973-Hemoglobin A1c

Course # DL-973: Hemoglobin A1c Testing of Patients with Hemoglobinopathies

by Amy Fang - Graduate Student in Clinical Science - California State University, Dominguez Hills
&

by Ellen Hope Kearns, Ph.D. - Professor, College of Health & Human Services - California State University, Dominguez Hills

&

by Helen M. Sowers, M.A., CLS - Dept. of Biological Science (retired) - California State University, East Bay

Approved for 1.0 CE
Level of Difficulty: Intermediate

Introduction:

Hemoglobin A1c is the most useful single index of blood glucose control available to diabetics. Increased HbA1c is closely linked to risk of long-term microvascular diabetic complications (1). HbA1c is measured in the laboratory using a variety of methods. The presence of hemoglobinopathies in a patient presents a confounder to HbA1c testing, yielding erroneous laboratory test results. Beginning with a description of HbA1c and its relationship to blood glucose followed by methods of testing for HbA1c in the laboratory, this course focuses on the problematic aspects of testing for HbA1c in a patient with a hemoglobinopathy using each of these methods. General conclusions, limitations, and recommendations for testing are given.

Objectives:

On completion of this course the participant will be able to:

1. describe hemoglobin A1 structure and function

2. discuss the formation of hemoglobin A1c (HbA1c) and its relationship to blood glucose levels

3. give the normal HbA1c range and the recommended percentage for diabetics

4. outline the chronic complications of diabetes due to long term increase in blood glucose

5. list the names of three HbA1c testing methodologies

6. state examples for each of the HbA1c methodologies

7. describe how hemoglobinopathies may give erroneous results in HbA1c testing

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