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Wan Yaacob WN, Yaacob LH, Draman N. Type 2 Diabetes Mellitus with HbJ trait: A management conundrum. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2022; 17:86-89. [PMID: 35440968 PMCID: PMC9004435 DOI: 10.51866/cr1288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Optimal glycaemic control is crucial in patients with diabetes mellitus (DM) to avoid episodes of hypoglycaemia and both micro- and macrovascular complications. Diabetic control relies mainly on the evaluation of haemoglobin A1c (HbA1c), which is unfortunately unreliable in patients with haemoglobinopathies. This case report describes a patient with type 2 DM and haemoglobin J (HbJ) trait, which resulted in erratic HbA1c values throughout her follow-up. Other approaches, such as self-blood glucose monitoring, are needed to evaluate glycaemic control instead of relying on HbA1c alone to guide the management DM in these patients.
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Affiliation(s)
- Wan Natrah Wan Yaacob
- MBBS (Manipal), MMed Fam Med (USM), Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Lili Husniati Yaacob
- MBBS (Adelaide), MMed Fam Med(USM), Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia,
| | - Nani Draman
- MBBS (USM), MMed Fam Med(USM), Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Nakamura M, Miyazaki A, Takubo T, Matsuzawa Y, Saito J, Omura M, Nishikawa T. Identification of the First Japanese Family Harboring a Novel Hemoglobin Variant "Perpignan", Which Caused Low HbA1c Measurement During Diabetic Follow-Up. JAPANESE CLINICAL MEDICINE 2011; 2:1-7. [PMID: 23885183 PMCID: PMC3699472 DOI: 10.4137/jcm.s5971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Hemoglobin A1c (HbA1c) is an important parameter for evaluating long-term (6-8 weeks) control of blood glucose levels in patients with diabetes mellitus. We report a Japanese diabetic case who harbored abnormal Hb and demonstrated falsely low HbA1c levels in the regular ion exchange HPLC-based assay. His abnormal β-globin chain had an amino acid replacement that corresponded to glycine to serine substitution at amino acid position 136 of the β-globin chain (Hb Perpignan). Accordingly, a heterozygotic point mutation replacing guanine by adenine at nucleotide position 406 (β136G > S) was identified in the β-globin gene of the proband and his son. These results indicate that the patient had Hb Perpignan, and this abnormal Hb interfered with the HPLC-based HbA1c assay commonly used in the clinic. The cases presented are the first report of patients in the Japanese population harboring Hb Perpignan (β136G > S).
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Affiliation(s)
- Mami Nakamura
- Department of Medicine, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kohoku-ku, Yokohama City, 222-0036, Japan
| | - Ayako Miyazaki
- Division of Comprehensive Medicine, Department of Clinical and Laboratory Medicine, Osaka Medical College, Takatsuki City, Osaka, 569-8686, Japan
| | - Takayuki Takubo
- Division of Comprehensive Medicine, Department of Clinical and Laboratory Medicine, Osaka Medical College, Takatsuki City, Osaka, 569-8686, Japan
| | - Yoko Matsuzawa
- Department of Medicine, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kohoku-ku, Yokohama City, 222-0036, Japan
| | - Jun Saito
- Department of Medicine, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kohoku-ku, Yokohama City, 222-0036, Japan
| | - Masao Omura
- Department of Medicine, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kohoku-ku, Yokohama City, 222-0036, Japan
| | - Tetsuo Nishikawa
- Department of Medicine, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kohoku-ku, Yokohama City, 222-0036, Japan
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