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Caution is Needed in Interpreting Hemoglobin A1c Levels in the Muslim Bedouin Population of Southern Israel.
Isr Med Assoc J 2019; 21(8):546-551IM

Abstract

BACKGROUND

The Bedouins living in southern Israel are a Muslim-Arab population that is transitioning from a nomadic lifestyle to life in permanent settlements. The population has unique characteristics that could affect hemoglobin A1c (HbA1c) measurements. The objective of this study was to describe the socio-demographic and unique morbidity characteristics of this community and their effect on HbA1c measurements. Consanguinity, especially among cousins in the Bedouin population, results in a high prevalence of autosomal recessive genetic diseases such as thalassemia (underestimate of HbA1c), hemoglobinopathies (underestimate and overestimate), Gilbert's disease, and glucose-6-phosphate dehydrogenase deficiency, an X-linked disorder, which can cause hyperbilirubinemia with an overestimate of HbA1c. Furthermore, nutritional deficiencies, autosomal recessive diseases, high birth rates, parasitic infections, and poverty can all cause high rates of anemia (iron and vitamin B12 deficiencies) that can raise HbA1c levels. Congenital dyserythropoietic anemia is found among Bedouin tribes in the Negev region and can lead to an underestimation of HbA1c levels. Pregnancy can also affect HbA1c levels. Medical teams working in the Bedouin community and in other Muslim populations with similar morbidity characteristics throughout the world should identify patients with medical conditions that can affect HbA1c measurements and be aware of possible measurement alternatives such as fructosamine and glycated albumin.

Authors+Show Affiliations

Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. Clalit Health Services, Southern District, Israel.Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. Clalit Health Services, Southern District, Israel.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31474018

Citation

Treister-Goltzman, Yulia, and Roni Peleg. "Caution Is Needed in Interpreting Hemoglobin A1c Levels in the Muslim Bedouin Population of Southern Israel." The Israel Medical Association Journal : IMAJ, vol. 21, no. 8, 2019, pp. 546-551.
Treister-Goltzman Y, Peleg R. Caution is Needed in Interpreting Hemoglobin A1c Levels in the Muslim Bedouin Population of Southern Israel. Isr Med Assoc J. 2019;21(8):546-551.
Treister-Goltzman, Y., & Peleg, R. (2019). Caution is Needed in Interpreting Hemoglobin A1c Levels in the Muslim Bedouin Population of Southern Israel. The Israel Medical Association Journal : IMAJ, 21(8), pp. 546-551.
Treister-Goltzman Y, Peleg R. Caution Is Needed in Interpreting Hemoglobin A1c Levels in the Muslim Bedouin Population of Southern Israel. Isr Med Assoc J. 2019;21(8):546-551. PubMed PMID: 31474018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Caution is Needed in Interpreting Hemoglobin A1c Levels in the Muslim Bedouin Population of Southern Israel. AU - Treister-Goltzman,Yulia, AU - Peleg,Roni, PY - 2019/9/2/entrez PY - 2019/9/2/pubmed PY - 2019/9/11/medline SP - 546 EP - 551 JF - The Israel Medical Association journal : IMAJ JO - Isr. Med. Assoc. J. VL - 21 IS - 8 N2 - BACKGROUND: The Bedouins living in southern Israel are a Muslim-Arab population that is transitioning from a nomadic lifestyle to life in permanent settlements. The population has unique characteristics that could affect hemoglobin A1c (HbA1c) measurements. The objective of this study was to describe the socio-demographic and unique morbidity characteristics of this community and their effect on HbA1c measurements. Consanguinity, especially among cousins in the Bedouin population, results in a high prevalence of autosomal recessive genetic diseases such as thalassemia (underestimate of HbA1c), hemoglobinopathies (underestimate and overestimate), Gilbert's disease, and glucose-6-phosphate dehydrogenase deficiency, an X-linked disorder, which can cause hyperbilirubinemia with an overestimate of HbA1c. Furthermore, nutritional deficiencies, autosomal recessive diseases, high birth rates, parasitic infections, and poverty can all cause high rates of anemia (iron and vitamin B12 deficiencies) that can raise HbA1c levels. Congenital dyserythropoietic anemia is found among Bedouin tribes in the Negev region and can lead to an underestimation of HbA1c levels. Pregnancy can also affect HbA1c levels. Medical teams working in the Bedouin community and in other Muslim populations with similar morbidity characteristics throughout the world should identify patients with medical conditions that can affect HbA1c measurements and be aware of possible measurement alternatives such as fructosamine and glycated albumin. SN - 1565-1088 UR - https://www.unboundmedicine.com/medline/citation/31474018/Caution_is_Needed_in_Interpreting_Hemoglobin_A1c_Levels_in_the_Muslim_Bedouin_Population_of_Southern_Israel L2 - http://www.ima.org.il/IMAJ/ViewArticle.aspx?year=2019&month=08&page=546 DB - PRIME DP - Unbound Medicine ER -