The Korle-Bu Hb Variant in Caucasian Women With Type 1 Diabetes
A pitfall in the assessment of diabetes control
- Ana Chico, MD, PHD1,
- Anna Padrós, MD2 and
- Anna Novials, MD, PHD1
- 1Department of Diabetology, Fundación Sardà Farriol, Barcelona, Spain
- 2Department of Biochemistry, Quality Medical Service Laboratory Medical Center, Barcelona, Spain
- Address correspondence to Dr. Ana Chico, Fundación Sardà Farriol, Department of Diabetology, Paseo Bonanova 69, Barcelona 08020, Spain. E-mail: 28299acb{at}comb.es
Measuring HbA1c concentrations in diabetic patients is an established procedure for evaluating the long-term control of diabetes. The Diabetes Control and Complications Trial confirmed the direct relationship between diabetes complications and HbA1c levels in type 1 diabetic patients. As a result, both the American Diabetes Association and the European Group for the Study of Diabetes have drawn up guidelines for assessing glycemic control by measuring HbA1c levels. However, in spite of advances in standardizing methods for measuring HbA1c concentrations, an increasing number of Hb variants produce false HbA1c determinations.
We report the first case of the Korle-Bu Hb variant in a Caucasian woman, which is also the first case described in a diabetic subject. We also describe the interference of this variant in some of the methods used to determine HbA1c concentrations. In our patient, HbA1c levels were underestimated for 20 years and, as a result of this misleadingly good metabolic control, the patient has developed microangiopathic diabetes complications.
A 29-year-old Caucasian type 1 diabetic woman was referred to our center in order to optimize her glycemic control because she was planning to become pregnant. Diabetes had been diagnosed 20 years earlier, and she had since been …
