ArticlePloS one2020
Influence of hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency on diagnosis of diabetes by HbA1c among Tanzanian adults with and without HIV: A cross-sectional study.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Pooled it
- Glycemic assessment when hemoglobin A1c is unreliable: a clinical-laboratory framework for kidney disease, anemia, and hemoglobinopathies.Frontiers in endocrinology · 2026Review
- Discordantly Low HbA1c in Type 1 Diabetes: Undiagnosed G6PD Deficiency Masking Poor Glycemic Control-A Case Report.Case reports in endocrinology · 2026Article
- HbA1c levels in hemoglobin H disease.Biochemistry and biophysics reports · 2025Article
- Hemoglobin S Promotes Glycemic Dysregulation in a Mouse Model of Human Sickle Cell Disease.Endocrinology · 2025Article
- Quantifying the effect of glucose 6-phosphate dehydrogenase deficiency on glycated hemoglobin values in children and adolescents with type 1 diabetes.Scientific reports · 2024Article
- Impact of haemoglobin variants on the diagnostic sensitivity of glycated haemoglobin (HbA1c) assay methodologies in sub-Saharan Africa: a laboratory-based method validation study.The Pan African medical journal · 2024Article
- The Association between Glucose 6-Phosphate Dehydrogenase Deficiency and Attention Deficit/Hyperactivity Disorder.Nutrients · 2023Article
- Dietary patterns and diabetes mellitus among people living with and without HIV: a cross-sectional study in Tanzania.Frontiers in nutrition · 2023Article
- 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023.Diabetes care · 2023 · on this mapReview
- Association of sickle cell trait with β-cell dysfunction and physical activity in adults living with and without HIV in Tanzania.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2022Article
- Article
- Misleading HbA1c Measurement in Diabetic Patients with Hemoglobin Variants.Medical sciences (Basel, Switzerland) · 2021Article
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Authors and funding
11 authors at 5 institutions in 4 countries.
Funding
Abstract
introductionHemoglobin A1c (HbA1c) is recommended for diagnosing and monitoring diabetes. However, in people with sickle cell disease (SCD), sickle cell trait (SCT), α-thalassemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency, HbA1c may underestimate the prevalence of diabetes. There are no data on the extent of this problem in sub-Saharan Africa despite having high prevalence of these red blood cell disorders.
methodsBlood samples from 431 adults in northwestern Tanzania, randomly selected from the prospective cohort study, Chronic Infections, Comorbidities and Diabetes in Africa (CICADA), were analysed for SCT/SCD, α-thalassemia and G6PD deficiency and tested for associations with the combined prevalence of prediabetes and diabetes (PD/DM) by HbA1c, using the HemoCue 501 HbA1c instrument, and by 2-hour oral glucose tolerance test (OGTT).
resultsThe mean age of the participants was 40.5 (SD11.6) years; 61% were females and 71% were HIV-infected. Among 431 participants, 110 (25.5%) had SCT and none had SCD. Heterozygous α-thalassemia (heterozygous α+ AT) was present in 186 (43%) of the participants, while 52 participants (12%) had homozygous α-thalassemia (homozygous α+ AT). Furthermore, 40 (9.3%) participants, all females, had heterozygous G6PD deficiency while 24 (5.6%) males and 4 (0.9%) females had hemizygous and homozygous G6PD deficiency, respectively. In adjusted analysis, participants with SCT were 85% less likely to be diagnosed with PD/DM by HbA1c compared to those without SCT (OR = 0.15, 95% CI: 0.08, 0.26, P < 0.001). When using OGTT, in adjusted analysis, SCT was not associated with diagnosis of PD/DM while participants with homozygous α+ AT and hemizygous G6PD deficiency were more likely to be diagnosed with PD/DM.
conclusionsHbA1c underestimates the prevalence of PD/DM among Tanzanian adults with SCT. Further research using other HbA1c instruments is needed to optimize HbA1c use among populations with high prevalence of hemoglobinopathies or G6PD deficiency.
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