Abstract
American Diabetes Association has suggested the use of HbA1c as diagnostic tool for prediabetes and diabetes. A value between 5.7% and 6.5% represents prediabetes while a value ≥6.5% is considered as diabetes mellitus. However, several factors other than glycemic status can influence HbA1c levels, factors which affect the RBC turnover like Haemoglobinopathies (sickle cell anemia etc.), even Blood transfusion and as Thyroid status affects cell turnover, it is being hypothesised that thyroid status changes( hypo or hyperthyroid) will cause raised levels of HB1AC levels. Raised HB1AC levels in thyroid disorders can falsely classify patients as prediabetic. The aim of the study was to determine the effects of altered thyroid status on HbA1c levels in individuals without diabetes, with overt hyper- and hypo-thyroidism. All newly diagnosed cases matching the inclusion criteria(attending the outdoors of medicine department, DMCH, Laheriasarai) with thyroid disorders between 1st april 2017 till 31st october 2018 in Department of Medicine, DMCH were included in the study, with equal numbers of age and sex matched controls. Results showed an increased level of HBA1C in patients with thyroid disorders and the presumed conclusion was that in patients with thyroid disorders glycated haemoglobin is not an assured marker of imapired glucose metabolism and other methods should be used.
References
- Study of Glycated Haemoglobin (HbA1c) In Non-Diabetic Subjects with Subclinical Hypothyroidism Mayur Goradhanbhai Makadia,1Vishwal Indravadan Patel,, journal of clinical and diagnostic research, 2017
- The Importance of HbA1c Control in Patients with Subclinical Hypothyroidism Edina Billic-Komarica,, Materiasocio-medica 2012.
- Phillips P J et al. A1C – frequently asked questions. Australian Family Physician 2005: 34; 663-7.
- Gallagher E J, Roith D L, Bloomgarden Z. Review of hemoglobin A1c in the management of diabetes.Journal of Diabetes 2009: 1; 9–17.
- Jeppsson JO, Kobold U, ABarr J et al. Approved IFCC reference method for the measurement of HbA1c in human blood. Clin Chem Lab Med. 2002; 40: 78–89.
- UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). The Lancet. 1998
- ADVANCE Collaboratrive Group . Intensive blood glucose and vascular outcomes in patients with type 2 diabetes . N Engl J Med 2008
- Effects of thyroid hormone replacement on glycated hemoglobin levels in non diabetic subjects with overt hypothyro-idism. Anantarapu S1, Vaikkakara S. arch endocrinol metab,2015
- American Diabetes Clinical practice recommendations 2012. Diabetes Care
- Harrison’s internal medicine 19th edition
- William’s manual of endocrinology
- National Collaborating Centre for Chronic Type 2 Diabetes: National Clinical Guideline for Management in Primary and Secondary Care (Update) . London: Royal College of Physicians, 2008 .
- International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care 2009.
- Tahara Y, Shima K. Kinetics of HbA1c, glycated albumin, and fructosamine and analysis of their weight functions against preceding plasma glucose level. Diabetes Care 1995.
Corresponding Author
Dr Peyalee Sarkar
3rd year post graduate trainee, Dept of Medicine, DMCH, Laheriasarai
DOI: https://dx.doi.org/10.18535/jmscr/v6i11.82
