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The Question
Sun Aug 04 07:19:18 EDT 2013

Found that there a several genetic defects that can cause significant discrepancies between meter and A1C.. want more info for others?
Asked By: pveelle  
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Recently diagnosed with hemochromatosis, in doing research found there are a number of genetic variants that can cause significant discrepancies between meter and A1C (the gold standard of under evaluating for my condition). I have been T-2 for 37 years, The last 8 years I have been complaining to my endo's about the sig. difference between meter and A1C only to be told the AiC is great don't worry. Now with neuropathies an other complications because no matter how by the book I am nothing is working. A neurologist visit recently shed some light on this. Hemochomatosis.! Why are my endo's not looking for this stuff? And why am I the poster child for fell through the cracks. I am angry. I work hard to keep my sugars at bay. People of European and Irish descent for Bronze Diabetes. People with other genetic variants - Mediterranean, South East Asian, and African descent can have genetic variants that affect blood sugar monitoring and their diabetes and management. Risk of life
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Expert Answers (1)
2013-08-03 07:23:01.0

Thank you for bringing your comments to dLife. You obviously have researched this subject. Although the HbA1c blood test is the GOLD standard for monitoring glucose control for people with Diabetes, it is not foolproof. Any problem that affects hemoglobin will skew the results. A person with Sickle Cell, Thalassemia, or any abnormally high or low hemoglobin levels will have inaccurate A1c levels that do not truly reflect how well the disease is controlled. You mention Bronze Diabetes or Hemochromatosis. Since people with this condition have abnormally high hemoglobin levels, it follows that they will have higher A1c levels just because they have more red blood cells that could by glycated. Ask your provider to also order a CBC with Differential when the HbA1c level is being drawn. That way, the doctor can evaluate if your red blood cells are within normal range at the time of the draw. And it will also show the hemoglobin level in the red blood cells. These results should help the doctor know if the A1c is usable.

Continue to log your fingersticks at least twice a day. If you have enough testing supplies, also do readings two hours after your largest meal, one at bedtime and set your alarm for a 3AM reading. Just do this once or twice. This information will also help your providers see your control level.

Answered By: Rita Juray
Accreditations: RN, MLT-ASCP, CCM, CDE
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Community Answers (2)
2013-08-09 12:41:53.0

To everyone using this sight, it is very good but I also subscribe to ...WEBMD. They have a fantastic following and many people answering. I suggest you try that sight also and check you want the 'DIABETIC COMMUNITY" or diabetes help. I have found lots of good suggestions from people that have lived it. All kinds of questions come up and always lots of suggestions, as the answers are not meant to be like a doctor's order! You will be amazed.
Answered By: picklepus

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2013-08-03 10:24:18.0

Thank you for your answer. What I have found is that my A1C is reporting LOW not high. My blood sugars seem to be running high 220+ and my A1C is 7.2.... have tried to talk to my doctors about it and they keep saying I must be dropping in the middle of the night. They can see from my finger sticks that is not the case. On the same line I am experiencing problems with my fast and long acting insulins. I have never heard anyone talk, or post, about this issue. My fast acting insulin doesn't start working for 2+ hours but when I take my long acting my sugars start dropping immediately and then stabizes and slows. Fast - Novolog and Long = Levemier. Have attempted to talk to manufacturers developers without success. All in all frustrated as I am showing a lot of long term complications.'
Answered By: pveelle

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