concept · created 2026-08-26 · updated 2026-08-26 · lab-test, glycemic-control
HbA1c may be unreliable in anemia or polycythemia, splenectomy, severe bleeding, G6PD deficiency, chronic hemolytic anemia (e.g., thalassemia), marked hypertriglyceridemia, severe hyperbilirubinemia, high alcohol or vitamin C/E intake, and pregnancy. When HbA1c conflicts with glucose readings, consider fructosamine or glycated albumin. See c-peptide-reference-ranges for alternative glycemic markers.
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…n should consider age, disease course, family history, and complementary tests ([[hba1c-limitations|HbA1c]] caveats).
…o relax glycemic targets rather than pursue aggressive HbA1c normalization. See [[hba1c-limitations]] and [[fasting-precautions-diabetes]].
…0 ng/mL. Assess via 25‑hydroxyvitamin D measurement 3‑4 months after start. See [[hba1c-limitations]] for contexts where HbA1c may be unreliable.