HbA1c test – a blood test to diagnose and monitor diabetes

Key facts

• HbA1c is a blood test that is used to help diagnose type 2 diabetes and monitor blood glucose control in people who have diabetes.
• People with diabetes are advised to have this test every 3 to 6 months.
• No preparation is needed for this test.
• You should discuss your results with your doctor to see what the test results mean in your situation.

What is an HbA1c test?

HbA1c is a blood test that is used to diagnose type 2 diabetes. It is also used to monitor blood glucose control in people with diabetes.

HbA1c is short for glycated haemoglobin. The test is also sometimes called haemoglobin A1c.

Haemoglobin (Hb) is the protein in red blood cells that carries oxygen through your body. HbA1c refers to glucose and haemoglobin joined together (the haemoglobin is ‘glycated’). The amount of HbA1c formed is directly related to the amount of glucose in your blood.

Red blood cells live for an average of 120 days, so HbA1c gives an indication of how much sugar there has been in your blood over the past few months. It’s different to a blood glucose test, which measures how much sugar is in the blood at that moment.

Why would I need an HbA1c test?

If you are at increased risk of type 2 diabetes, your doctor may recommend this test to check if you have diabetes. The HbA1c test may also be done if you have symptoms of type 2 diabetes, to confirm a diagnosis.

For people with diabetes, the test is used to indicate how well your diabetes has been controlled over the last few months. People with diabetes are advised to have this test every 3 months. This can be less frequent if your blood sugar levels are well controlled.

Monitoring HbA1c in people with diabetes is important. That’s because the higher your HbA1c, the greater your risk of developing diabetes complications such as:

• diabetic retinopathy
• diabetic kidney disease
• diabetic neuropathy

How to prepare for an HbA1c test

No preparation is needed for this blood test.

Understanding your results

It’s important to discuss your test results with your doctor to see what they mean in your situation.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

Diagnosis of diabetes

A diagnosis of diabetes can be made if your HbA1c result is 6.5% (48 mmol/mol) or more. Sometimes the test needs to be repeated to confirm the result.

If your HbA1c level is lower than this, you might need other tests to check whether you have diabetes or not.

Diabetes monitoring

If you have diabetes, the recommended general HbA1c target is 7% (53 mmol/mol) or less.

Your HbA1c target will depend on several factors, such as:

• the type of diabetes you have
• how long you have had diabetes
• your health in general

If your HbA1c result is higher than your target range, your doctor may consider changing your treatment or monitoring your blood sugars more closely.

What can affect my result?

Some medical conditions can alter HbA1c results, including:

• anaemia
• iron deficiency
• kidney failure
• pregnancy

Talk to your doctor about your results and what they mean for you.

HbA1c test explanation video

Video provided by Pathology Tests Explained

Resources and support

About HbA1c testing

Visit the Pathology Tests Explained website for more information about HbA1c testing.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

About blood testing

See our ‘Guide to blood testing’ to learn more about blood tests in general with information such as:

• what happens during a blood test
• the accuracy of your blood test results
• the cost of your blood tests

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Hemoglobin A1C (HbA1c) Test – Testing.com

Test Quick Guide

The hemoglobin A1c test estimates how much glucose, or blood sugar, has been in your bloodstream over the last three months. A marker for long-term glucose control, this test can identify diabetes or keep track of how well it is being controlled.

About the Test

Purpose of the test

The hemoglobin A1c test may have several purposes:

• Screening for prediabetes and diabetes: If you are over 40 and are obese, overweight, or otherwise at high risk for diabetes, your doctor may want to check for health conditions before you experience symptoms. The test can be used for diabetes screening, but the results may need to be confirmed by repeating the test or using another type of test.
• Diagnosing prediabetes and diabetes: This uses tests and procedures to find out the cause of health changes. Your doctor may order hemoglobin A1c and other tests if you have symptoms or show signs of diabetes. Symptoms can include excessive thirst, frequent urination, blurred vision, tingling or loss of sensation in the feet and hands, and feeling extremely tired.
• Monitoring diabetes: If you have been diagnosed with diabetes, your doctor may order this test at least twice a year. This gives your doctor an idea of how well your blood glucose has been controlled in the months between appointments and allows your doctor to make adjustments to your treatment plan and lower your chance of health problems.

The hemoglobin A1c test is not used to diagnose gestational diabetes, a form of the disease that can develop during pregnancy.

What does the test measure?

The hemoglobin A1c test measures the percentage of hemoglobin A in your blood that has glucose attached.

Glucose is the type of sugar that your body uses as its principal energy source. Your body makes or receives glucose from the food you eat. The glucose enters your bloodstream and is taken up by your body’s cells with the help of a hormone called insulin.

If your body isn’t able to make enough insulin, or if your body’s cells have trouble accepting insulin, your blood glucose level can rise to a dangerous level. This may lead to diabetes, a serious disease that can damage your body’s organs if it is not kept under control.

Glucose has the ability to attach to hemoglobin in the blood and form hemoglobin A1c. Hemoglobin is the protein in red blood cells that carries oxygen. Measurement of hemoglobin A1c reflects the percentage of hemoglobin A that is attached to glucose compared to the total amount of hemoglobin A in the blood.

The more glucose in the blood, the more glucose can attach to hemoglobin. If your hemoglobin A1c percentage is too high, your average blood glucose in the previous months has been too high as well.

When should I get this test?

The CDC recommends every adult age 45 and older, or those under 45 who are overweight and have risk factors for prediabetes or type 2 diabetes get a baseline A1c test.

If your result comes back normal, repeat the test every three years. If your results show you have prediabetes, repeat the test as often as your doctor recommends, which is usually every one to two years.

If you have diabetes, it is important to get an A1c test at least once a year and more often if you change your medication or have other health conditions. Your doctor can help determine how often you should get tested.

Finding a Hemoglobin A1c Test

How can I get a hemoglobin A1c test?

A hemoglobin A1c test is usually ordered by a doctor. Your doctor may refer you to a lab to have the test performed. Or, if the test is to monitor your diabetes, you may have the test in your doctor’s office. Your doctor may also recommend an at-home version of the test.

Can I take the test at home?

The FDA has approved or cleared a number of over-the-counter hemoglobin A1c test kits that you can use at home. At-home versions of the hemoglobin A1c test may not be as accurate as tests that are performed in a lab. But they offer a convenient alternative to testing in a medical office, which may be useful for some patients.

Your doctor can advise you whether taking the test at home would be right for you and may be able to recommend a specific brand.

How much does the test cost?

The full cost of a hemoglobin A1c test depends on many variables, such as what type of hemoglobin A1c test your doctor orders for you, where the test is performed, whether you have medical insurance, and how much of the cost your insurance provider will cover.

Hemoglobin A1c testing can involve several different charges. These can include fees charged by the laboratory for the technician’s labor and the analysis of your sample, as well as the costs of your visits to your doctor’s office to receive the test or discuss its results.

If your doctor has ordered a hemoglobin A1c test for you, many of these charges will be paid in part or in full by your insurance company. But you may still be responsible for out-of-pocket expenses such as deductibles or copayments. Your doctor or insurance provider can give you more information about the costs that you can expect to pay.

The price of an at-home hemoglobin A1c test device can vary greatly depending on the test kit and manufacturer, the number of tests that come with the kit, and whether the device is covered by your insurance. You may also need to pay for replacement cartridges or other components if you use the device regularly.

Taking a Hemoglobin A1c Test

The hemoglobin A1c test requires a sample of blood. If the test is performed at a lab, the sample is taken through a needle from a vein. And if the test is performed in a doctor’s office or taken at home, a fingerstick is used to obtain the blood sample.

Before the test

You do not need to make any specific preparations before getting your hemoglobin A1c test. But be sure to talk to your doctor about any additional tests that may be conducted during the same visit, since some of those tests may require you to fast or change your diet beforehand or to prepare in other ways.

During the test

For a hemoglobin A1c test that uses a blood sample from a vein, the phlebotomist may start by tying a band at the top of your arm under your shoulder to put pressure on your vein, increasing blood flow. They will clean the skin around your vein using a sterile wipe, then insert a small needle into the vein in the pit of your elbow. Your blood sample will be collected in a tube attached to the needle.

You may notice mild discomfort or stinging when the phlebotomist inserts or removes the needle. Most of the time, your blood draw will take five minutes or less to complete.

If your hemoglobin A1c test uses a fingerstick blood sample, your doctor, nurse, or medical assistant will use a lancet to prick the tip of your finger until a drop of blood appears. You may feel a small amount of pain when your finger is pricked. The blood sample will be mixed with a special substance and then put into a cartridge that is inserted into the testing machine.

For at-home testing, you will collect a blood sample from your finger and process the sample yourself.

After the test

You can generally return to normal activities after the hemoglobin A1c test. If you receive a blood draw, the phlebotomist will put a small bandage over the injection site to make sure any bleeding stops. You may want to leave the bandage on for an hour or more. You may notice some bruising where the needle was inserted.

Fingersticks do not typically cause lasting pain or discomfort. If needed, you can apply a bandage to your fingertip to stop the bleeding.

Hemoglobin A1c Test Results

Receiving test results

If your hemoglobin A1c test was performed in a lab, you will generally receive test results in a few business days. Your results may be available to access online, or they may be sent to you through postal mail or email. Your doctor may call you or reach you by email to talk over your results.

If you have a fingerstick hemoglobin A1c test, your test results will be available in a few minutes. Your doctor may discuss the results right away or may schedule an appointment to go over the results at a later date.

Interpreting test results

Hemoglobin A1c test results are given as percentages. Your test report will also have information on the reference ranges used to interpret your results. Reference ranges are the test result ranges considered normal and the test result ranges that may indicate prediabetes or diabetes.

Doctors use the reference ranges along with your overall health context to interpret the results of your hemoglobin A1c test. Your results will be interpreted differently depending on whether the test is used to diagnose or monitor diabetes that has already been diagnosed.

For diagnostic hemoglobin A1c testing, many expert organizations cite these reference ranges:

• Normal: Under 5.7 percent
• Prediabetes: 5. 7 to 6.4 percent
• Diabetes: At or over 6.5 percent

While the hemoglobin A1c test can be used to diagnose diabetes, doctors do not often rely on the results of just one test to make this diagnosis. Your doctor may order a repeat of your hemoglobin A1c test or compare your results with other tests that have been performed. Your doctor may also order additional diagnostic tests, such as other blood glucose tests.

To understand what the results of a diagnostic hemoglobin A1c test mean for you, it’s important to talk about them thoroughly with your doctor. They can address how your hemoglobin A1c results fit into the reference ranges, what follow-up tests might be required, and what next steps to take in managing your health.

If your test results show that you have prediabetes, this means that you could have an increased risk of diabetes in the coming years. Your doctor may advise you to make changes to your diet, exercise routine, and other aspects of your lifestyle that could reduce your chance of developing diabetes or delay the onset of this disease.

If you are given a diagnosis of diabetes, your doctor or another health care provider may give you advice about monitoring and managing the disease over time. Steps to take often include using blood glucose tests at home, repeating hemoglobin A1c tests periodically, and making lifestyle changes. You may also be prescribed medications to help control your blood sugar.

When the test is used to monitor diabetes, you will work with your doctor to establish a target hemoglobin A1c number. This goal will be specific to you and may change during the course of your diabetes care based on factors such as your age, your past success in controlling blood glucose levels, and any diabetic complications you may have. Your doctor will also consider whether you are prone to low blood glucose.

Resources

• Glucose Tolerance Test
  Learn More
• Fructosamine
  Learn More
• Continuous Glucose Monitoring
  Learn More
• American Diabetes Association
  Learn More
• CDC: Diabetes
  Learn More
• National Institute of Diabetes and Digestive and Kidney Diseases: Managing Diabetes
  Learn More

Sources

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Blood test for glycated hemoglobin – will help to detect diabetes in the early stages!

Blood test for glycated hemoglobin – will help to detect diabetes in the early stages!

Glycated or glycosylated hemoglobin is the most important indicator of a biochemical nature, showing the level of sugar in the blood over a certain period. In general, this is a complex consisting of hemoglobin and glucose, which are irreversibly connected, which is a sign of diabetes. With the help of an analysis for glycated hemoglobin in the blood, diabetes can be detected in the early stages, and this helps to start timely and adequate treatment, which will certainly give positive results in improving the patient’s condition.

Glycosylated hemoglobin is present in any blood: both in healthy people and in those with diabetes. But the essential difference lies in the fact that in a patient with diabetes, its norm is significantly exceeded and this becomes the reason for the further development of diabetes and all serious complications against its background.

Benefits of Glycated Hemoglobin:

• It can be done at any time, whether you have eaten a large meal or on an empty stomach;
• It more effectively and accurately allows you to detect diabetes in the early stages;
• Testing is much easier and faster than other tests;
• Helps doctors understand if a person with diabetes has accurately controlled their blood sugar levels in the past 3 months;
• The quality and accuracy of the analysis are not affected by other factors (infectious, viral and colds).

First of all, this analysis allows not only to identify the early stages of diabetes mellitus that have already begun, but even to show whether a person has a predisposition to diabetes mellitus. It is the preventive measures to prevent the risk of developing and developing diabetes mellitus that graze a person’s life and allow him to live a normal life.

The second important aspect of the analysis is the ability to understand how attentive the patient is to his health, whether he is able to compensate for the level of sugar in the blood and for a long time to keep it in the norm necessary for his life.

But even healthy people should do this analysis at least once a year to prevent the risk of developing diabetes or to detect diseases in the early stages.

This test is done at any time, regardless of whether blood is taken on an empty stomach or after a meal. You can also conduct this study at the moment when you are taking various sugar-lowering drugs, drugs for other diseases.

For those who have already been diagnosed with diabetes, testing is recommended depending on how well the diabetes is compensated.

General recommendations for glycated hemoglobin testing:

1. If the HbA1C is lower than 5.7% (there is no disease and the risk of developing it is minimal), you can take tests once every few years;
2. With sufficient control of diabetes mellitus and the index of glycated hemoglobin is not higher than HbA1C 7%, it is necessary to do the analysis 1 time in 6 months;

When changing treatment methods or diabetes mellitus and a short history of the disease, testing every 3 months is recommended.

How to test for glycated hemoglobin

Capillary blood is taken to test for glycated hemoglobin. Although there are no contraindications regarding whether on an empty stomach or after a meal, it is better to do the analysis in the morning on an empty stomach, without prior physical exertion. Based on the results of the analyzes, it is possible to draw appropriate conclusions about the state of the person.

Glycated hemoglobin test results show:

• With HbA1C less than 5.7%, there is no risk of developing diabetes and carbohydrate metabolism is normal;
• With HbA1C, which is from 5.7 to 6.0%, the disease is not yet present, but the person is at risk;
• With HbA1C, which is from 6.1 to 6.4% of the disease, there is still no disease, but the degree of risk is already determined to be quite high and the person is already recommended to review his diet and use a special diet low in light carbohydrates, start leading an active lifestyle and engage in physical loads;
• If HbA1C is greater than or equal to 6. 5%, the doctor diagnoses pre-diabetes and additional laboratory tests are needed to obtain a refutation or confirmation of the disease.
• It is important to know: the lower the glycated hemoglobin in a patient with diabetes, the more carefully he compensated for it during the previous 3 months. As a rule, the indicator should vary between 5 and 7%.
• Regular analysis helps not only to slow down the further development of diabetes, but even significantly reduce the risk of complications associated with diabetes, which is very important for the patient.
• Important to know: even a 1% decrease in HbA1C is an extension of the life of a diabetic by several more years!
• The main goal of all therapy for a diabetic patient is to achieve a normal HbA1C level, which should be less than or equal to 7%. If this goal is achieved, it can be said with confidence that diabetes mellitus is well compensated and the risks of developing various complications are minimized.
  Of course, it is best to achieve an HbA1C level that is present in healthy people and is no more than 4.6%, and this is the level that a diabetic patient should always strive for.
• It is important to know: such indicators of glycated hemoglobin as 4.6% can be achieved with any type of diabetes mellitus, for this you need to follow a diet and lead a healthy, active lifestyle with the necessary physical activity.
• You can simplify your life and get the right level of glycated hemoglobin even without the help of sugar-lowering drugs: a diet low in carbohydrates will make it possible to inject less insulin, which means that the risk of developing hypoglycemia will also decrease.
• After testing for glycated hemoglobin, the HbA1C in the elderly should be no more than 8%, better when it is 7.5%.
• HbA1C in children, adolescents, pregnant women should be less than 6.5%, and ideally even lower than 5%.
• Glycated hemoglobin testing is vital and very important. A large percentage of diabetic patients die due to the development of cardiovascular complications and stroke, kidney failure and other diseases. To prevent such complications and live a fairly long life, it is necessary to control not only the level of sugar in the blood, but also to undergo regular studies on glycated hemoglobin.
• Many diabetic patients make one terrible mistake when they think that the analysis of glycated hemoglobin and positive data allows not to carry out self-monitoring of blood sugar levels.
• Based on the above, it is always necessary to evaluate the HbA1C indicator during self-monitoring and obtaining its results, which will help to understand how and with what dynamics the disease proceeds.
  • Observe special diet and regimen.
  • Actively engage in physical education.
  • Take medication or insulin on time.
  • Maintain sleep and wake patterns.
  • Monitor glucose levels at home more often.
  • Arrive to your appointment on time.
    • HbA1c should be determined once every three months. After evaluating the result, take appropriate measures.
    • HbA1c testing does not replace the measurement of blood sugar with a regular glucometer.
    • Even if you have an ideal HbA1c, but there are daily fluctuations in blood sugar of more than 5 mmol / l, then this cannot in any way protect you from the development of complications. It has been proven that with the same indicator, those who have had or have such fluctuations are most susceptible to complications.
    • Reduce long-term elevated HbA1c levels gradually, at 1% per year.
    • Do not chase the ideal, strive for your target. What is given to the young can harm the elderly.

to the content How and how to reduce glycated hemoglobin Reducing glycated hemoglobin is inextricably linked with a decrease in blood glucose levels. Therefore, in order to reduce the level of HbA1c, it is necessary to follow all the doctor’s recommendations for the treatment of diabetes, namely:

If you see that from all your efforts, the glucose level normalizes during the day and you feel better, then you are on the right track and then the next blood test will please you well.

Glycated hemoglobin summary:

Total:

Lead a healthy lifestyle, because the causes of diabetes most often lie in malnutrition.

If a doctor has diagnosed diabetes, one diet is no longer enough. In this case, you will be assigned additional examinations and recommended treatment. If you follow all the recommendations of a specialist, you can live a full life for many years, regularly monitoring blood sugar levels.

Clinician

laboratory diagnostics Elena V. Shishkina

Views: 502503

Glycated hemoglobin (HbA 1c)

The main task of the doctor in the treatment of diabetes is to normalize the level of glucose in the blood. The patient can control this metabolite in the blood either independently (with portable glucometers) or in the laboratory. By a single determination of blood glucose, it is possible to judge only the concentration of glucose at the time of taking, therefore, it is not possible to assume the state of the patient’s carbohydrate metabolism between measurements. To assess the patient’s carbohydrate metabolism over a longer period of time, it is necessary to conduct a test for the content of glycated hemoglobin (HbA1c) in the blood.

According to data obtained from a 10-year study called DCCT (The Diabetes Control and Complications Trial) conducted by the National Institute of Diabetes, Digestive and Kidney Diseases (USA) in the USA and Canada in 1983-1993, it was found that glycemic control, correlated by the level of HbA1c concentration, is directly related to the risk of developing long-term complications of type 1 diabetes and their progression. In 1999, specialists from the UK showed that a decrease in the content of glucose in the patient’s serum, assessed by the concentration of HbA1c, reduces the number of microangiopathies in type 2 diabetes mellitus.

Glycated hemoglobin is hemoglobin in which the glucose molecule is non-enzymatically linked to the β-terminal valine of the β-globin chains of hemoglobin A1 and is referred to as HbA1c. The content of HbA1c has a direct correlation with the level of blood glucose. Normally, the concentration of HbA1c is from 4.4 to 6.1%; in diabetic patients, its level depends on the degree of hyperglycemia and is usually 2-3 times higher than normal values. Glycated hemoglobin accumulates inside erythrocytes and persists throughout the entire period of erythrocyte circulation in the bloodstream, which is about 60 days. Thus, the concentration of HbA1c reflects the degree of glycemia for 60 – 90 days before study. Multiple studies of glucose measurement with traditional methods have confirmed the relationship between HbA1c and the patient’s glycemic level. The results of the DCCT studies conducted in the 1990s confirmed the hypothesis that the HbA1c level is directly related to the level of glucose in the blood and is the most appropriate criterion in monitoring the effectiveness of the treatment of patients with diabetes mellitus.

In the early 1990s, there was no single internationally agreed standardization for the measurement of glycated hemoglobin, which reduced the clinical effectiveness of this test. In order to achieve a single standard and overcome the problems associated with its development, the International Federation of Clinical Chemistry (IFCC) created in 1993 Working Group on Standardization of HbA1c Assessment. Her work resulted in the National Glycosylated Hemoglobin Standardization Program (NGSP). Most manufacturers of devices and kits for testing blood for glycosylated hemoglobin are required to be checked for compliance with the results obtained with reference methods. If the test result satisfies the reference data, the manufacturer is issued an “NGSP certificate of conformity”. The American Diabetes Association (ADA) recommends that all laboratories use NGSP certified glycosylated hemoglobin blood tests.

There are many analytical methods available for the determination of HbA1c. These methods include electrophoresis, liquid chromatography, affinity chromatography, immunological techniques, column techniques. One of the main criteria when choosing an analyzer for performing a blood test for glycated hemoglobin is the availability of a reference NGSP method, which is liquid chromatography. When using standardized test methods, the laboratory has the ability to compare the results obtained with data obtained using reference methods. Such a comparison maximizes the reliability of the research results.

It is of undeniable importance that the treating physician only use test results obtained from laboratories using NGSP-certified glycated hemoglobin blood tests.

Indications for

• Diagnosis of diabetes mellitus and other disorders of carbohydrate metabolism.
• Evaluation of the effectiveness of therapy in diabetes mellitus.

Preparation for analysis

• It is recommended to donate blood for research on an empty stomach, you can only drink water.
• At least 8 hours must have elapsed since the last meal.
• Blood sampling should be carried out before the start of medication (if possible) or no earlier than 1-2 weeks after their withdrawal. If it is impossible to cancel drugs in the direction for the study, it should be indicated which drugs the patient receives and in what doses.
• The day before blood sampling, limit fatty and fried foods, do not take alcohol, exclude heavy physical exertion.

Factors affecting test results

• Hemolysis, clot in sample.

Prescribing physician

Therapist, endocrinologist.

Attention! The interpretation of test results is for informational purposes, is not a diagnosis and does not replace the advice of a doctor. Reference values ​​may differ from those indicated depending on the equipment used, actual values ​​will be indicated on the results sheet.

The research team conducted DCCT studies demonstrating the clinical relevance of HbA1c as an estimate of mean blood glucose (over 60 to 90 days). The scheme of the study was as follows: once every 3 months, a daily glucose profile was taken from patients (according to seven measurements daily) and then compared with the level of HbA1c. For 9 years, more than 36,000 studies have been conducted.

A linear dependence of the HbA1 level and the average glucose content was experimentally obtained:

Mean glucose concentration (mmol/l)= HbA1cx 1.59 -2.59, where:

HbA1c is the concentration of glycated hemoglobin.

Simply put, a 1% change in HbA1c corresponds to a 1.59 mmol/L change in mean glucose. Note: This relationship was obtained in the study of glucose concentration in capillary blood.
The chart (Fig. 1) can be used to interpret the results of HbA1c studies.

Rice. 1. Diagram of the control of carbohydrate metabolism in patients with diabetes mellitus.

Note: Glucose concentration is indicated in mmol/l, in parentheses in mg/100 ml, 1 – High risk of developing long-term complications such as retinopathy, nephropathy and neuropathy. 2 – Increased risk of hypoglycemic reactions in patients with type 1 or 2 diabetes when taking insulin or oral hypoglycemic drugs.

The American Diabetes Association (1999) recommends screening successful patients (stable blood glucose) for HbA1c at least 2 times a year, and increasing the frequency of screening to 4 times if diet or treatment changes. once a year. In Russia, in accordance with the Targeted Federal Program “Diabetes Mellitus”, it is recommended to study HbA1c in patients with diabetes mellitus at least once a quarter for any type of diabetes.

A special monitoring regimen is recommended by the American Diabetes Association (1999) for women with diabetes when planning a pregnancy. The level of HbA1c should be reduced to create optimal conditions in the body of the expectant mother for conception and fetal development. In early pregnancy, HbA1c should be monitored once a month. When an optimal blood glucose level is reached, as a result of appropriate therapy, an HbA1c test should be carried out at an interval of 6 to 8 weeks before conception.

Modern research has shown that often patients do not comply with the recommended frequency of examinations, however, experts say that the risk of complications in patients with diabetes is significantly reduced with regular examinations for HbA1c. The goal of hypoglycemic therapy in diabetes mellitus is to normalize blood glucose levels. Studies within the DCCT (DCCT Research Group, 1993) have shown that with intensive treatment, the risk of such long-term complications as neuropathy, nephropathy, retinopathy is significantly reduced, or the duration of their clinical manifestation is shifted in time. Patients must strictly adhere to the regimen aimed at normalizing carbohydrate metabolism, then the incidence of nephropathy is 35–36%, the risk of polyneuropathies is reduced by 60%, and retinopathy is reduced by 75%.

Below is a list of therapeutic targets for the treatment of diabetes mellitus according to the Target Federal Program “Diabetes Mellitus”.

Table 1. Therapeutic goals in the treatment of type 1 diabetes mellitus.

Table 2. Therapeutic goals in the treatment of type 2 diabetes mellitus.

Note: Glucose values ​​in mg% (mg/100 ml) are in brackets.

The Federal Target Program “Diabetes Mellitus” set the values ​​recommended by the European Diabetes Policy Group in 1998.

As shown by the results of treatment for patients with an unusual pattern of diabetes, with concomitant diseases, the elderly, young people, pregnant women, it is necessary to apply other standards for the stabilization of carbohydrate metabolism.