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HbA1c tests may not provide accurate blood glucose readings for individuals with type 1 diabetes or type 2 diabetes who have kidney failure

Many doctors recommend that their patients with type 1 diabetes or type 2 diabetes undergo regular hemoglobin A1c (HbA1c) tests to evaluate whether or not they have good long-term control of their blood sugar levels.

This is because these types of tests account for an individual's average blood glucose measurements over the course of the previous three months.

However, a recent study published in the Clinical Journal of the American Society of Nephrology indicated that HbA1c tests may not provide accurate readings for diabetics who have advanced kidney failure.



This finding may be troublesome for many people, since about half a million Americans undergo dialysis treatment for kidney failure each year, and 50 percent of these individuals have either type 1 diabetes or type 2 diabetes, the researchers explained.

The research involved 444 diabetic participants who were being treated with dialysis.

The study's results showed that HbA1c failed to predict instances of hospitalizations and survival among these subjects. However, the findings indicated that the glycated albumin (GA) test - which evaluates average blood glucose levels over the prior 17 days - acted as a strong predictor of these medical outcomes.

Researchers said that HbA1c screenings may not be a good option for individuals with type 1 diabetes or type 2 diabetes who have extensive kidney damage, since the latter condition may skew the results.

"Many organs don't function properly in severe kidney failure. For example, most dialysis patients have anemia with fewer red blood cells than they should, which has a dramatic impact on the accuracy of the HbA1c reading," said lead investigator Barry I. Freedman, MD.

In addition to diligent diabetes management, people can consider using two types of drugs, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, as well as a low-protein diabetic diet to help prevent or delay the onset of kidney disease, the American Diabetes Association states.
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