Drugs affecting HbA1c levels

Ranjit Unnikrishnan, Ranjit Mohan Anjana, Viswanathan Mohan, Ranjit Unnikrishnan, Ranjit Mohan Anjana, Viswanathan Mohan

Abstract

Glycated hemoglobin (HbA1c) is an important indicator of glycemic control in diabetes mellitus, based on which important diagnostic and therapeutic decisions are routinely made. However, there are several situations in which the level of HbA1c may not faithfully reflect the glycemic control in a given patient. Important among these is the use of certain non-diabetic medications, which can affect the HbA1c levels in different ways. This review focuses on the non-diabetic medications which can inappropriately raise or lower the HbA1c levels, and the postulated mechanisms for the same.

Keywords: Dapsone; diabetes; glycated hemoglobin.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Rahbar S, Blumenfeld O, Ranney HM. Studies of an unusual haemoglobin in patients with diabetes mellitus. Biochem Biophys Res Commun. 1969;36:838–43.
    1. Gonen B, Rubenstein A, Rochman H, Tanega SP, Horwitz DL. D. Haemoglobin A1: An indicator of the metabolic control of diabetic patients. Lancet. 1977;2:734–7.
    1. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86.
    1. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) Lancet. 1998;352:837–53.
    1. Goldstein DE, Little RR, Lorenz RA, Malone JI, Nathan D, Peterson CM, et al. Tests of glycemia in diabetes. Diabetes Care. 2004;27:1761–63.
    1. The American Diabetes Association, European Association for the Study of Diabetes, International Federation of Clinical Chemistry and Laboratory Medicine and the International Diabetes Federation. Consensus statement on the worldwide standardization of the HbA1c measurement. Diabetologia. 2007;50:2042–3.
    1. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2012;35(Suppl 1):S11–63.
    1. Rodbard HW, Jellinger PS, Davidson JA, Einhorn D, Garber AJ, Grunberger G, et al. Statement by an American association of clinical endocrinologists/ american college of endocrinology consensus panel on type 2 diabetes mellitus: An algorithm for glycemic control. Endocr Pract. 2009;15:540–59.
    1. The International Expert Committee. International Expert Committee report on the role of the A1c assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327–34.
    1. Gallagher EJ, Le Roith D, Bloomgarden Z. Review of hemoglobin A1c in the management of diabetes. J Diabetes. 2009;1:9–17.
    1. Kesson CM, Whitelaw JW, Ireland JT. Drug-induced haemolysis and fast haemoglobin A1 in diabetes mellitus. Br Med J. 1979;2:1037–8.
    1. Serratrice J, Granel B, Swiader L, Disdier P, de Roux- Serratrice C, Raccah D, et al. Interference of dapsone in HbA1c monitoring of a diabetic patient with polychondritis. Diabetes Metab. 2002;28:508–9.
    1. Albright ES, Ovalle F, Bell DS. Artifactually low hemoglobin A1c caused by use of dapsone. Endocr Pract. 2002;8:370–2.
    1. Polgreen PM, Putz D, Stapleton JT. Inaccurate glycosylated hemoglobin A1c measurements in human immunodeficiency virus-positive patients with diabetes mellitus. Clin Infect Dis. 2003;37:e53–5.
    1. Tack CJ, Wetzels JF. Decreased HbA1c levels due to sulfonamide-induced hemolysis in two IDDM patients. Diabetes Care. 1996;19:775–6.
    1. Unnikrishnan R, Anjana RM, Uthra S, Jayashri R, Mohan V. Unexpectedly low HbA1c levels In a diabetes patient following dapsone use. Indian J Endocrinol Metab. 2012;16:658–9.
    1. Robertson M. Artificially low HbA1c associated with ribavirin. BMJ. 2008;336:505.
    1. Diop ME, Bastard JP, Meunier N, Thévenet S, Maachi M, Capeau J, et al. Inappropriately low glycated hemoglobin values and hemolysis in HIV-infected patients. AIDS Res Hum Retroviruses. 2006;22:1242–7.
    1. Karsegard J, Wicky J, Mensi N, Caulfield A, Philippe J. Spurious glycohemoglobin values associated with hydroxyurea treatment. Diabetes Care. 1997;20:1211–2.
    1. Camargo JL, Stifft J, Gross JL. The effect of aspirin and vitamins C and E on HbA1c assays. Clin Chim Acta. 2006;372:206–9.
    1. Ceriello A, Giugliano D, Dello Russo P, Sgambato S, D’Onofrio F. Increased glycosylated haemoglobin A1 in opiate addicts: Evidence for a hyperglycaemic effect of morphine. Diabetologia. 1982;22:379.
    1. Ng JM, Cooke M, Bhandari S, Atkin SL, Kilpatrick ES. The effect of iron and erythropoietin treatment on the HbA1c of patients with diabetes and chronic kidney disease. Diabetes Care. 2010;33:2310–3.
    1. Camargo EG, Pedrini RO, Gross JL, Camargo JL, Silveiro SP. Lack of interference of aspirin in HbA1c measured by ion-exchange HPLC in type 2 diabetic patients: A randomized, double-blind, placebo-controlled study. Clin Chim Acta. 2008;391:120–2.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa