Glycated Haemoglobin Levels and Type 2 Diabetes Mellitus

Abstract

Prevalence of diabetes, especially type 2, has reached epidemic levels worldwide. HbA1c is one of the best tests for diagnosing and monitoring diabetes. HbA1c measures average blood sugar levels over 2-3 months by looking at glycated haemoglobin levels. It helps set treatment goals to reduce diabetes complications. However, there are many factors that can cause variation and inaccuracy in HbA1c results, such as anaemia, certain medications, HIV/hepatitis infections, and haemoglobin variants. Over 700 haemoglobin variants can interfere with HbA1c measurement, so test methods like HPLC may need modification for accurate results. While accurate and recommended by diabetes associations for diagnosis, HbA1c has mixed acceptance worldwide as a sole diagnostic test. In India, lack of standardization, prevalence of haemoglobin disorders, and fragmented healthcare access limit using HbA1c alone for diagnosis. Supporting tests are often needed. The review concludes that in the current Indian scenario, HbA1c cannot be the sole independent test for diagnosing diabetes due to various limitations.