Importance of the Average Glucose Level and Estimated Glycated Hemoglobin in a Diabetic Patient with Hereditary Hemolytic Anemia and Liver Cirrhosis

Intern Med. 2018 Feb 15;57(4):537-543. doi: 10.2169/internalmedicine.9135-17. Epub 2017 Dec 8.

Abstract

Glycated hemoglobin (HbA1c) is a widely used marker of glycemic control but can be affected by hemolytic anemia. Glycated albumin (GA) is also affected in patients with liver cirrhosis. We herein report the assessment of glycemic control in a 41-year-old man with dehydrated hereditary stomatocytosis and a PIEZO1 gene mutation complicated by diabetes mellitus and liver cirrhosis due to hemochromatosis. The estimated HbA1c calculated from the average glucose level obtained by continuous glucose monitoring or by self-monitoring of blood glucose was useful for evaluating the glycemic control in this patient, as HbA1c and GA were unreliable due to the coexisting conditions.

Keywords: average glucose level; continuous glucose monitoring; dehydrated hereditary stomatocytosis with PIEZO1 gene mutation; diabetes mellitus; estimated HbA1c; hemolytic anemia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Hemolytic, Congenital / blood
  • Anemia, Hemolytic, Congenital / complications*
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Blood Glucose Self-Monitoring
  • Diabetes Complications / blood*
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Hydrops Fetalis / blood
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / complications*
  • Male

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human

Supplementary concepts

  • Xerocytosis, hereditary