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Perhaps the most common circumstance in which a healthy individual may have an elevated HbA1c includes endurance athletes who are observed to have higher fasting glucose levels, likely due to the bodys regular demand for circulating blood glucose during times of prolonged physical activity, resulting in upregulated gluconeogenesis (increased production of glucose in the liver and kidneys)

cGAMP binds to and activates the endoplasmic reticulum transmembrane receptor STING, finally resulting in the production and release of type I interferons (IFN), which are potent anti-viral and anti-cancer cytokines (136)