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Hemoglobin A 1c and fructosamine correlate in a patient with sickle cell disease and diabetes on chronic transfusion therapy
Author(s) -
McLean Ashley,
Wright Frances,
deJong Neal,
Skinner Sarah,
Loughlin Ceila E.,
Levenson Amy,
Carden Marcus A.
Publication year - 2020
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.28499
Subject(s) - medicine , diabetes mellitus , fructosamine , glycemic , transfusion therapy , hemoglobin , disease , blood transfusion , intensive care medicine , gastroenterology , endocrinology
In patients with sickle cell disease (SCD) and diabetes mellitus (DM), hemoglobin A 1c (HbA 1c ) is unreliable and the American Diabetes Association recommends monitoring long‐term glycemia by measuring serum glucose, but use of serum fructosamine (SF), a measurement independent of red cell lifespan, has been reported. SF as a screen for DM in SCD, however, is not standardized and its relationship to serum glucose has not been validated. Further, screening for DM was not adequately addressed in the 2014 National Heart, Lung, and Blood Institute (NHLBI) guidelines for SCD management. Blood transfusions, an important treatment for some patients with SCD, can also impact HbA 1c . We present a case of a patient with SCD and cystic fibrosis‐related diabetes on monthly chronic transfusions therapy (CTT) who had well‐correlated “steady state” HbA 1c and SF levels over time, suggesting for the first time these markers may actually be useful when following long‐term glycemic control in patients with SCD on CTT programs.