New research suggests the widely used HbA1c test may not accurately reflect blood sugar levels in many Indians, potentially affecting diabetes diagnosis and treatment.
A recent scientific study has raised concerns about the reliability of the HbA1c test, a standard tool used to diagnose and monitor diabetes, for a large section of India’s population. The HbA1c test measures average blood glucose levels over the past two to three months by assessing how much glucose is attached to haemoglobin in red blood cells.
Researchers found that the test may give misleading results in people with conditions that affect red blood cells or haemoglobin. These conditions are common in India and include iron-deficiency anaemia, inherited haemoglobin disorders, and G6PD enzyme deficiency. Such conditions can change the lifespan or structure of red blood cells, which can distort HbA1c readings.
As a result, some individuals may show falsely low or high HbA1c levels that do not match their actual blood sugar status. This can lead to delayed diagnosis, incorrect classification of diabetes or prediabetes, and problems in monitoring blood sugar control. In some cases, diabetes diagnosis could be delayed by several years, increasing the risk of complications affecting the eyes, kidneys, heart, and nerves.
The researchers recommend that HbA1c should not be used alone for diagnosing diabetes in India. Instead, it should be combined with other glucose-based tests such as the oral glucose tolerance test, fasting blood sugar checks, or continuous glucose monitoring. Additional screening for anaemia or related conditions may also help improve accuracy.
The findings are significant as India faces a growing diabetes burden, with millions affected by diabetes and prediabetes nationwide.
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