PDF(Pubmed)
Abstract：
A man in his 70s presented with a history of low glycated haemoglobin (HbA1c) values despite a diagnosis of type 2 diabetes. His blood glucose readings ranged between 8 and 15 mmol/L, but his HbA1c values were below 27 mmol/mol. Initial investigations demonstrated evidence of reduced red blood cell lifespan as a cause of misleadingly low HbA1c values. Further investigation revealed chronic liver disease and splenomegaly, with hypersplenism being the probable cause of increased red blood cell turnover. HbA1c estimation was no longer reliable, so ongoing diabetic care was guided by home capillary blood glucose monitoring. Healthcare providers and clinical laboratorians need to be aware of the possible clinical implications of very low HbA1c values in patients with type 2 diabetes.
摘要：
一名70多岁的男子尽管诊断为2型糖尿病，但仍有低糖化血红蛋白（HbA1c）值的病史。他的血糖读数在8到15mmol/L之间,但他的HbA1c值低于27mmol/mol。初步调查显示，红细胞寿命减少是导致HbA1c值低且具有误导性的原因。进一步调查显示慢性肝病和脾肿大，脾功能亢进可能是红细胞更新增加的原因。HbA1c估计不再可靠，因此，正在进行的糖尿病护理是在家庭毛细血管血糖监测的指导下进行的。医疗保健提供者和临床实验室人员需要意识到2型糖尿病患者中HbA1c值非常低的可能临床意义。
