HbA1c Test Inaccuracy in India

A new evidence-based viewpoint published in The Lancet Regional Health: Southeast Asia highlights that the widely used glycated hemoglobin (HbA1c) test may not accurately reflect blood glucose levels for millions of people in India. This inaccuracy is attributed to the high prevalence of anemia, hemoglobinopathies, and red blood cell enzyme (G6PD) deficiency in the Indian population. Led by Anoop Misra, the review questions the sole reliance on HbA1c for diagnosing and monitoring type 2 diabetes in South Asia, as it can lead to misclassification and delayed diagnosis, potentially increasing complications. The authors recommend a comprehensive approach combining oral glucose tolerance tests, self-monitoring of blood glucose, and hematologic assessments, tailored to available resources and patient risk factors. This research has significant implications for public health estimates and resource allocation for diabetes care in India.