Millions of people may be taking diabetes medication they don't actually need because of a quirk in their DNA.
April 17, 2026
Original Paper
HbA1c-Based Diagnosis of Type 2 Diabetes and Complication Risk Are Distorted in British South Asians Due to HbE Thalassaemia Trait
SSRN · 6555024
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The Takeaway
Doctors use a test called 'HbA1c' as the gold standard to diagnose Type 2 Diabetes by looking at average blood sugar over three months. However, this study found that in British South Asians with a common genetic trait called 'HbE,' the test gives a high reading even when their blood sugar is perfectly normal. It’s a diagnostic 'glitch' that has likely led to thousands of people being misdiagnosed with a serious chronic illness. Because this trait is so common in South Asian populations, a standard global medical protocol is essentially failing an entire ethnic group. This means we need to rethink how we use 'one-size-fits-all' medical tests for a diverse global population.
From the abstract
Background: Genetic variants impacting red blood cell biology disrupt the relationship between glycaemia and glycated haemoglobin (HbA1c), with implications for diagnosis and management of type 2 diabetes (T2D). Thalassaemia trait is estimated to affect 350 million people globally, but its impact on T2D and related outcomes is not clear.<br><br>Methods: We explored associations between thalassaemia trait, HbA1c, and T2D diagnosis and complications in 43,088 British Bangladeshi and Pakistani part