Finally, HbA1c values can be affected by a variety of genetic, hematologic, and illness-related factors that influence erythropoiesis, hemoglobin structure, glycation, and erythrocyte destruction and have been found in previous studies to cause falsely high or low HbA1c results [27, 56] Some examples include recent blood loss, erythropoietin treatment, hemodialysis or transfusion, iron-deficiency anemia, kidney failure, and liver disease. This evidence concerns the gene EPO and anemia.