Caution is needed in interpreting hemoglobin A1c levels in the Muslim Bedouin population of southern Israel

Yulia Treister-Goltzman, Roni Peleg

    Research output: Contribution to journalReview articlepeer-review

    Abstract

    The Bedouins living in southern Israel are a Muslim-Arab population that is transitioning from a nomadic lifestyle to life in permanent settlements. The population has unique characteristics that could affect hemoglobin A1c (HbA1c) measurements. The objective of this study was to describe the socio-demographic and unique morbidity characteristics of this community and the effect on HbA1c measurements. Consanguinity, especially among cousins in the Bedouin population, results in a high prevalence of autosomal recessive genetic diseases such as thalassemia (underestimate of HbA1c), hemoglobinopathies (underestimate and overestimate), Gilbert's disease, and glucose-6-phosphate dehydrogenase deficiency, an X-linked disorder, which can cause hyperbilirubinemia with an overestimate of HbA1c. Furthermore, nutritional deficiencies, autosomal recessive diseases, high birth rates, parasitic infections, and poverty can all cause high rates of anemia (iron and vitamin B12 deficiencies) that can raise HbA1c levels. Congenital dyserythropoietic anemia is found among Bedouin tribes in the Negev region and can lead to an underestimation of HbA1c levels. Pregnancy can also affect HbA1c levels. Medical teams working in the Bedouin community and in other Muslim populations with similar morbidity characteristics throughout the world should identify patients with medical conditions that can affect HbA1c measurements and be aware of possible measurement alternatives such as fructosamine and glycated albumin.

    Original languageEnglish
    Pages (from-to)546-551
    Number of pages6
    JournalIsrael Medical Association Journal
    Volume21
    Issue number8
    StatePublished - 1 Jan 2019

    Keywords

    • Bedouin
    • Diabetes mellitus
    • Hemoglobin A1c (HbA1c)
    • Muslim

    ASJC Scopus subject areas

    • Medicine (all)

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