A1c–Glucose Discordance

• A positive A1c–Glucose Discordance (actual HbA1c higher than predicted) indicates accelerated protein glycation, which increases risk of diabetic complications independent of average glucose
• A negative discordance may indicate reduced glycation or altered red blood cell lifespan
• This helps personalize diabetes management

HbA1c estimated glucose - Fasting glucose

• Shows whether your HbA1c-estimated average glucose aligns with your blood glucose at the time of your lab draw

• High A1c–Glucose Discordance itself is asymptomatic but indicates increased risk of diabetes complications (nephropathy, retinopathy, neuropathy, cardiovascular disease) beyond what glucose control would predict

• High A1c–Glucose Discordance: Genetic factors affecting glycation, oxidative stress, certain medications, nutritional deficiencies (B vitamins).
• Low A1c–Glucose Discordance: Hemolytic conditions, recent transfusion, chronic kidney disease.