EPO and hyperinsulinemic hypoglycemia, familial, 4: Moreover, changes in HbA1C levels could result from false decreases/increases, occurring due to various clinical situations and diseases such as iron deficiency anemia, deficiency of vitamin B12 or folic acid, severe hypertriglyceridemia, severe hyperbilirubinemia, chronic salicylate ingestion, chronic opioid ingestion, lead poisoning, acute or chronic blood loss, splenomegaly, pregnancy, vitamin E ingestion, red blood cell transfusion, ribavirin and interferon-alpha use, hemoglobin variants, vitamin C ingestion, uremia, hemodialysis and erythropoietin injections [39].