{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T05:44:09Z","timestamp":1768887849420,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T00:00:00Z","timestamp":1556582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000051","name":"National Human Genome Research Institute","doi-asserted-by":"publisher","award":["UM1HG006370"],"award-info":[{"award-number":["UM1HG006370"]}],"id":[{"id":"10.13039\/100000051","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the relationship between HbA<jats:sub>1c<\/jats:sub> and glucose in people with co\u2010existing liver disease and diabetes awaiting transplant, and in those with diabetes but no liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HbA<jats:sub>1c<\/jats:sub> and random plasma glucose data were collected for 125 people with diabetes without liver disease and for 29 people awaiting liver transplant with diabetes and cirrhosis. Cirrhosis was caused by non\u2010alcoholic fatty liver disease, hepatitis C, alcoholic liver disease, hereditary haemochromatosis, polycystic liver\/kidneys, cryptogenic\/non\u2010cirrhotic portal hypertension and \u03b1\u20101\u2010antitrypsin\u2010related disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median (interquartile range) age of the diabetes with cirrhosis group was 55 (49\u201363) years compared to 60 (50\u201371) years (<jats:italic>P<\/jats:italic>=0.13) in the group without cirrhosis. In the diabetes with cirrhosis group there were 21 men (72%) compared with 86 men (69%) in the group with diabetes and no cirrhosis (<jats:italic>P<\/jats:italic>=0.82). Of the group with diabetes and cirrhosis, 27 people (93%) were of white European ethnicity, two (7%) were South Asian and none was of Afro\u2010Caribbean\/other ethnicity compared with 94 (75%), 16 (13%), 10 (8%)\/5 (4%), respectively, in the group with diabetes and no cirrhosis (<jats:italic>P<\/jats:italic>=0.20). Median (interquartile range) HbA<jats:sub>1c<\/jats:sub> was 41 (32\u201356) mmol\/mol [5.9 (5.1\u20137.3)%] vs 61 (52\u201370) mmol\/mol [7.7 (6.9\u20138.6)%] (<jats:italic>P<\/jats:italic>&lt;0.001), respectively, in the diabetes with cirrhosis group vs the diabetes without cirrhosis group. The glucose concentrations were 8.4 (7.0\u201311.2) mmol\/l vs<jats:italic>\u00a0<\/jats:italic>7.3 (5.2\u201311.5) mmol\/l (<jats:italic>P<\/jats:italic>=0.17). HbA<jats:sub>1c<\/jats:sub> was depressed by 20 mmol\/mol (1.8%; <jats:italic>P<\/jats:italic>&lt;0.001) in 28 participants with cirrhosis but elevated by 28 mmol\/mol (2.6%) in the participant with \u03b1\u20101\u2010antitrypsin disorder. Those with cirrhosis and depressed HbA<jats:sub>1c<\/jats:sub> had fewer larger erythrocytes, and higher red cell distribution width and reticulocyte count. This was reflected in the positive association of glucose with mean cell volume (<jats:italic>r<\/jats:italic>=0.39) and haemoglobin level (<jats:italic>r<\/jats:italic>=0.49) and the negative association for HbA<jats:sub>1c<\/jats:sub> (<jats:italic>r<\/jats:italic>=\u20130.28 and <jats:italic>r<\/jats:italic>=\u20130.26, respectively) in the diabetes group with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HbA<jats:sub>1c<\/jats:sub> is not an appropriate test for blood glucose in people with cirrhosis and diabetes awaiting transplant as it reflects altered erythrocyte presentation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13870","type":"journal-article","created":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T08:34:55Z","timestamp":1543221295000},"page":"1444-1452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Utility of HbA<sub>1c<\/sub> assessment in people with diabetes awaiting liver transplantation"],"prefix":"10.1111","volume":"36","author":[{"given":"D.","family":"Bhattacharjee","sequence":"first","affiliation":[{"name":"Medical School University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Vracar","sequence":"additional","affiliation":[{"name":"Medical School University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. A.","family":"Round","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Services University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Diabetes Translational Research Group Diabetes Centre Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Institute of Translational Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. G.","family":"Nightingale","sequence":"additional","affiliation":[{"name":"Institute of Translational Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Institute of Translational Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"College of Medical and Dental Sciences Institute of Cancer and Genomic Sciences University of Birmingham Birmingham UK"},{"name":"Mammalian Genetics Unit Medical Research Council Harwell Institute Harwell UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. V.","family":"Gkoutos","sequence":"additional","affiliation":[{"name":"Institute of Translational Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"College of Medical and Dental Sciences Institute of Cancer and Genomic Sciences University of Birmingham Birmingham UK"},{"name":"MRC Health Data Research UK (HDR UK) Birmingham UK"},{"name":"NIHR Experimental Cancer Medicine Centre Birmingham UK"},{"name":"NIHR Surgical Reconstruction and Microbiology Research Centre Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. M.","family":"Stratton","sequence":"additional","affiliation":[{"name":"Gloucestershire Retinal Research Group Gloucestershire Hospitals NHS Foundation Trust Cheltenham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Parker","sequence":"additional","affiliation":[{"name":"Leeds Liver Unit St James's University Hospital Leeds UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. D.","family":"Luzio","sequence":"additional","affiliation":[{"name":"Diabetes Translational Research Group Diabetes Centre Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Diabetes Research Group Swansea University Swansea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Webber","sequence":"additional","affiliation":[{"name":"Diabetes Translational Research Group Diabetes Centre Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8298-4511","authenticated-orcid":false,"given":"S. E.","family":"Manley","sequence":"additional","affiliation":[{"name":"Diabetes Translational Research Group Diabetes Centre Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Institute of Translational Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"College of Medical and Dental Sciences Institute of Metabolism and Systems Research University of Birmingham Birmingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. A.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Diabetes Translational Research Group Diabetes Centre Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Diabetes Research Group Swansea University Swansea"},{"name":"HRB\u2010Clinical Research Facility \u2010 Cork University College Cork Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Diabetes Translational Research Group Diabetes Centre Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Institute of Translational Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-1539"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2014.01.003"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2509"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.280"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2015-1084"},{"issue":"1","key":"e_1_2_10_7_1","first-page":"P138","article-title":"Effects of concurrent illnesses and treatments on surrogate glycaemic markers","volume":"34","author":"Webber J","year":"2017","journal-title":"Diabet Med"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.03.012"},{"issue":"1","key":"e_1_2_10_9_1","first-page":"P440","article-title":"Post introduction of HbA1c as a diagnostic test: consequences for requesting and reporting","volume":"32","author":"Dowd RP","year":"2015","journal-title":"Diabet Med"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-S081"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2016.01.023"},{"issue":"1","key":"e_1_2_10_12_1","first-page":"P466","article-title":"Review of HbA1c results >120 mmol\/mol as patients may require urgent assessment if request for diagnosis of Type 2 diabetes","volume":"31","author":"Dowd RP","year":"2014","journal-title":"Diabet Med"},{"key":"e_1_2_10_13_1","unstructured":"KadriF StuartK CrambR ManleyS MtemererwaB GhoshS.HbA1cinterpretation and its caveats: a case of targeting apparently good glycaemic control causing severe hypoglycaemia.International Diabetes Federation (IDF) meeting Vancouver Canada 30 November to 4 December 2015. Abstract: 0550\u2010P."},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/8390210"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/he.2000.5852"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2014.05.003"},{"key":"e_1_2_10_17_1","unstructured":"R Core Team.R: A language and environment for statistical computing. Vienna Austria: R Foundation for Statistical Computing; 2017. Available at\u00a0https:\/\/www.R-project.org\/. Last accessed 19 December 2017."},{"key":"e_1_2_10_18_1","unstructured":"WeiT SimkoV.R package \u201ccorrplot\u201d: Visualization of a Correlation Matrix(Version 0.84) 2017. Available athttps:\/\/github.com\/taiyun\/corrplot. Last accessed 19 December 2017"},{"key":"e_1_2_10_19_1","unstructured":"Revelle W.psych: Procedures for Personality and Psychological Research(Version 1.7.8) 2017. Northwestern University Evanston Illinois USA. Available athttps:\/\/CRAN.R-project.org\/package=psych. Last accessed 19 December 2017."},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0545"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-04-154112"},{"issue":"1","key":"e_1_2_10_22_1","first-page":"A584","article-title":"How is fructosamine affected by urinary albumin excretion?","volume":"60","author":"Manley SE","year":"2011","journal-title":"Diabetes"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000376"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-S002"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.44.8.968"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7258.405"},{"key":"e_1_2_10_27_1","first-page":"87","article-title":"Diagnosis of diabetes: HbA1c versus WHO criteria","volume":"12","author":"Manley S","year":"2010","journal-title":"Diabetes Prim Care"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13870","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13870","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.13870","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T02:26:59Z","timestamp":1694140019000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.13870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,30]]},"references-count":26,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1111\/dme.13870"],"URL":"https:\/\/doi.org\/10.1111\/dme.13870","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,30]]},"assertion":[{"value":"2018-11-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}