Situation: A diabetic HIV patient came with A1c of 6.5.
Dr Bad: It’s perfect.
Dr Good: It is not 100% reliable for your situation.
Lesson: A1c may not be accurate for assessing glycemia among HIV-infected patients on NRTI–based therapy, especially those with macrocytosis or those on abacavir. In a prospective study evaluating the accuracy of A1c in HIV–infected patients with diabetes, glucose levels were significantly higher than anticipated by A1c levels when compared with HIV–uninfected control subjects and established reference values. Relative to the control subjects, A1C underestimated glucose by 29 ± 4 in the HIV–infected subjects (Diabetes Care 2009;32(9):1591–3).
Dr Bad: It’s perfect.
Dr Good: It is not 100% reliable for your situation.
Lesson: A1c may not be accurate for assessing glycemia among HIV-infected patients on NRTI–based therapy, especially those with macrocytosis or those on abacavir. In a prospective study evaluating the accuracy of A1c in HIV–infected patients with diabetes, glucose levels were significantly higher than anticipated by A1c levels when compared with HIV–uninfected control subjects and established reference values. Relative to the control subjects, A1C underestimated glucose by 29 ± 4 in the HIV–infected subjects (Diabetes Care 2009;32(9):1591–3).
We can use fructosamine levels in this scenario.
ReplyDeletehere is the link which shows fructosamine levels & there corresponding A1c conversion.
http://www.healthyinfo.com/clinical/endo/dm/hga1c.test.shtml