Co-existing illness, drug treatments and their impact on HbA1c
Research type
Research Study
Full title
To investigate co-existing illness, drug treatments and other conditions that render HbA1c unsuitable for diagnosis of diabetes and monitoring glycaemic control
IRAS ID
112342
Contact name
Jonathan Webber
Contact email
Sponsor organisation
Queen Elizabeth Hospital Birmingham
Research summary
The HbA1c test is a measure of blood glucose levels for the previous two to three months and is used to assess how good glycaemic control is in those with diabetes. HbA1c measures the amount of glucose that is being carried by the red blood cells in the body. Good diabetes control is essential in reducing the risk of many diabetes complications including eye and kidney disease. Previously, HbA1c was only used for the regular monitoring of glucose control in patients with diabetes. Now it is also being used for diagnosis of diabetes. This means it is critical that it provides accurate information on glycaemic control. In some patients HbA1c is not an accurate reflection of blood glucose. A number of conditions, illnesses or drugs that affect the structure of haemoglobin or its turnover can impact on HbA1c. Misleadingly low HbA1c has been found in individual patients with anaemias, liver or kidney disease, on various drug treatments e.g. dapsone or ribavirin, or with co-eluting haemoglobins and high values in patients with iron deficiency or alpha thalassaemia.
Given the complex patients managed at UHB, any issues with HbA1c are likely to impact on significant numbers of patients.
We plan to recruit patients at diagnosis of diabetes, or previously diagnosed with diabetes from the Diabetes Clinics and from other clinics (e.g. renal, liver, rheumatology) where we anticipate HbA1c may not accurately represent blood glucose control. Patients will be followed up over time and quantitative limits established for factors affecting the reliability of HbA1c. This will help guide future management of diabetes in these patient groups.REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
13/WM/0424
Date of REC Opinion
13 Dec 2013
REC opinion
Further Information Favourable Opinion