Hba1c test if you have high levels of HBF

[Wall]

Hi All,
Just a quick question, is there a form of Hba1c testing for people that have high levels of HbF (Fetal hemoglobin levels) as my Hba1c levels for the last couple of years have been effected by my HbF levels and I have other way of measuring my long term sugar levels.
Thanks in Advance

 

[mikeyB]

Hi Wall, welcome to the forum.

That’s not a quick question, for sure. Why do you have high levels of HbF? 6 months old? Sickle cell anaemia? Thallasemia?

HbA1c is notoriously unreliable in anaemias, usually producing a lower result. I don’t know of any reliable alternative test for measuring long term glucose levels, to be honest, because the variability caused by anaemia is not linear.

 

[trophywench]

Don't they test Fructosamine instead of HbA1c for anaemics, Mike?

 

[Wall]

Hi MikeyB, No I have none of those conditions, my Specialist did tell me that 1.5% of the population have high levels of HbF for no reason, However I did have Bladder Cancer in 2014 and I also have Chron's disease so I don't know if that effects them. Struggling to control my sugars as I have no way of monitoring them long term, tx

Update - I am not anaemics and my HbA1c results come out excessively high

 

[everydayupsanddowns]

Don't they test Fructosamine instead of HbA1c for anaemics, Mike?

That's what I thought TW.

These days I wonder if something like a Libre and 'time in range' would be a better measure if A1c is unreliable. Though I don't know if your HbF would affect Libre sensors.

 

[mikeyB]

Shouldn’t affect Libre sensors, that’s a plasma measurement.

 

[AJLang]

But Libre isn't always that accurate, mine keeps over estimating my average BG. With regard to the original I had also thought Fructosamine.

 

[AJLang]

This is from the Diabetes UK site.
Fructosamine test
If your red blood cells are affected by, for example, anaemia, sickle cell anaemia or thalassaemia (all of which involve a lack of or abnormal type of haemoglobin – the oxygen-carrying part) then your doctor may carry out a blood test for fructosamine. Fructosamine gives an average result for the previous 14 to 21 days. If you normally have a fructosamine test, discuss your individual target with your doctor.

 

[Wall]

Thanks for the input Guys, my doctor never mentioned a Fructosamine test so I will ask him about that, I do check my bloods several times a day with a OneTouch Verio monitor (In Ireland) and those results are usually good however my eyes have gotten Diabetic retinopathy damage in the last few months so he is wondering whether my monitor is actually giving me true readings

 

[mikeyB]

It may not have been mentioned because it may not be reliable with Crohn’s disease present. Depends on the activity.