Editorial eMedinewS

Health Care 228 Comments

HbA1C variation by race weakens its exclusive
diabetes diagnostic power

Differences in HbA1c levels are attributed to differences in blood glucose levels because the concentration of blood glucose determines the formation of HbA1c. However, HbA1c level may also be influenced by other physiologic, environmental, genetic, or socioeconomic factors, including race and ethnicity.

Uremia, hyperbilirubinemia, hypertriglyceridemia, chronic alcoholism, chronic ingestion of salicylates, and opiate addiction can falsely increase HbA1c results, whereas vitamin C and vitamin E ingestion have also been reported to falsely lower HbA1c results.

Participants enrolled in the Diabetes Prevention Program who had prediabetes were found to have HbA1c levels that differed between black and white participants with no differences in glucose concentration. Black persons have higher HbA1c levels than white persons across the full spectrum of glycemia, and the differences increase as glucose intolerance worsens. (June 14, 2010, Annals of Internal Medicine)

Dr KK Aggarwal
Editor in Chief