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Hi, I would imagine that the problem wouldn’t be an in vitro analytical interference, but rather an in vivo one. Would there be higher levels of HbA1a1 (fructose 1,6 diphosphate) and if so would this impact on the linear kinetics of glycation at the N-terminal valine? Anion exchange HPLC should see good separation of all Hb factions including HbA1a1 which is well away from the sA1C peak, but obviously in vitro interference is so method dependent, it’s possible The only way to know for sure would be to do: 1. HbA1c by anion exchange 2. HbA1c by alternative method e.g. boronate affinity or immunoassay 3. Continuous glucose monitoring with estimated HbA1c based on time in range This is how I’ve picked up G6PD deficiencies, different pathology but similar discordance Let us know! S Dr Shivani Misra MRCP, FRCPath PhD Consultant in Metabolic Medicine North West London Pathology (Imperial College Healthcare NHS Trust) Honorary Senior Clinical Lecturer (Imperial College London). From: Clinical biochemistry discussion list on behalf of "Galloway, Peter" Reply-To: "Galloway, Peter" Date: Monday, 5 March 2018 at 17:01 To: "[log in to unmask]<mailto:[log in to unmask]>" Subject: HbA1c in Hereditary Fructose Intolerance I am looking for advice about the impact of hereditary fructose intolerance on HbA1c The patient who rigorously avoids fructose, has developed NIDDM. Does her likely slightly higher plasma fructose level have an effect on HbA1c as assessed by HPLC ? (Menarini HA-8180V) If so, who offers a mass based assay to assess the impact ? Thank you for any guidance and assistance you can offer. Peter Galloway Glasgow **************************************************************************** NHSGG&C Disclaimer The information contained within this e-mail and in any attachment is confidential and may be privileged. If you are not the intended recipient, please destroy this message, delete any copies held on your systems and notify the sender immediately; you should not retain, copy or use this e-mail for any purpose, nor disclose all or any part of its content to any other person. All messages passing through this gateway are checked for viruses, but we strongly recommend that you check for viruses using your own virus scanner as NHS Greater Glasgow & Clyde will not take responsibility for any damage caused as a result of virus infection. ************************************************************************** ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/