Table 1.

Conditions Associated with False Alterations in A1c Level

False IncreaseFalse Decrease
Anemia (in particular those associated with increased red cell turnover)Anemia (from acute or chronic blood loss)
Severe hypertriglyceridemia (typically >1750 mg/dL)Vitamin E ingestion
Severe hyperbilirubinemia (typically >20 mg/dL)Medications (ribavirin, interferon-alpha)
Chronic alcohol consumptionRed blood cell transfusion
Chronic salicylate ingestionHemoglobin variants (most often with homozygous hemoglobinopathies)
Chronic opioid ingestionVitamin C ingestion
Lead poisoning
  • Adapted from Radin, 2013,4 with permission.