Plasma glucose and HbA1c discrepancy may indicate hemoglobinopathy: a case series

For patients with discrepancies between PG levels and HbA1c, we suggest a thorough evaluation that includes consideration of potential hemoglobinopathies. These hemoglobin variants can present with isolated microcytosis or entirely normal hematologic parameters and may lead to falsely low HbA1c values. In cases of discordance between PG and HbA1c, hemoglobin electrophoresis can serve as a valuable diagnostic tool. Identifying hemoglobinopathies before determining treatment regimens can help mitigate the risk of complications from inadequate treatment, and awareness of HbA1c limitations allows clinicians to use both HbA1c and PG/SMBG to optimize diabetes management and minimize the risk of diabetic complications.