{"doi":"10.1371/journal.pone.0244782","title":"Influence of hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency on diagnosis of diabetes by HbA1c among Tanzanian adults with and without HIV: A cross-sectional study","abstract":"INTRODUCTION: Hemoglobin A1c (HbA1c) is recommended for diagnosing and monitoring diabetes. However, in people with sickle cell disease (SCD), sickle cell trait (SCT), α-thalassemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency, HbA1c may underestimate the prevalence of diabetes. There are no data on the extent of this problem in sub-Saharan Africa despite having high prevalence of these red blood cell disorders. METHODS: Blood samples from 431 adults in northwestern Tanzania, randomly selected from the prospective cohort study, Chronic Infections, Comorbidities and Diabetes in Africa (CICADA), were analysed for SCT/SCD, α-thalassemia and G6PD deficiency and tested for associations with the combined prevalence of prediabetes and diabetes (PD/DM) by HbA1c, using the HemoCue 501 HbA1c instrument, and by 2-hour oral glucose tolerance test (OGTT). RESULTS: The mean age of the participants was 40.5 (SD11.6) years; 61% were females and 71% were HIV-infected. Among 431 participants, 110 (25.5%) had SCT and none had SCD. Heterozygous α-thalassemia (heterozygous α+ AT) was present in 186 (43%) of the participants, while 52 participants (12%) had homozygous α-thalassemia (homozygous α+ AT). Furthermore, 40 (9.3%) participants, all females, had heterozygous G6PD deficiency while 24 (5.6%) males and 4 (0.9%) females had hemizygous and homozygous G6PD deficiency, respectively. In adjusted analysis, participants with SCT were 85% less likely to be diagnosed with PD/DM by HbA1c compared to those without SCT (OR = 0.15, 95% CI: 0.08, 0.26, P < 0.001). When using OGTT, in adjusted analysis, SCT was not associated with diagnosis of PD/DM while participants with homozygous α+ AT and hemizygous G6PD deficiency were more likely to be diagnosed with PD/DM. CONCLUSIONS: HbA1c underestimates the prevalence of PD/DM among Tanzanian adults with SCT. Further research using other HbA1c instruments is needed to optimize HbA1c use among populations with high prevalence of hemoglobinopathies or G6PD deficiency.","journal":"PLoS ONE","year":2020,"id":86083,"datarank":0.41588830833596724,"base_score":2.772588722239781,"endowment":2.772588722239781,"self_citation_contribution":0.41588830833596724,"citation_network_contribution":0.0,"self_endowment_contribution":0.41588830833596724,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":15,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.963,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":439547,"name":"Eric Lyimo","orcid":"0000-0002-1904-7410","position":1,"is_corresponding":false},{"id":318233,"name":"Kidola Jeremiah","orcid":"0000-0001-7900-9689","position":2,"is_corresponding":false},{"id":318234,"name":"Suzanne Filteau","orcid":"0000-0002-1119-6825","position":3,"is_corresponding":false},{"id":318241,"name":"Andrea M. Rehman","orcid":"0000-0001-9967-5822","position":4,"is_corresponding":false},{"id":318244,"name":"Henrik Friis","orcid":"0000-0002-2848-2940","position":5,"is_corresponding":false},{"id":439548,"name":"Alphaxard Manjurano","orcid":"0000-0001-7583-6425","position":6,"is_corresponding":false},{"id":318235,"name":"Daniel Faurholt‐Jepsen","orcid":"0000-0001-8561-0155","position":7,"is_corresponding":false},{"id":318238,"name":"Rikke Krogh‐Madsen","orcid":"0000-0003-4914-2715","position":8,"is_corresponding":false},{"id":318245,"name":"George PrayGod","orcid":"0000-0002-0329-4839","position":9,"is_corresponding":false},{"id":289268,"name":"Douglas C. Heimburger","orcid":"0000-0003-3551-9710","position":10,"is_corresponding":false},{"id":439546,"name":"Belinda Kweka","orcid":"0000-0002-6523-9894","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T21:58:41.997408Z","pmid":"33382828","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}