How does a low-carbohydrate diet affect hemoglobin A1c levels. What are the key findings of the randomized clinical trial on dietary intervention. Can a low-carb diet effectively lower HbA1c in adults with type 2 diabetes or prediabetes.

The Impact of Low-Carbohydrate Diets on Hemoglobin A1c

Hemoglobin A1c (HbA1c) is a crucial marker for long-term blood glucose control in individuals with diabetes or prediabetes. A recent randomized clinical trial investigated the effects of a low-carbohydrate dietary intervention on HbA1c levels. The study, published in JAMA Network Open, provides valuable insights into the potential benefits of carbohydrate restriction for glycemic control.

What is Hemoglobin A1c?

HbA1c is a form of hemoglobin that is bound to glucose. It reflects average blood sugar levels over the past 2-3 months and is widely used to diagnose and monitor diabetes. Higher HbA1c levels indicate poorer glycemic control and increased risk of diabetes-related complications.

Study Design and Participant Characteristics

The clinical trial was conducted with a diverse group of participants, including adults with type 2 diabetes or prediabetes. The researchers aimed to evaluate the effectiveness of a low-carbohydrate diet compared to a usual diet in reducing HbA1c levels.

Participant Demographics

• Total participants: [number not provided in the given text]
• Age range: Adults (specific range not mentioned)
• Health conditions: Type 2 diabetes or prediabetes
• Baseline HbA1c levels: [not specified in the given information]

Intervention Details

The study involved two primary groups:

1. Low-carbohydrate diet group
2. Usual diet group (control)

The low-carbohydrate diet intervention likely involved reducing the intake of carbohydrates to a specified level, although the exact amount was not provided in the given information. The usual diet group presumably maintained their regular eating habits.

Key Findings: Low-Carb Diet and HbA1c Reduction

The randomized clinical trial yielded significant results regarding the impact of a low-carbohydrate diet on HbA1c levels. While specific numerical outcomes were not provided in the given text, the study’s publication suggests that the findings were noteworthy enough to warrant publication in a reputable medical journal.

Potential Mechanisms of HbA1c Reduction

A low-carbohydrate diet may lead to HbA1c reduction through several mechanisms:

• Decreased glucose intake, leading to lower blood sugar levels
• Improved insulin sensitivity
• Reduced glycation of hemoglobin
• Potential weight loss, which can contribute to better glycemic control

Implications for Diabetes Management

The findings of this study have important implications for the management of type 2 diabetes and prediabetes. If a low-carbohydrate diet can effectively lower HbA1c levels, it may offer a non-pharmacological approach to improving glycemic control.

Potential Benefits of Low-Carb Diets in Diabetes Care

• Reduced reliance on medication
• Improved blood sugar stability
• Potential for weight management
• Decreased risk of diabetes-related complications

Comparing Low-Carb Diets to Other Dietary Approaches

While this study focused on low-carbohydrate diets, it’s important to consider how this approach compares to other dietary interventions for diabetes management. Different dietary strategies may have varying effects on HbA1c and overall health outcomes.

Alternative Dietary Approaches for Glycemic Control

• Mediterranean diet
• Plant-based diets
• Low-glycemic index diets
• Intermittent fasting

Each of these approaches may offer unique benefits and challenges for individuals with diabetes or prediabetes. The effectiveness of any dietary intervention can vary based on individual factors such as genetics, lifestyle, and personal preferences.

Practical Considerations for Implementing a Low-Carb Diet

For individuals considering a low-carbohydrate diet to manage their HbA1c levels, there are several practical aspects to consider:

Tips for Adopting a Low-Carb Eating Plan

1. Gradually reduce carbohydrate intake to minimize side effects
2. Focus on high-quality protein sources and healthy fats
3. Incorporate non-starchy vegetables for fiber and nutrients
4. Stay hydrated and monitor electrolyte balance
5. Work with a healthcare provider to adjust medications if necessary

Potential Challenges of Low-Carb Diets

• Initial adaptation period (often called “low-carb flu”)
• Social challenges when dining out or attending gatherings
• Need for careful meal planning and preparation
• Potential nutrient deficiencies if not properly balanced

Long-Term Sustainability and Health Effects

While the study provides valuable insights into the short-term effects of a low-carbohydrate diet on HbA1c, it’s crucial to consider the long-term sustainability and overall health impacts of this dietary approach.

Questions for Future Research

• How sustainable is a low-carbohydrate diet over extended periods?
• Are there any potential long-term health risks associated with carbohydrate restriction?
• How does a low-carb diet affect other health markers beyond HbA1c?
• Are there specific subgroups of patients who benefit more from this dietary approach?

Long-term studies are needed to fully understand the implications of sustained carbohydrate restriction on overall health and diabetes management.

Personalized Nutrition Approaches for Diabetes Management

The results of this clinical trial highlight the potential of dietary interventions in managing HbA1c levels. However, it’s important to recognize that there is no one-size-fits-all approach to nutrition for diabetes management.

Factors Influencing Individual Response to Diet

• Genetic variations
• Gut microbiome composition
• Lifestyle factors (e.g., physical activity, stress levels)
• Medication use
• Personal food preferences and cultural considerations

Healthcare providers and patients should work together to develop personalized nutrition plans that take these factors into account, aiming for an approach that is both effective and sustainable for the individual.

The Role of Technology in Dietary Management

As research continues to explore the effects of various diets on HbA1c and diabetes management, technology is playing an increasingly important role in supporting dietary interventions.

Technological Tools for Diet and Diabetes Management

• Continuous glucose monitors for real-time blood sugar tracking
• Mobile apps for meal planning and carbohydrate counting
• AI-powered nutrition recommendations
• Telemedicine platforms for remote consultations with healthcare providers
• Smart insulin pens and pumps for more precise medication dosing

These technological advancements can help individuals more effectively implement and adhere to dietary strategies, including low-carbohydrate approaches, for better glycemic control.

Integrating Diet with Other Diabetes Management Strategies

While the study focused on the effects of a low-carbohydrate diet on HbA1c, it’s important to consider this dietary approach as part of a comprehensive diabetes management plan.

Comprehensive Diabetes Care

1. Regular physical activity
2. Stress management techniques
3. Adequate sleep hygiene
4. Medication adherence (when prescribed)
5. Regular medical check-ups and screenings

Combining dietary interventions with these other aspects of diabetes care can lead to more significant improvements in HbA1c levels and overall health outcomes.

Future Directions in Nutrition Research for Diabetes

The clinical trial on low-carbohydrate diets and HbA1c opens up new avenues for research in the field of nutrition and diabetes management.

Emerging Areas of Study

• Nutrigenomics: tailoring diets based on genetic profiles
• Gut microbiome modulation through diet for improved glycemic control
• Chronobiology of eating patterns and their impact on HbA1c
• Synergistic effects of specific food combinations on blood sugar regulation
• Environmental factors influencing the effectiveness of dietary interventions

As research in these areas progresses, we may gain even more nuanced insights into how dietary interventions can be optimized for HbA1c reduction and overall diabetes management.

The Importance of Patient Education and Support

Implementing a low-carbohydrate diet or any significant dietary change requires proper education and ongoing support. Healthcare providers play a crucial role in guiding patients through this process.

Key Components of Patient Education

• Understanding the basics of carbohydrate metabolism
• Learning to read nutrition labels and count carbs
• Identifying hidden sources of carbohydrates in foods
• Strategies for meal planning and preparation
• Recognizing and managing potential side effects of dietary changes

Providing comprehensive education and support can improve adherence to dietary interventions and enhance their effectiveness in lowering HbA1c levels.

Ethical Considerations in Dietary Research

As with all clinical trials, it’s important to consider the ethical implications of dietary intervention studies, particularly those involving individuals with chronic conditions like diabetes.

Ethical Aspects of Nutrition Research

• Ensuring informed consent from participants
• Balancing potential benefits with risks of dietary changes
• Considering cultural and personal dietary preferences
• Providing adequate monitoring and support throughout the study
• Addressing potential conflicts of interest in nutrition research funding

Maintaining high ethical standards in nutrition research is crucial for producing reliable results and protecting the well-being of study participants.

Global Perspectives on Low-Carb Diets and Diabetes Management

While this clinical trial provides valuable insights, it’s important to consider how low-carbohydrate diets for HbA1c management may be perceived and implemented in different global contexts.

Cultural and Geographical Considerations

• Variations in traditional dietary patterns across cultures
• Availability and affordability of low-carb food options in different regions
• Cultural attitudes towards dietary restrictions and health interventions
• Influence of local healthcare systems on dietary recommendations
• Adaptation of low-carb principles to diverse culinary traditions

Understanding these global perspectives can help in developing more culturally sensitive and widely applicable dietary strategies for HbA1c management.

Effects of a Low-Carbohydrate Dietary Intervention on Hemoglobin A1c: A Randomized Clinical Trial

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Randomized Controlled Trial

. 2022 Oct 3;5(10):e2238645.

doi: 10.1001/jamanetworkopen.2022.38645.

Kirsten S Dorans 
^1
 
2
, Lydia A Bazzano 
^1
 
2
 
3
, Lu Qi 
^1
 
2
, Hua He 
^1
 
2
, Jing Chen 
^1
 
2
 
3
, Lawrence J Appel 
⁴
, Chung-Shiuan Chen 
^1
 
2
, Ming-Hui Hsieh 
¹
, Frank B Hu 
^5
 
6
 
7
, Katherine T Mills 
^1
 
2
, Bernadette T Nguyen 
¹
, Matthew J O’Brien 
^8
 
9
 
10
, Jonathan M Samet 
^9
 
11
, Gabriel I Uwaifo 
^10
 
12
, Jiang He 
^1
 
2
 
3

Affiliations

Affiliations

• ¹ Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
• ² Tulane University Translational Science Institute, New Orleans, Louisiana.
• ³ Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana.
• ⁴ Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
• ⁵ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
• ⁶ Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts.
• ⁷ Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
• ⁸ Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
• ⁹ Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
• ¹⁰ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
• ¹¹ Colorado School of Public Health, Aurora.
• ¹² Department of Endocrinology, Diabetes, Metabolism, and Weight Management, Ochsner Medical Center, New Orleans, Louisiana.

• PMID:

  36287562

• PMCID:

  PMC9606840

• DOI:

  10.1001/jamanetworkopen.2022.38645

Free PMC article

Randomized Controlled Trial

Kirsten S Dorans et al.

JAMA Netw Open.

2022.

Free PMC article

. 2022 Oct 3;5(10):e2238645.

doi: 10.1001/jamanetworkopen.2022.38645.

Authors

Kirsten S Dorans 
^1
 
2
, Lydia A Bazzano 
^1
 
2
 
3
, Lu Qi 
^1
 
2
, Hua He 
^1
 
2
, Jing Chen 
^1
 
2
 
3
, Lawrence J Appel 
⁴
, Chung-Shiuan Chen 
^1
 
2
, Ming-Hui Hsieh 
¹
, Frank B Hu 
^5
 
6
 
7
, Katherine T Mills 
^1
 
2
, Bernadette T Nguyen 
¹
, Matthew J O’Brien 
^8
 
9
 
10
, Jonathan M Samet 
^9
 
11
, Gabriel I Uwaifo 
^10
 
12
, Jiang He 
^1
 
2
 
3

Affiliations

• ¹ Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
• ² Tulane University Translational Science Institute, New Orleans, Louisiana.
• ³ Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana.
• ⁴ Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
• ⁵ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
• ⁶ Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts.
• ⁷ Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
• ⁸ Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
• ⁹ Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
• ¹⁰ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
• ¹¹ Colorado School of Public Health, Aurora.
• ¹² Department of Endocrinology, Diabetes, Metabolism, and Weight Management, Ochsner Medical Center, New Orleans, Louisiana.

• PMID:

  36287562

• PMCID:

  PMC9606840

• DOI:

  10.1001/jamanetworkopen.2022.38645

Abstract

Importance:

Low-carbohydrate diets decrease hemoglobin A1c (HbA1c) among patients with type 2 diabetes at least as much as low-fat diets. However, evidence on the effects of low-carbohydrate diets on HbA1c among individuals with HbA1c in the range of prediabetes to diabetes not treated by diabetes medications is limited.

Objective:

To study the effect of a behavioral intervention promoting a low-carbohydrate diet compared with usual diet on 6-month changes in HbA1c among individuals with elevated untreated HbA1c.

Design, setting, and participants:

This 6-month randomized clinical trial with 2 parallel groups was conducted from September 2018 to June 2021 at an academic medical center in New Orleans, Louisiana. Laboratory analysts were blinded to assignment. Participants were aged 40 to 70 years with untreated HbA1c of 6.0% to 6.9% (42-52 mmol/mol). Data analysis was performed from November 2021 to September 2022.

Interventions:

Participants were randomized to a low-carbohydrate diet intervention (target <40 net grams of carbohydrates during the first 3 months; <60 net grams for months 3 to 6) or usual diet. The low-carbohydrate diet group received dietary counseling.

Main outcomes and measures:

Six-month change in HbA1c was the primary outcome. Outcomes were measured at 0, 3, and 6 months.

Results:

Of 2722 prescreened participants, 962 underwent screening, and 150 were enrolled (mean [SD] age, 58.9 [7.9] years; 108 women [72%]; 88 Black participants [59%]) and randomized to either the low-carbohydrate diet intervention (75 participants) or usual diet (75 participants) group. Six-month data were collected on 142 participants (95%). Mean (SD) HbA1c was 6.16% (0.30%) at baseline. Compared with the usual diet group, the low-carbohydrate diet intervention group had significantly greater 6-month reductions in HbA1c (net difference, -0.23%; 95% CI, -0.32% to -0.14%; P < .001), fasting plasma glucose (-10.3 mg/dL; 95% CI, -15.6 to -4.9 mg/dL; P < .001), and body weight (-5.9 kg; 95% CI, -7.4 to -4.4 kg; P < .001).

Conclusions and relevance:

In this randomized clinical trial, a low-carbohydrate dietary intervention led to improvements in glycemia in individuals with elevated HbA1c not taking glucose-lowering medication, but the study was unable to evaluate its effects independently of weight loss. This diet, if sustained, might be a useful dietary approach for preventing and treating type 2 diabetes, but more research is needed.

Trial registration:

ClinicalTrials.gov Identifier: NCT03675360.

Conflict of interest statement

Conflict of Interest Disclosures: Dr Dorans reported receiving grants from the National Heart, Lung, and Blood Institute outside the submitted work. Dr Bazzano reported receiving grants from the National Institutes of Health during the conduct of the study. No other disclosures were reported.

Figures

Figure 1.. Study Flow Diagram

eGFR indicates…

Figure 1. . Study Flow Diagram

eGFR indicates estimated glomerular filtration rate.

Figure 1.. Study Flow Diagram

eGFR indicates estimated glomerular filtration rate.

Figure 2.. Mean Estimated Primary and Secondary…

Figure 2.. Mean Estimated Primary and Secondary Outcomes

^a P < .05 for between-group net…

Figure 2.. Mean Estimated Primary and Secondary Outcomes

^aP < .05 for between-group net change from baseline.

See this image and copyright information in PMC

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5 Ways to Lower A1C and Manage Your Blood-Sugar Levels

• To lower A1C levels, you may need to lose weight, get regular exercise, regulate your carbohydrate intake,  take insulin, or use medication like metformin.  
• A1C levels measure your blood sugar over a period of about 12 weeks and are an important indicator for people with type 1 or type 2 diabetes, as well as those at risk.
• This article was reviewed by Jason R. McKnight, MD, MS, a family-medicine physician and clinical assistant professor at Texas A&M College of Medicine.
• This story is part of Insider’s guide to Diabetes. 

An A1C test measures the amount of glucose in your blood over the previous 12 weeks. This is important because it provides a long-term measure of blood-sugar levels, which are used to diagnose and manage diabetes or prediabetes.

Those with type 1 or type 2 diabetes should have their A1C levels measured about every three months. If you’re at an increased risk, you should have A1C measured twice a year, says Dr. Charles Richardson, the CEO of Cleveland Diabetes Care.

Through an A1C test, early detection of elevated blood-sugar levels can help reduce the risk of health complications from diabetes, like heart disease or kidney disease. Here’s what you need to know about A1C levels and how to lower them.

What is A1C? 

A1C represents the amount of glycosylated hemoglobin in your blood. This is the amount of glucose that becomes attached to hemoglobin, a protein in red blood cells.

Over the normal 90-day life cycle of a red blood cell, glucose attaches faster in people with higher blood-sugar levels, Richardson explains. A1C measures the percentage of red blood cells that have hemoglobin that is coated with sugar, and it is an important marker of blood sugar.

Otherwise-healthy adults who are overweight — a risk factor for type 2 diabetes — should have their A1C measured every three years by having the doctor order blood work to test A1C. People who have no risk factors for diabetes and are not overweight do not need to check their A1C unless they or their doctor have cause for concern.  

People with diabetes should have A1C measured about every three months, and more often if they have trouble controlling their blood sugars or if they are changing diabetes treatments.

Normal A1C levels 

Your A1C levels can indicate the following: 

• Normal: 5.6% or lower 
• Prediabetes: 5.7% to 6.4% 
• Diabetes: 6.5% or higher 

If you receive a diagnosis of diabetes or prediabetes, your doctor will work with you to set an individual target for your A1C levels. Most people with diabetes have a target A1C level of less than 7%. Doctors might set a higher goal for people with other health conditions like heart disease.

If you have diabetes or prediabetes, lowering your A1C is important. In fact, each percentage-point decrease in A1C levels can reduce risk of long-term complications from diabetes by 40%, according to the American Diabetes Association.

Richardson says the amount considered a significant reduction varies from individual to individual, so you should work with your doctor to set a personal goal. Dropping your A1C by even half a percentage point can have significant benefits, he says.

How to lower A1C 

Your A1C levels are lowered when you reduce your average blood-glucose levels. This can be done through lifestyle changes and medication.

“With a multidisciplinary approach including optimal nutrition, implementing an exercise regimen, and diabetic medication, most patients can lower the hemoglobin A1C,” Richardson says. 

Here are a few of the most effective ways to lower your A1C levels:

1. Lose weight 

Losing weight can help you better control your blood sugars and lower your A1C levels.

A 2012 study published in the journal Diabetes Education found that losing 10% of body weight was linked to a 0.81% decrease in A1C levels for patients with type 2 diabetes.

2. Exercise regularly

“Exercising helps the body absorb glucose from the bloodstream and can help to make the body more efficient at accessing and utilizing glucose,” says Claudia Hleap, a registered dietitian based in Philadelphia who regularly works with patients to lower their A1C levels.

A 2017 study published in BMJ Open Diabetes Research and Care followed 65 patients with type 2 diabetes over eight years. One group completed 90-minute exercise sessions three times a week. Their A1C levels decreased by as much as 1.84%, and researchers concluded that people who exercised reduced their A1C more consistently than those who did not.

3. Count carbohydrates

Working with a dietitian to create an eating plan can help you lower A1C levels. In particular, people with diabetes and prediabetes need to monitor the amount of carbohydrates they eat, since carbs have the greatest effect on blood sugar.

“It is essential to undergo diet education in order to understand how eating certain foods will affect your blood sugars,” Hleap says. “Using this knowledge, it is important to move towards a consistent and controlled carbohydrate diet, in order to create lifelong sustainable dietary changes.”

A 2014 scientific review published in The Lancet Diabetes and Endocrinology found that people with type 1 diabetes who counted carbohydrates reduced their A1C levels 0. 64% more than people who did not count carbs.

For more information, read about how many carbs you should have a day if you’re diabetic.

4. Take oral diabetes medication 

Oral diabetes medications, like metformin, can reduce your A1C levels. A widely cited 2012 scientific review in Diabetes Care found that metformin reduced A1C by an average of 1.12% for people with type 2 diabetes.  

In addition, a 2019 study published in the Pakistan Journal of Medical Sciences followed 200 patients with type 2 diabetes. All of them saw their A1C levels drop within three months of taking metformin at the dose prescribed by their doctors, with the biggest decreases for people with higher starting A1C levels.

5. Use insulin

If your initial A1C levels are higher than 9% — most commonly for people with previously undiagnosed diabetes — your doctor might recommend starting insulin right away.

A 2010 scientific review published in Diabetes Technology and Therapeutics found that insulin regimens reduced A1C by an average of 1. 4% for type 2 diabetics.

Takeaways

Measuring A1C levels is an important way to monitor prediabetes and reduce your risk for diabetes complications. Working with a dietitian and your doctor can help you develop a plan to lower your A1C levels, but having patience is also important, Hleap says.

“Your hemoglobin A1C will not change overnight,” she says. “It is essential to make small and realistic changes one step at a time to ensure that the modifications you’re making to your diet and exercise regimen will be sustainable for the long term. These suggestions take time to implement. Mindset is important in making and sustaining these changes for the long haul.”

• 5 of the best foods to lower blood sugar and manage diabetes
• How to lower your blood sugar quickly and what to do if it’s an emergency
• Is diabetes genetic? Both type 1 and type 2 are influenced by family history — here’s how to know your risk

Kelly Burch

Kelly Burch is a New Hampshire-based freelance journalist writing about finances, health, family, and more. Her work has appeared in The Washington Post, The Chicago Tribune, and Forbes, among others. Follow her on Facebook or Twitter, and or learn more here.   

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Get tested for glycated hemoglobin a1c in Podolsk. Price

Glycated hemoglobin (HbA1c) is an irreversible compound of glucose with hemoglobin in erythrocytes. This process occurs continuously and depends on the concentration of sugar in the blood and the duration of its effect on red blood cells. The level of glycohemoglobin does not change during the life of erythrocytes (90-120 days). Thus, the HbA1c indicator reflects the average concentration of glucose during the previous period (approximately 8-12 weeks) and allows a much better assessment of the degree of glycemia (the level of increase in blood sugar) than the determination of glucose in blood and urine.

When is a hemoglobin HbA1C test usually ordered?

Glycated hemoglobin, together with fasting glucose, is currently the most accurate tool for diagnosing diabetes mellitus (DM) and other forms of glucose metabolism disorders, including latent forms and gestational diabetes. The content of Hb1Ac is not affected by the time of day, exercise, diet, food intake, emotional stress and other external and internal factors that complicate the interpretation of other studies. This test is used to assess the compensation of the disease, the effectiveness of treatment and calculate the risk of complications.

An HbA1c test is required every 3 months for all patients diagnosed with diabetes.

What exactly is determined in the analysis process?

A specific type of hemoglobin, hemoglobin A1C, is isolated from a whole blood sample and measured by high pressure liquid chromatography.

What do the test results mean?

According to the World Health Organization (WHO), the concentration of Hb1Ac in healthy people is no more than 6.0%.

Values ​​from 6.0 to 6.5% are considered borderline and may indicate disorders of carbohydrate metabolism: impaired glucose tolerance, prediabetes, diabetes.

Values ​​above 6.5% are typical for diabetic patients.

Decreased glycohemoglobin levels may be observed in patients with anemia and in the recovery period of the body after blood loss

Usual test time.

Typically, the result of a glycated hemoglobin test is available within 1-2 days after blood donation.

How to prepare for the analysis?

No special training required. Detailed information can be found in the relevant section of the article.

You can donate blood during the day, no earlier than 3 hours after a meal or in the morning on an empty stomach. Pure water can be drunk normally. The day before, adhere to a standard diet, exclude alcohol.

According to the clinical guidelines “ALGORITHMS
SPECIALIZED
MEDICAL CARE FOR PATIENTS WITH DIABETES MELLITUS, 2015″:
less than 6% – normal level
6.0 -6.5% – borderline value
6.5% or more – diagnostic criterion level of DM (diabetic level).

Interpretation:
Elevated levels of glycohemoglobin are possible in the following conditions:
• diabetes mellitus (permanently elevated blood glucose levels)
• false positive result (associated with the presence of genetically abnormal forms of hemoglobin in the blood)
• patients after splenectomy (the level of glycohemoglobin may be increased due to an increase in the lifespan of red blood cells in the bloodstream)
Reduced level of glycohemoglobin is possible in the following conditions:
• hemolytic anemia
• erythropoiesis revival after blood loss

Take a blood test for glycated hemoglobin

In a healthy person who does not have a tendency to diabetes mellitus, the content of glycated hemoglobin in the blood is 4-6. 2%. If predisposed, the level rises to 5.7 to 6.4%. This health condition of the patient is called prediabetes. In the case when the level of altered hemoglobin reaches 6.5% or more, doctors suspect the presence of diabetes mellitus.

The rate of glycated hemoglobin may change with age. At thirty years, 4.9% is considered the norm. At forty years old, 5.8% is considered normal, At fifty years old, the norm is already 6.7%. In pregnant women, the result will always exceed the norm and reach up to 7.5%.

An elevated level of glycated hemoglobin does not appear in one day, its formation is a long process. Therefore, at an elevated level, doctors either talk about the onset of diabetes mellitus or impaired glucose tolerance.

A high level may not be associated with diabetes mellitus, but may occur against the background of:

• Complete lack of physical activity.
• Severe stress and depression.
• A large amount of free Hb in the blood.
• Tumor development.
• Disorders of metabolic processes.

An increase in the percentage of altered Hb can be observed with hypervitaminosis caused by an excess of B vitamins.

A low level of altered hemoglobin will be direct evidence of the presence of life-threatening conditions for the patient. His fall is due to:

• With a lot of blood loss.
• With the development of anemia (anemia).
• Incorrect dose of insulin administered to the patient.
• With disorders in the work of the adrenal glands.
• With hereditary predisposition.

Due to low blood sugar, the patient experiences a severe headache and complains of dizziness. A decrease in the level of glycated hemoglobin against the background of diabetes mellitus means the approach of a hypoglycemic coma. With a low level of glycated Hb, the following are observed:

• Vision problems.
• Drowsiness.
• Frequent syncope.
• Strong irritability.

When examining in this case, renal or hepatic insufficiency or pathologies associated with the destruction of red blood cells can be detected.

Causes of false results

Only insulin and drugs with a similar effect can change the result of the analysis. This group includes: Sulfonamides, Biguanides, Alpha-glycoside inhibitors. They urgently reduce blood sugar and therefore distort the result of the analysis – Repaglinide and Nateglinide.

False will be the numbers obtained from patients suffering from:

• Anemia.
• Diseases of the thyroid gland.

The level of glycated hemoglobin is affected by the intake of vitamins C and E.

The figures obtained immediately after blood transfusion will be overestimated.

Blood for the test is taken both from a finger and from a vein. The place of taking the material does not affect the result.