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Hemoglobin A1c and fructosamine correlate in a patient with sickle cell disease and diabetes on chronic transfusion therapy.
Pediatr Blood Cancer. 2020 Sep; 67(9):e28499.PB

Abstract

In patients with sickle cell disease (SCD) and diabetes mellitus (DM), hemoglobin A1c (HbA1c ) 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 HbA1c . 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" HbA1c 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.

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Authors+Show Affiliations

McLean A
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Wright F
University of North Carolina School of Medicine, Chapel Hill, North Carolina. Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
deJong N
University of North Carolina School of Medicine, Chapel Hill, North Carolina. Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Skinner S
University of North Carolina School of Medicine, Chapel Hill, North Carolina. Department of Medicine, Division of Hematology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. University of North Carolina Blood Research Center, Chapel Hill, North Carolina.
Loughlin CE
University of North Carolina School of Medicine, Chapel Hill, North Carolina. Department of Pediatrics, Division of Pediatric Pulmonology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Levenson A
University of North Carolina School of Medicine, Chapel Hill, North Carolina. Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Carden MA
University of North Carolina School of Medicine, Chapel Hill, North Carolina. Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. Department of Medicine, Division of Hematology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. University of North Carolina Blood Research Center, Chapel Hill, North Carolina.

MeSH

AdolescentAnemia, Sickle CellBiomarkersBlood GlucoseBlood TransfusionCystic FibrosisDiabetes MellitusFemaleFructosamineGlycated HemoglobinHumansPrognosis

Pub Type(s)

Case Reports
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

32618413

Citation

McLean, Ashley, et al. "Hemoglobin A1c and Fructosamine Correlate in a Patient With Sickle Cell Disease and Diabetes On Chronic Transfusion Therapy." Pediatric Blood & Cancer, vol. 67, no. 9, 2020, pp. e28499.
McLean A, Wright F, deJong N, et al. Hemoglobin A1c and fructosamine correlate in a patient with sickle cell disease and diabetes on chronic transfusion therapy. Pediatr Blood Cancer. 2020;67(9):e28499.
McLean, A., Wright, F., deJong, N., Skinner, S., Loughlin, C. E., Levenson, A., & Carden, M. A. (2020). Hemoglobin A1c and fructosamine correlate in a patient with sickle cell disease and diabetes on chronic transfusion therapy. Pediatric Blood & Cancer, 67(9), e28499. https://doi.org/10.1002/pbc.28499
McLean A, et al. Hemoglobin A1c and Fructosamine Correlate in a Patient With Sickle Cell Disease and Diabetes On Chronic Transfusion Therapy. Pediatr Blood Cancer. 2020;67(9):e28499. PubMed PMID: 32618413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hemoglobin A1c and fructosamine correlate in a patient with sickle cell disease and diabetes on chronic transfusion therapy. AU - McLean,Ashley, AU - Wright,Frances, AU - deJong,Neal, AU - Skinner,Sarah, AU - Loughlin,Ceila E, AU - Levenson,Amy, AU - Carden,Marcus A, Y1 - 2020/07/03/ PY - 2020/3/11/received PY - 2020/5/27/revised PY - 2020/5/28/accepted PY - 2020/7/4/pubmed PY - 2020/12/15/medline PY - 2020/7/4/entrez KW - chronic transfusion therapy KW - cystic fibrosis KW - diabetes mellitus KW - hemoglobin A1c KW - serum fructosamine KW - sickle cell disease SP - e28499 EP - e28499 JF - Pediatric blood & cancer JO - Pediatr Blood Cancer VL - 67 IS - 9 N2 - In patients with sickle cell disease (SCD) and diabetes mellitus (DM), hemoglobin A1c (HbA1c ) 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 HbA1c . 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" HbA1c 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. SN - 1545-5017 UR - https://www.unboundmedicine.com/medline/citation/32618413/Hemoglobin_A1c_and_fructosamine_correlate_in_a_patient_with_sickle_cell_disease_and_diabetes_on_chronic_transfusion_therapy_ DB - PRIME DP - Unbound Medicine ER -