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Lucy seabrooke's avatar

Really interesting analysis. Thanks for this great considered response. Thinking about it and please excuse me if I've got things back to front, but……when blood donors donate blood, it’s thought that they lose approximately one tenth of their blood volume. Consequently, they lose one tenth of preformed HbA1c. In this scenario, the bone marrow compensates for the blood loss by an increase in erythropoiesis, resulting in an increased flow of newly formed erythrocytes devoid of HbA1c. As glycation of hemoglobin is a relatively slow chemical process, the increased synthesis of erythrocytes would therefore, theoretically, result in a drop in HbA1c for a significant amount of time thereafter - weeks rather than days. So regardless of iron levels, wouldn’t bloodletting affect the correct interpretation of glycemic control?

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Dr. Max Gowland's avatar

Great article Nicola on a topic which is so controversial......there is certainly no simple answer but I thought you gave a really sensible and reasonable overview. The Fe hypothesis is particularly interesting and this was a new one for me so thanks for that.

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