Trust for Your Health?

Previously, I visited a nearby major hospital's endocrinology department due to thyroid issues. The doctor conducted blood tests and a urinalysis, and while my thyroid function was normal, my hemoglobin A1c was 6.5%. However, my fasting blood glucose was within the normal ra...

Dr. Liu Hongxiang reply Family Medicine
Hello Lisa, Glycated hemoglobin (HbA1c) is formed by the binding of glucose to hemoglobin in the blood. The average lifespan of red blood cells is 120 days, so glycated hemoglobin reflects the average blood glucose levels over the past three months. Daily fluctuations in blood ...

Understanding Anemia and High Platelet Counts in Diabetic Patients

Good evening, doctor. My wife is 60 years old and has type 2 diabetes without complications for over two years. Her blood pressure is 143/77, and her heart rate is approximately 113. She has been taking the prescribed medication to control her blood sugar. Recently, I noticed tha...

Dr. He Dongjin reply Cardiology
Hello, it is recommended to visit a hematology department for further examination due to worsening anemia and increased platelet count. It would be prudent to investigate potential issues with the hematopoietic system. Changhua Hospital cares about your well-being.