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HbA1c is the most widely used follow-up test for diabetes mellitus (DM) worldwide. Although the
fructosamine test is not widely used, this test can also be useful for the follow-up of DM in the
previous 2 weeks.
This study aimed to determine the effect of pathological conditions associated with heme
abnormalities by measuring the hemoglobin content in patients with both iron-deficiency anemia
and diabetes. To investigate pathological conditions associated with the globin content of
hemoglobin, diabetic and prediabetic patients with thalassemia minor were also enrolled. The
effects of thalassemia minor on HbA1c levels were evaluated, and serum fructosamine was assayed
in both groups to evaluate the accuracy of the results.
Our results demonstrate that while HbA1c levels are altered as a result of hemoglobinopathies
related to severe iron deficiency anemia or thalassemia, fructosamine results are not affected by
these conditions in either diabetic or prediabetic patients. Furthermore, there was no relationship
between HbA1c and fructosamine in either the diabetic or prediabetic groups. These results indicate
that the HbA1c test is inadequate for the diagnosis and follow-up of DM patients with heme- or
globin-related anomalies. The addition of the fructosamine test is suggested to improve the
interpretation of the test results.
Keywords: Diabetes Mellitus, HbA1c, Fructosamine