The HbA1c assay is the gold-standard measurement of chronic glycemia and measures the amount of glucose that binds to hemoglobin over a period of 3 months.
The HbA1c Test is often prescribed as a must-do blood test for pre-diabetic, type 1 diabetic or type 2 diabetic or even non-diabetics. So what exactly is HbA1c? How does this measure work? How will it help you manage your diabetes better? All this and more info on the HbA1c counter and teach yourself how best you can interpret your blood test results.(1✔ ✔Trusted Source
Is there a Relationship Between mean Blood Glucose and Glycated Hemoglobin?
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In the abbreviation “HbA1c”, ‘Hb’ refers to hemoglobin while 'A1c' is a specific subtype of hemoglobin. Also called the Glycated/ Glycosylated Hemoglobin A Protein test, the HbA1c test gives the level of blood glucose estimated over a period of time (ideally 3 months or 8-10 weeks), The correct format of HbA1c is HbA1c but for convenience it is mentioned as HbA1c. Unlike the customary finger-prick blood test which reads blood glucose at a specific point in time, the HbA1c gives us a long range value. This reading of blood glucose is unaffected by immediate or short-term fluctuations in blood sugar and reflects how well glucose levels have been maintained over the specific period.
HbA1c test improves the effectiveness of diabetes treatment by tablets or insulin injection or both. It is a good guiding test by which the patient can understand how best he has controlled his condition and take further necessary corrective action.
The HbA1c test range should be as follows -
- A non-diabetic should have an A1c result between 4% and 6%.
- In Diabetics - A1c level should be 6.5% (47 mmol/mol) or higher.
- In Pre-diabetes (increased risk of developing diabetes in the future): A1c is 5.7% to 6.4% (39 - 46 mmol/mol)
In most diabetic individuals the blood glucose level is higher and results in a higher HbA1c level. This higher level also reflects the possible level of damage to tissues due to glycation and hence diabetic complications. The normal recommended HbA1c readings for diabetics should fall within the reference range of 6.5 to 7%. What this really implies is that for every 100 red blood cells, 6-7 cells have glucose attached to them.
In the long term the importance of the HbA1c test can be understood from the fact that if well controlled, it lowers the possibility of vascular complications that can be traced back to diabetes.
How often should one test with HbA1c
If someone is first diagnosed with diabetes or if the control of diabetes is not good then Hb A1c is usually ordered more frequently.
The American Diabetes Association recommends testing HbA1c at least twice a year.
Usually the test is conducted less often if diabetes is well controlled but most physicians would subject their patients to have the test 2 to 4 times each year.
When should HbA1c Not be Used as a test to detect Diabetes control-
- Pregnant women
- Recent severe bleeding
- Recent blood transfusions
- Chronic kidney disease
- Chronic liver disease
- Iron-deficiency anemia
- Anemia due to Vitamin B12 deficiency
- Hemoglobin variants like sickle cell hemoglobin (hemoglobin S)
Many epidemiological studies and clinical trials (UK Prospective Diabetes Study and the Diabetes Control and Complications Trial) have now established the importance of the relationship between HbA1c levels and risk for long-term diabetes complications. Today worldwide, HbA1c targets for diabetes management are used as the means to delay or prevent the development of complications.
"Medicine might Be winning the battle of glucose control, but is Losing the war against diabetes"
- Is there a Relationship Between mean Blood Glucose and Glycated Hemoglobin? - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262729/)
- HbA1c: A Review of Analytical and Clinical Aspects - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819436/)
- Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus - (https://www.who.int/diabetes/publications/report-hba1c_2011.pdf)
- HbA1c and Monitoring Glycaemia - (https://www.racgp.org.au/afp/2012/januaryfebruary/hba1c-and-monitoring-glycaemia/)
- Glycated Hemoglobin (HbA1c): Clinical Applications of a Mathematical Concept - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037982/)
- Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933534/)
Latest Publications and Research on Decoding HbA1c Test for Blood Sugar
- Can Short Bouts of Exercise ("Exercise Snacks") Improve Body Composition in Adolescents with Type 1 Diabetes? A Feasibility Study. - Published by PubMed
- Reduction in HbA1c with SGLT2 inhibitors vs DPP-4 inhibitors as add-ons to metformin monotherapy according to baseline HbA1c: a systematic review of randomized controlled trials. - Published by PubMed
- Long-term effects of continuous subcutaneous insulin infusion in adults with type 1 diabetes mellitus patients: Results of a public healthcare system. - Published by PubMed
- Overweight and obese children with optimal control in the T1D Exchange Registry: How are they different from lean children with optimal control? - Published by PubMed
- Toe brachial index predicts major acute cardiovascular events in patients with type 2 diabetes independently of arterial stiffness. - Published by PubMed
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