PT  - JOURNAL ARTICLE
AU  - Jason G. Arnold
AU  - Howard J. McGowan
TI  - Delay in Diagnosis of Diabetes Mellitus Due to Inaccurate Use of Hemoglobin A<sub>1C</sub> Levels
AID  - 10.3122/jabfm.2007.01.060086
DP  - 2007 Jan 01
TA  - The Journal of the American Board of Family Medicine
PG  - 93--96
VI  - 20
IP  - 1
4099  - http://www.jabfm.org/content/20/1/93.short
4100  - http://www.jabfm.org/content/20/1/93.full
SO  - J Am Board Fam Med2007 Jan 01; 20
AB  - Testing of hemoglobin A1C (HbA1C) levels has become widespread in the management of patients with diabetes mellitus. Since the 1980s, it has proven to be an invaluable tool correlating with a patient’s average blood glucose levels as well as with their disease morbidity. Clinicians often base treatment decisions and make adjustments depending on a patient’s HbA1C level. As useful as the HbA1C is, it does have notable limitations. A number of conditions can lead to a falsely elevated or a falsely low HbA1C level. When one of these conditions is present, it is important to recognize the inaccuracy of the HbA1C test to prevent a delay or error in the diagnosis or care of patients with diabetes mellitus. It is also important to be aware of alternative methods of monitoring a patient’s diabetes such as a fructosamine assay or home and office blood glucose measurements. Presented is the case of a patient with diabetes mellitus and hereditary spherocytosis, a condition that interfered with her HbA1C value and resulted in a delay in her care.