Key result
HbA1c alone proves unreliable for diabetes diagnosis in India, driven by widespread anemia and hemoglobinopathies.
Answers are grounded in this paper and cite their sources.
Due to high rates of anemia and hemoglobinopathies in India, relying solely on HbA1c for diabetes management is inadequate and should be supplemented with other glycemic and hematologic assessments.
Glycated hemoglobin (HbA1c) is commonly used to diagnose and monitor type 2 diabetes (T2D). However, in South Asia-particularly India-the high prevalence of anemia, hemoglobinopathies, and glucose-6-phosphate dehydrogenase (G6PD) deficiency, and poorly standardized HbA1c assay methods complicates the interpretation of HbA1c values, challenging its reliability in both diagnosis and monitoring of diabetes. Overall, reliance solely on HbA1c is constrained by several clinical and biological factors in India. A multiparametric, risk-stratified approach that integrates oral glucose tolerance test, self-monitoring of blood glucose, and whenever possible, continuous glucose monitoring, in addition to relevant hematologic assessments are essential to enhance diagnostic and monitoring accuracy and inform appropriate treatment decisions, especially in primary care and resource-limited settings. Funding: No funding was received for this work.
No takes yet. Share an insight, caveat, or question.
Samajdar et al. (2026) conducted a review in Type 2 diabetes. Glycated hemoglobin (HbA1c) was evaluated. Relying solely on HbA1c for diagnosing and monitoring type 2 diabetes in India is unreliable due to the high prevalence of anemia, hemoglobinopathies, and G6PD deficiency.
Synapse has enriched 10 related papers. Consider them for comparative context: