Abstract
A1c is used extensively in diagnosing diabetes and evaluating glycemic control. This value can be unreliable with certain comorbidities such as hemoglobinopathies. A false high or low A1c can lead to over- or undertreatment of diabetes with adverse outcomes. This article describes a patient situation in which A1c was inaccurate in estimating mean serum glucose. Providers unknowingly based treatment plans on a false low A1c value. Comorbidities that can lead to false high or low A1c results are discussed with recommendations for using the A1c value to plan patient care decisions for people with diabetes.
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