Core IM | Internal Medicine Podcast #124 A1c & Glucose Measurements: Mind the Gap Segment
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Apr 26, 2023 AI Snips
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HbA1c: A Long-Term Average
- Hemoglobin A1c (HbA1c) measures average glucose by assessing glucose bound to hemoglobin over time.
- It acts as a long-term average, similar to how left atrial size reflects heart health.
HbA1c Limitations: Red Blood Cell Lifespan
- HbA1c is affected by red blood cell lifespan.
- Processes impacting lifespan, like bleeding or hemolysis, can lead to inaccurate HbA1c readings.
Hemolytic Anemia Masking
- A resident's patient with fatigue and poor diabetes control had unexpectedly low HbA1c.
- This revealed hemolytic anemia, initially masked by the low HbA1c due to reduced red blood cell lifespan.