Context
A Lancet Regional Health: Southeast Asia review warns that reliance only on HbA1c for diagnosing and monitoring Type-2 diabetes can mislead in South Asia due to widespread anaemia and blood disorders.
What is Haemoglobin (Hb)?
• Protein in red blood cells that carries oxygen.
What is HbA1c?
• Glycated haemoglobin with glucose attached.
• Reflects average blood sugar over past 2–3 months.
• Widely used for diabetes diagnosis and monitoring.
Key Findings
• High prevalence of anaemia, haemoglobinopathies (sickle cell disease, thalassemia) and G6PD deficiency distorts HbA1c values.
• Can delay diagnosis by up to 4 years in some conditions.
• Recommends multiparametric approach:
• Oral glucose tolerance tests
• Self-monitoring
• Continuous glucose monitoring
• Relevant blood tests, especially in primary care.
