Type 2 Diabetes - Hemoglobin A1c: A Useful Test for Diabetes Control

It is widely acknowledged good Type 2 diabetes care rests on a foundation of patient knowledge. Knowing what care you should receive is vital, since not even all doctors are aware of the guidelines set by the American Diabetes Association. A survey published in the Annals of Internal Medicine in the year 2002, estimated only 30 percent of people with diabetes had a hemoglobin A1c, (HbA1c), test during the previous year. This is a crucial test which should be given to all people with diabetes at least twice a year.

Are you a diabetic? Does your doctor advise you to have your hemoglobin A1c taken every three months? Are you wondering why you still need to have your hemoglobin A1c examined when you already check your blood sugar level regularly? What is Hemoglobin A1c? What is the importance of having this laboratory test?

The hemoglobin A1c is the stable glucose portion on the beta-chain of the hemoglobin, the oxygen transporters of red blood cells. It is formed by an irreversible reaction when red blood cells become exposed to glucose. And because it is irreversible, no diabetic can ever alter or manipulate the results of his or her hemoglobin A1c. Therefore, it is the single best test to monitor a diabetic's overall blood sugar control for the past three months.

Hemoglobin A1c values are a strong indicator for the development of long-term complications of Type 2 diabetes. In fact, the risk for diabetic retinopathy, neuropathy, and diabetic nephropathy can be easily projected by just looking at the previous HbA1c results. Cardiovascular disease, another complication of diabetes, is also another risk seen with the rising values of HbA1c through smoking, hypertension and increased blood lipid levels can also trigger its development.

What are the usual indications for hemoglobin A1c monitoring? Everyone with diabetes who needs constant monitoring and tight blood sugar control need to have their HbA1c level checked once every three to six months. However, it can be performed more often in cases where treatment management is changed rapidly or drastically. As well, anyone who is known to be at high risk for developing Type 2 diabetes should also undergo this laboratory test according to the Johns Hopkins Point-of-Care Information Technology Center.

How do you interpret your HbA1c results? The HbA1c percentage is the average blood sugar control for the past three months. It accounts for all the highs and lows of blood sugar spikes and troughs, this test is a better indicator of your overall status than the fasting blood sugar test. Non-diabetics usually have a HbA1c value of 4 to 6 percent. People who have a result of 8 percent have poor blood sugar control while those with a reading higher than 10 percent have uncontrolled Type 2 diabetes. Diabetes is considered controlled when the reading is less than 6.5 to 7 percent.

What are the limitations in HbA1c monitoring? Anything that can possibly decrease the survival rate of red blood cells also affects this value. Therefore, people with hemolytic anemia, a condition where individual red blood cells burst, have lower HbA1c values. In contrast to this, an increase in the lifespan of red blood cells, such as in aplastic anemia can also increase the hemoglobin A1c value independent of the blood sugar level.

A report published in the Lancet, May 2009 reported that diabetic patients who lowered their hemoglobin A1c value by just 1 percent over 5 years can reduce the overall rate of heart attacks by 17 percent and fatal and non-fatal heart attacks by 15 percent. It seems worthwhile to me in order to savor life longer!

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