Common diabetes test fails patients with sickle cell trait

The study, led by Dr. Elikem Kumahor of Korle Bu Teaching Hospital in Accra, analyzed over 1,200 HbA1c tests to compare two diagnostic techniques. While immunoturbidimetry is a widespread tool for measuring blood protein concentrations, it showed a significant bias when used on patients carrying the HbAS hemoglobin variant. In these individuals, the immunoassay reported an average HbA1c of 5.1%, whereas high-performance liquid chromatography (HPLC) identified a more accurate 5.9%.

This discrepancy has immediate clinical consequences. When researchers used the standard immunoassay, they identified only 11.1% of sickle cell trait carriers as pre-diabetic. When the same samples were re-examined using HPLC, the detection rate jumped to 34.5%. Perhaps more concerning, the immunoassay failed to identify any diabetic patients within the group, while HPLC successfully diagnosed 4% of participants. Given that approximately 30% of the Ghanaian population carries the sickle cell trait, Dr. Kumahor warned that relying on generic immunoassays contributes to a silent epidemic of undetected diabetes. The team now advocates for mandatory reflex testing or the adoption of HPLC platforms in regions where hemoglobin variants are prevalent to ensure patients receive appropriate care.