Diabetes and the HbA1c Test
Diabetes is a health condition in which patient suffers from a high level of sugar in the blood. Blood sugar levels have to be maintained at an optimal range, otherwise, the condition can result in several severe complications, including kidney failure. While diabetics test their blood sugar levels multiple times daily with a glucometer, their health care professional typically will use an HbA1c test to monitor an average of blood glucose levels to better determine the prescribed dosages.
What HbA1c is:
Red blood cells within the blood stream are made up of a molecule called haemoglobin. Glucose ingested through diet sticks to the heamoglobin and creates what is called ‘glycosolated haemoglobin molecules’ otherwise known as both: A1C and HbA1C. The higher the amount of glucose in the blood, the will result in a higher presence of glycosolated haemoglobin molecules.
What the HbA1C test does:
Red blood cells live only for a period of eight to twelve weeks before being replaced. The HbA1C test takes a measurement of the HbA1C and determines the average blood glucose for the last 8-12 weeks. Unlike glucose levels, which change from minute to minute, hour to hour, and day to day, the red blood cells and their HbA1C levels change slowly over weeks. Thus it is used as a form of ‘quality control’ for diabetes treatments.
How an HbA1c test is performed:
A sample of blood is required to perform an HbA1c test. Some testing methods require only a finger stick of blood similar to that used with a glucometer, while other methods will require a small sample of blood from a vein.
Who Needs an HbA1c Test and When:
Patients who are at risk of diabetes may be asked to undergo an HbA1C test in order to properly diagnose the disease. The HbA1c test is also used on patients who have already been diagnosed with Diabetes are normally given an HbA1c Test every three months if their Diabetes is not under control. Meanwhile, diabetics who have control over their blood sugar levels are typically tested every six months. Doctors use the results of the HbA1c Test to assist them in better prescribing accurate doses of insulin based on the HbA1c Test results.
HbA1c Test Results:
Because the HbA1c test is given as both a diagnostic test and a maintenance test, it’s important to note results separately here:
- Results of HbA1C for diagnosis only: A patient with a HbA1c Test result of 5.7% or lower is normal. While a patient with a result ranging from 5.7% to 6.4% is considered to be a pre-diabetic. Results of 6.5% or higher are ranges considered to be Diabetes.
- Results of HbA1c for Diabetics: Your doctor will discuss with you the optimum range they want to see when the test is performed. For the largest majority of diabetics, the range is 6.5% to 7%. Diabetics with an HbA1c Test result within the range of 6.5-7% show they have their diabetes well controlled. Conversely, diabetics who return an HbA1c Test result which exceeds 7% show that their diabetes is not controlled well and should expect to see changes prescribed in both medication and lifestyle.
Limitations of HbA1c Test: It is important to note that the HbA1c Test has limitations. The test cannot detect the absence or presence of hypoglycemia or hyperglycemia. The test may be falsely influenced to a increased result due to medical conditions such as kidney failure, chronic or excessive alcohol intake as well as hypertriglyceridemia. There are also medical conditions which can give a false decrease in the HbA1c Test results. They include acute or chronic blood loss, sickle cell disease and thalassemia.