What factors contribute to diabetes in certain ethnic populations outside of the glycemic index? Clinical laboratorians seeking answers should attend “Influence of Non-Glycemic Factors on Hemoglobin A1c: Fact and Fiction” (32208), an afternoon symposium taking place at AACC’s Annual Meeting & Clinical Lab Expo on July 27.
AACC’s Clinical Society Collaborations Committee worked in partnership with the American Diabetes Association to develop this session.
Literature has widely documented the presence of higher HbA1c values in certain ethnic groups, such as African Americans and Hispanics. Why this occurs is where the disagreement exists, session moderator Mitchell G. Scott, PhD, professor of pathology and immunology and co-medical director for clinical chemistry at Washington University School of Medicine in St. Louis, told CLN Stat.
“Are there socioeconomic differences in diet, activity, environment, or lifestyle versus a genetic or physiologic difference such as red blood cell permeability to glucose, or differences in deglycation enzymes?” Scott asks.
From a clinical perspective, a number of non-glycemic factors can affect HbA1c, such as altered red blood cell lifespan, hemolytic diseases, hemoglobin S, transfusions, or interferences due to hemoglobin variants, he noted.
Whether it makes sense to have population-specific HbA1c values is the debate at hand, Scott indicated. As an example, is HbA1c as predictive for complications in African Americans versus non-African Americans? Does overtreatment of higher HbA1c lead to a higher incidence of hypoglycemia in the African American population?
A trio of experts will join Scott on the session’s panel to address these questions: David Sacks, MB, ChB, FRCPath, chief of clinical chemistry service with the National Institutes of Health’s Department of Laboratory Medicine; William Herman, MD, MPH, professor of internal medicine at University of Michigan; and Elizabeth Selvin, PhD, co-director of the cardiovascular epidemiology training program at the Johns Hopkins Bloomberg School of Public Health.
Clinical laboratorians who attend this discussion will be better equipped to assist doctors in using HbA1c to help diagnose and manage patients with diabetes, according to Scott.