diabetes.2 Therefore, an average primary care panel with 1,500 patients will include approximately 4 patients with both hereditary hemochromatosis and diabetes. In this report, we discuss a patient with concurrent hereditary hemochromatosis and diabetes glycated hemoglobin levels (A1C) appeared to be inaccurate relative to his home capillary blood glucose readings and fasting blood glucose values. Since the vast majority of primary care physicians will have several patients with these concurrent diseases, it is important to understand the optimal management and diabetes monitoring for such patients, especially in light of the American Diabetes Association recommendation that A1C can be used for diagnosis of diabetes.3 Case Presentation A 59 year old Caucasian male with hemochromatosis and diabetes was referred for discordant fasting blood glucose and glycated hemoglobin levels (A1C). He was diagnosed with diabetes fifteen years previously and had been treated with oral agents for several years. His A1C remained below 7% until 6 months prior to consultation. At the time of referral, he was taking metformin 1500 mg daily and glimepiride 2 mg every morning. Additional medications were hydrochlorothiazide/irbesartan 12.5 mg/300 mg daily, aspirin 100 mg daily, and sildenafil 50 mg as needed. The patient’s physical examination showed truncal obesity with a BMI of 38, but was otherwise unremarkable without hyperpigmentation.
diabetes.2 Therefore, an average primary care panel with 1,500 patients will include approximately 4 patients with both hereditary hemochromatosis and diabetes. In this report, we discuss a patient with concurrent hereditary hemochromatosis and diabetes glycated hemoglobin levels (A1C) appeared to be inaccurate relative to his home capillary blood glucose readings and fasting blood glucose values. Since the vast majority of primary care physicians will have several patients with these concurrent diseases, it is important to understand the optimal management and diabetes monitoring for such patients, especially in light of the American Diabetes Association recommendation that A1C can be used for diagnosis of diabetes.3 Case Presentation A 59 year old Caucasian male with hemochromatosis and diabetes was referred for discordant fasting blood glucose and glycated hemoglobin levels (A1C). He was diagnosed with diabetes fifteen years previously and had been treated with oral agents for several years. His A1C remained below 7% until 6 months prior to consultation. At the time of referral, he was taking metformin 1500 mg daily and glimepiride 2 mg every morning. Additional medications were hydrochlorothiazide/irbesartan 12.5 mg/300 mg daily, aspirin 100 mg daily, and sildenafil 50 mg as needed. The patient’s physical examination showed truncal obesity with a BMI of 38, but was otherwise unremarkable without hyperpigmentation.
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