Something the nurse practitioner needs to be aware of is that hemoglobinopathies like Sickle Cell Anemia and Trait can affect the Hgb A1c reading. African Americans have an increased risk of inheriting sickle cell trait. In fact, about one in 12 African Americans has the sickle cell trait. This is important because about 12.7 African Americans ages 18 years or older have diabetes, therefore, many will have both diabetes and sickle cell trait.