Glucose 6-phosphate dehydrogenase deficiency and Southeast Asian-specific mutations lower HbA1c levels in a Thai population: implications for diabetes diagnosis – Published online 01/09/2025
Punchalee Mungkalasut, Makamas Chanda, Watcharapong Jugnam-Ang, Poonlarp Cheepsunthorn, Poranee Ganokroj, Chalisa L. Cheepsunthorn
Glucose 6-phosphate dehydrogenase (G6PD) deficiency is a common inherited condition in Southeast Asia that shortens the lifespan of red blood cells. In this issue, Mungkalasut et al (https://doi.org/10.1007/s00125-025-06523-2) report that G6PD deficiency and the presence of common G6PD genetic mutations in a Thai population caused HbA1c to appear falsely low, even when blood glucose levels were normal. Adjusting HbA1c thresholds by about 0.5% improved the detection of prediabetes without altering overall diabetes prevalence. These findings highlight that exclusive reliance on HbA1c for diagnosing type 2 diabetes could lead to missed cases in populations with a high frequency of G6PD deficiency. The authors conclude that incorporating genetic background into screening strategies may help achieve more accurate and equitable diabetes diagnoses.
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