A patient with hyperglycaemia and normal HbA Ic due to impaired glycation.

Neth J Med

Department of Internal Medicine, Deventer Hospital, Deventer, the Netherlands.

Published: November 2007

A diabetic Caucasian woman presented with discrepantly low HbA Ic values compared with her glycaemia. High-performance liquid chromatography (HPLC) analysis disclosed 80% HbA and 20% HbI Philadelphia (I6alpha2 lys --> glut). The calculated glycosylation gap from the fructosamine level was 1.2%. The haemoglobin alpha/beta glycation ratios, as measured by electron spray ionisation mass spectroscopy (ESI-MS), for the patient and her three children also carrying the mutation were decreased by values of 0.56 and 0.51, 0.50 and 0.49, respectively (reference value 0.66).

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