A blood sample from a 39-year-old female patient with newly diagnosed type 2 diabetes was assayed for hemoglobin (Hb) A1c on a Bio-Rad D10 HPLC platform. No peak for A1c was seen on the chromatogram (Fig. 1A), and the result was reported as 0%. A complete blood count was clinically significant for an Hb concentration of 10.9 g/dL (reference interval 12–15 g/dL) and a mean corpuscular volume of 77 fL (reference interval 80–96 fL).


Questions

  1. What was the reason for the absent A1c peak?
  2. Can A1C be measured in this patient by an alternative method?
  3. What other factors can affect A1c measurement?

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