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It is also important to note that different conditions affect HbA1c in different ways: Haemolytic anaemia and acute blood loss shorten red cell lifespan and tend to lower HbA1c Iron deficiency anaemia is associated with increased HbA1c, likely due to prolonged red cell survival Haemoglobin variants (haemoglobinopathies) can cause variable or assay-dependent interference the effect depends on the specific variant and the HbA1c method used B12 or folate deficiency alters erythropoiesis and red cell indices, making HbA1c potentially unreliable in either direction Clinicians should therefore: Review the full blood count (FBC) alongside HbA1c Check serum B12 and folate when anaemia or macrocytosis (raised mean corpuscular volume, MCV) is identified Consider alternative glucose assessment methods specifically fasting plasma glucose or a 75 g OGTT for diagnostic purposes, or self-monitored blood glucose (SMBG) or fructosamine/glycated albumin for interim monitoring when HbA1c is unreliable Not sure where to start
A recent phase 2 trial investigated the triple biased GLP-1/GIP/GCC receptors agonist retatrutide (LY3437943) in 338 patients with a mean age of 48 years and BMI of 37.3 kg/m 2 without diabetes (prediabetes in 36% participants) showing BW and WC reduction ranging from 8.7% to 24.2% and 6.5 cm to 19.6 cm in the 1 mg and 12 mg dose groups, respectively, at 48 weeks 41
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