Aim: We aimed to evaluate HbA1c with HbA0, HbF, HbA1 subfractions and to discuss the clinical usefulness of HbA1c by considering the total hemoglobin (THb) levels of the patients.

Materials and Methods: This retrospektif study included 338 individuals recorded in the laboratory information system of Pamukkale University Hospital. HbA1c analysis was performed on TosohG8 device by ion-exchanger HPLC method. THb was measured by the colorimetric method on the Mindray BC6800 hematology analyzer. Subjects were divided into subgroups according to HbA1c or THb levels. SPSS 22.0 program was used for statistical analysis.

Results: The means of all patients were 7.2±1.68% for HbA1c, and 13.4±1.8 g/dL for THb. Compared to normals (n=29) with prediabetics (n=108), HbA1a (p=0.0001), HbA1b (p=0.004), LHbA1c (p=0.0001) were lower; HbA0 (p=0.0001) was higher. Compared to normals with diabetics (n=201) or prediabetics with diabetics HbA1a (p=0.0001), HbA1b (p=0.0001), LHbA1c (p=0.0001), SHbA1c/THb (p=0.0001) were higher; HbA0 (p=0.0001) was lower in diabetics. When the patients were evaluated according to THb; compared to normals (n=286) HbA1a (p=0.002), LHbA1c (p=0.002), SHbA1c/THb (p=0.0001); compared to hyperhemoglobinemics (n=21) HbA1a (p=0.034) and SHbA1c/THb (p=0.0001) were significantly higher in the anemic group (n=31). Compared to normal group with hyperhemoglobinemics; HbA0 (p=0.021) was higher; LHbA1c (p=0.004) and SHbA1c (p=0.014) were lower. There were strong positive correlations in SHbA1c with LHbA1c and HbA0 and weak positive correlations in HbA1b and HbF with SHbA1c.

Conclusion: Interpreting the patients' glycemia status, it could be more accurate to evaluate SHbA1c with the other Hb subfractions and THb in diabetes.