Diabetes Care In India: The HbA1c test, once considered the most reliable, can often give inaccurate results for Indians. Let's explain why.

Why the HbA1c test can be inaccurate in Indians

Why HbA1c Test May Give Wrong Results In Indians: The HbA1c test, which was considered the most reliable way to check diabetes, can often give wrong results for Indians. New research has revealed that many common blood-related problems can alter the results of this test, preventing the disease from being detected in time. This is why doctors are now recommending getting multiple tests done simultaneously instead of relying on just one test.

Why is there a difference between the report and the body?

According to a TOI report, Dr. Anoop Mishra, an endocrinologist and diabetes specialist at Fortis C-Doc Centre for Excellence in New Delhi, encountered a case that left even doctors wondering. A 45-year-old tribal patient from Madhya Pradesh had an HbA1c level of 5.8 percent. This is typically considered prediabetes, but his fasting blood sugar was consistently high, and he was also showing early signs of diabetic retinopathy. The report indicated one thing, but his body was signalling something else.

Lack of these things can affect the report.

Subsequently, Dr. Anoop Mishra, Dr. Shambo Samrat Samajdar, Dr. Shashank R. Joshi, and Dr. Naval K. Vikram conducted a study published in The Lancet Regional Health Southeast Asia. It revealed that anemia, thalassemia, G6PD deficiency, and other blood-related diseases in India and South Asia can lead to inaccurate HbA1c reports.

How does the report change?

Essentially, the HbA1c test gives an estimate of the average blood sugar level over the past two to three months. However, if the age of the red blood cells changes, the result can also change. Iron deficiency anaemia is very common in India and can lead to an overestimated HbA1c. In conditions like G6PD deficiency, red blood cells break down more quickly, which can lead to a lower HbA1c level, even though the actual blood sugar level may be higher.

What needs to be checked?

Dr. Anoop Mishra says that HbA1c is made from haemoglobin, so any disease that affects haemoglobin can impair the accuracy of this test. He clearly stated that relying solely on HbA1c to diagnose diabetes in Indians is not appropriate. Instead, it is important to use methods such as oral glucose tolerance tests, regular blood sugar testing, and, if necessary, continuous glucose monitoring.

In India, people are becoming victims at a young age.

Dr. Nishant Raizada, head of the endocrinology department at Amrita Hospital, also agrees that people in India are developing diabetes at a young age and are underweight. This makes accurate diagnosis crucial. Research also revealed that in a study conducted in South India, the oral glucose tolerance test detected prediabetes in approximately 88 percent of people, while HbA1c detected only 45 percent of cases. Experts say that in the future, diabetes treatment will move towards precision medicine, where treatment will be determined not just by a single report but by a patient's body, diet, genetics, and lifestyle. However, the biggest challenge is that such advanced tests are not yet accessible to everyone.