HbA1c testing is currently being accessed by clinicians as a non-fasting glucose test for the diagnosis and monitoring of diabetes; however, its clinical utility may not be universally applicable in regions with a high prevalence of hemoglobin variants<\/p>\n
Elikem Kumahor<\/p>\n
\u201cWe have a high prevalence of sickle cell disease \u2014 about 2% of all newborns \u2014 and sickle cell trait in about 30% of the Ghanaian population. However, the influence of hemoglobin variants on HbA1c testing hasn\u2019t been well characterized in our region,\u201d said lead study author Dr. Elikem Kumahor, a specialist laboratory physician at Korle Bu Teaching Hospital in Accra, Ghana. \u201cOur study indicates that relying on immunoassays alone likely contributes to a significant underdiagnosis of diabetes. We recommend adopting other laboratory methods that factor in hemoglobin variants, like HPLC or mandatory reflex testing algorithms, for accurate diabetes assessments in high-risk populations.\u201d\u00a0<\/p>\n
Dr. Kumahor and colleagues conducted a retrospective study using 1,283 consecutive HbA1c tests from patients ages 18 and older at a tertiary hospital in Accra in January and February 2026. Initial measurements were performed on an HPLC platform that automatically detects hemoglobin variants. Then, 256 samples with suspected variants were reanalyzed using immunoturbidimetric assays. Investigators confirmed the sickle cell trait using hemoglobin electrophoresis, a technique that separates hemoglobin protein variants based on their size and charge.\u00a0<\/p>\n
They categorized 1,027 patients as HbAA (normal) and 198 as HbAS (having the sickle cell trait). About 58 individuals with other hemoglobin variants were excluded from further study. Investigators then calculated the mean HbA1c differences between the two laboratory methods and compared the classification of patients to either pre-diabetes (HbA1c 5.7%) or diabetes (HbA1c 6.5%) categories.\u00a0<\/p>\n
Among the total samples screened, hemoglobin variants were detected in 256 people (20% of the sample), with HbAS confirmed in 198 (15.4%) of the total. In the HbAA group, mean HbA1c by immunoassay and HPLC showed minimal bias. However, in the HbAS group, the immunoassay significantly underestimated HbA1c compared to HPLC (5.1% vs. 5.9%).\u00a0<\/p>\n
Using immunoassay, only 11.1% (22 of the 198) HbAS participants were classified as pre-diabetic, compared to 34.5% (68 of the 198) using HPLC. Additionally, 4% (8 of the 198) of HbAS individuals met the diabetes criteria using HPLC, while none were classified as diabetic using immunoassay.\u00a0<\/p>\n
\u201cFrom this preliminary study, we noted that HbA1c results measured in participants carrying the sickle cell trait were significantly decreased compared to participants with normal hemoglobin when results from HPLC were compared to results from immunoturbidimetry,\u201d Dr. Kumahor said. \u201cHbA1c testing is currently being accessed by clinicians as a non-fasting glucose test for the diagnosis and monitoring of diabetes; however, its clinical utility may not be universally applicable in regions with a high prevalence of hemoglobin variants,\u201d he added, noting that people who are diabetic or who are routinely screened for diabetes should have their hemoglobin genotype tested. \u201cUnderstanding the limitations of testing, especially with immunoassays, has the benefit of guiding protocols and policies on the use of this testing in Ghana and other areas of West Africa.\u201d\u00a0<\/p>\n
Source: Association for Diagnostics & Laboratory Medicine\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"HbA1c testing is currently being accessed by clinicians as a non-fasting glucose test for the diagnosis and monitoring…\n","protected":false},"author":2,"featured_media":573370,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[103,61,60,241909,241910,241908],"class_list":["post-573369","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-health","tag-ie","tag-ireland","tag-presented-at-myadlm-039s-adlm2026-meeting-brkbth-gh","tag-presented-at-myadlm-039s-adlm2026-meeting-in-anaheim-brpresented-at-myadlm-bsky-social-039s-adlm2026-meeting-in-anaheim","tag-x-kbth_gh"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/573369","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=573369"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/573369\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/573370"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=573369"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=573369"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=573369"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}