2022 Volume 65 Issue 9 Pages 505-511
We experienced a case of variant hemoglobin that was discovered after the onset of acute-onset type 1 diabetes mellitus. In this case, HbA1c was able to be properly measured by the enzymatic method, but extremely low values of HbA1c and an abnormal peak that was likely caused by variant hemoglobin were observed on high-performance liquid chromatography. The variant hemoglobin was identified as Hb Hoshida [β43 Glu (GAG) →Gln (CAG) ]. Hb Hoshida is a genetic abnormality of the hemoglobin beta chain that was first reported by Iuchi et al. from Japan in 1978 and has since been reported in several cases associated with diabetes mellitus. In cases with type 1 diabetes mellitus, the existence of variant hemoglobin may cause difficulty in differentiating between acute-onset type 1 diabetes mellitus and fulminant type 1 diabetes mellitus, which requires special attention. In the outpatient setting, glycated albumin, intermittently scanned continuous glucose monitoring and continuous glucose monitoring may be useful for glycemic control.
