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Editorial
February 7, 2017

Sickle Cell Trait and Interpretation of Hemoglobin A1c Levels

Author Affiliations
  • 1Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
  • 2Section on Endocrinology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
JAMA. 2017;317(5):481-482. doi:10.1001/jama.2016.20994

The diagnosis of prediabetes and diabetes mellitus is often assigned based on assessment of discrete hemoglobin A1c (HbA1c) levels. Several studies have identified factors that affect HbA1c, including African ancestry,1 chronic kidney disease,2 and iron deficiency anemia.3 Increasing evidence suggests that at a given glucose level, white people have lower HbA1c levels than black people,4 although the effect of sickle cell trait (SCT) on HbA1c levels is not clearly defined. Approximately 10% of the black population has SCT.

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