We recommend adopting other laboratory methods that factor in hemoglobin variants, like HPLC or mandatory reflex testing algorithms, for accurate diabetes assessments in high-risk populations.” Investigators confirmed the sickle cell trait using hemoglobin electrophoresis, a technique that separates hemoglobin protein variants based on their size and charge. About 58 individuals with other hemoglobin variants were excluded from further study. Investigators then calculated the mean HbA1c differences between the two laboratory methods and compared the classification of patients to either pre-diabetes (HbA1c 5.7%) or diabetes (HbA1c 6.5%) categories. Additionally, 4% (8 of the 198) of HbAS individuals met the diabetes criteria using HPLC, while none were classified as diabetic using immunoassay.