What is A1C and how does it relate to diabetes. How often should you get an A1C test. What factors can affect your A1C results. How to interpret your A1C levels and set appropriate goals.

What is A1C and Why is it Important?

A1C, also known as hemoglobin A1C or HbA1c, is a crucial blood test that provides valuable insights into your average blood sugar levels over the past three months. This test plays a pivotal role in diagnosing prediabetes and diabetes, as well as monitoring the effectiveness of diabetes management strategies.

How does A1C work? When sugar enters your bloodstream, it attaches to hemoglobin, a protein found in your red blood cells. The A1C test measures the percentage of red blood cells that have sugar-coated hemoglobin. This percentage directly correlates with your average blood sugar levels over the past 90 days.

The Significance of A1C in Diabetes Management

Why is A1C so important for people with diabetes or those at risk? The A1C test offers several advantages:

• It provides a long-term view of blood sugar control
• It doesn’t require fasting
• It’s less affected by day-to-day fluctuations in blood sugar
• It helps predict the risk of diabetes complications

By monitoring A1C levels, healthcare providers can assess the effectiveness of diabetes treatment plans and make necessary adjustments to prevent complications.

Who Should Get an A1C Test and When?

A1C testing is recommended for various groups of people, depending on their risk factors and existing health conditions. Here’s a breakdown of who should consider getting an A1C test:

Testing for Prediabetes or Diabetes

• Adults over 45 years old
• People under 45 who are overweight and have one or more risk factors for prediabetes or type 2 diabetes
• Individuals with a history of gestational diabetes

How often should these groups get tested? For those with normal results but risk factors, the American Diabetes Association recommends retesting every three years. If prediabetes is detected, more frequent testing (every 1-2 years) may be advised.

Monitoring Existing Diabetes

For individuals already diagnosed with diabetes, regular A1C testing is crucial. Most experts recommend getting an A1C test at least twice a year. However, testing frequency may increase if there are changes in medication or other health conditions present.

Interpreting Your A1C Results

Understanding your A1C results is essential for effective diabetes management. Let’s break down the typical ranges and what they mean:

• Normal: Below 5.7%
• Prediabetes: 5.7% to 6.4%
• Diabetes: 6.5% or above

It’s important to note that within the prediabetes range, higher A1C levels indicate a greater risk of developing type 2 diabetes. For those managing diabetes, A1C results can also be reported as estimated average glucose (eAG), which correlates with the numbers seen on a blood sugar meter.

Setting A1C Goals

What should your A1C goal be? While the general target for most people with diabetes is 7% or less, individual goals may vary based on factors such as age, overall health, and risk of hypoglycemia. It’s crucial to work with your healthcare provider to establish a personalized A1C goal that balances effective diabetes management with your unique circumstances.

Factors That Can Affect Your A1C Results

While A1C is a reliable indicator of long-term blood sugar control, several factors can influence the results. Being aware of these factors is crucial for accurate interpretation of your A1C levels:

• Kidney failure, liver disease, or severe anemia
• Certain genetic hemoglobin variants
• Some medications, including opioids and HIV treatments
• Recent blood loss or transfusions
• Pregnancy

Do any of these factors apply to you? If so, it’s essential to discuss them with your healthcare provider. They may recommend additional tests to ensure accurate assessment of your blood sugar control.

The Relationship Between A1C and Daily Blood Sugar Monitoring

While A1C provides valuable long-term insights, it doesn’t replace the need for regular blood sugar testing at home. Why is this the case? A1C represents an average over three months, but it doesn’t capture the daily fluctuations in blood sugar levels that can significantly impact your health and well-being.

How do A1C and daily monitoring complement each other? Consider the following:

• A1C gives a broad overview of blood sugar control
• Daily monitoring reveals immediate effects of food, exercise, and medication
• Combining both methods provides a comprehensive picture of diabetes management

By integrating A1C results with daily blood sugar readings, you and your healthcare team can make more informed decisions about your diabetes management plan.

Strategies for Improving Your A1C Levels

If your A1C levels are higher than desired, there are several strategies you can employ to bring them down. Here are some evidence-based approaches:

1. Maintain a balanced diet rich in whole grains, lean proteins, and vegetables
2. Engage in regular physical activity, aiming for at least 150 minutes of moderate exercise per week
3. Take medications as prescribed by your healthcare provider
4. Monitor your blood sugar regularly and keep a log
5. Manage stress through relaxation techniques or counseling
6. Get adequate sleep, aiming for 7-9 hours per night
7. Stay hydrated by drinking plenty of water

Which of these strategies might be most effective for you? The answer depends on your individual circumstances, current lifestyle, and medical history. Work closely with your healthcare team to develop a personalized plan for improving your A1C levels.

The Role of A1C in Preventing Diabetes Complications

Maintaining good A1C levels is not just about managing diabetes day-to-day; it’s also crucial for preventing long-term complications. How does A1C relate to diabetes complications?

Research has shown that higher A1C levels are strongly associated with an increased risk of various diabetes-related complications, including:

• Cardiovascular disease
• Kidney damage (nephropathy)
• Eye problems (retinopathy)
• Nerve damage (neuropathy)
• Foot problems

By keeping your A1C levels within your target range, you can significantly reduce your risk of developing these serious health issues. How much can good A1C control impact your health? Studies have demonstrated that even a 1% reduction in A1C can lead to a 15-20% decrease in the risk of major cardiovascular events and a 37% reduction in microvascular complications.

The Importance of Consistent A1C Monitoring

Given the critical role of A1C in predicting and preventing complications, consistent monitoring is essential. Regular A1C tests allow you and your healthcare team to:

• Track progress over time
• Identify trends or patterns in your blood sugar control
• Make timely adjustments to your diabetes management plan
• Catch potential issues before they become serious problems

How often should you have your A1C checked? For most people with diabetes, the American Diabetes Association recommends A1C testing at least twice a year. However, if your treatment plan changes or if you’re not meeting your goals, more frequent testing may be necessary.

Emerging Technologies and the Future of A1C Monitoring

As diabetes care continues to evolve, new technologies are emerging that may complement or even revolutionize A1C testing. What innovations are on the horizon for diabetes management?

Continuous Glucose Monitoring (CGM)

CGM devices provide real-time glucose readings throughout the day and night, offering a more comprehensive view of blood sugar patterns. How does this relate to A1C? While CGM doesn’t replace A1C testing, it can provide valuable insights that complement A1C results, helping to identify periods of high or low blood sugar that may not be reflected in the A1C average.

Time in Range (TIR)

Time in Range is a metric that measures the percentage of time a person’s blood glucose levels are within a target range. Some researchers suggest that TIR could be as valuable as A1C in assessing overall glucose control. How might TIR and A1C work together? By combining these two measures, healthcare providers can gain a more nuanced understanding of a person’s diabetes management.

Glycated Albumin Testing

Glycated albumin is an alternative marker for average blood glucose levels over a shorter period (2-3 weeks) compared to A1C. In what situations might glycated albumin testing be useful? This test could be particularly beneficial for people with conditions that affect A1C accuracy, such as certain anemias or kidney disease.

As these technologies continue to develop, they may offer new ways to complement or enhance the insights provided by A1C testing, potentially leading to more personalized and effective diabetes management strategies.

The Psychological Impact of A1C Results

While A1C is a valuable clinical tool, it’s important to recognize the psychological impact that A1C results can have on individuals managing diabetes. How can A1C affect a person’s emotional well-being?

The Emotional Roller Coaster of A1C Results

For many people with diabetes, receiving A1C results can be an emotionally charged experience. A lower-than-expected A1C might bring feelings of accomplishment and motivation, while a higher result could lead to disappointment, frustration, or even anxiety.

It’s crucial to remember that A1C is just one piece of the diabetes management puzzle. How can you maintain a healthy perspective on A1C results?

• Focus on trends rather than single results
• Celebrate improvements, no matter how small
• Use higher results as motivation for positive changes rather than self-criticism
• Remember that diabetes management is a journey, not a destination

The Role of Healthcare Providers in A1C Discussions

Healthcare providers play a crucial role in helping patients interpret and respond to their A1C results. How can healthcare professionals support patients emotionally when discussing A1C?

• Use empathetic communication
• Provide context for the results
• Offer practical strategies for improvement
• Acknowledge the effort involved in diabetes management
• Encourage patients to express their feelings about their results

By addressing both the clinical and emotional aspects of A1C results, healthcare providers can help patients maintain a balanced and positive approach to their diabetes management.

Building Resilience in Diabetes Management

Developing resilience is key to long-term success in diabetes management. How can individuals build resilience in the face of A1C challenges?

• Practice self-compassion
• Set realistic, achievable goals
• Seek support from family, friends, or diabetes support groups
• Focus on overall health and well-being, not just numbers
• Celebrate non-A1C-related successes in diabetes management

By cultivating a resilient mindset, individuals can navigate the ups and downs of A1C results more effectively, maintaining motivation and a positive outlook on their diabetes journey.

All About Your A1C

Español (Spanish) | Print

What has your blood sugar been up to lately? Get an A1C test to find out your average levels—important to know if you’re at risk for prediabetes or type 2 diabetes, or if you’re managing diabetes.

The A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months. It’s one of the commonly used tests to diagnose prediabetes and diabetes, and is also the main test to help you and your health care team manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is really important if you have diabetes.

What Does the A1C Test Measure?

When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. Everybody has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin.

Who Should Get an A1C Test, and When?

Testing for diabetes or prediabetes:
Get a baseline A1C test if you’re an adult over age 45—or if you’re under 45, are overweight, and have one or more risk factors for prediabetes or type 2 diabetes:

• If your result is normal but you’re over 45, have risk factors, or have ever had gestational diabetes, repeat the A1C test every 3 years.
• If your result shows you have prediabetes, talk to your doctor about taking steps now to improve your health and lower your risk for type 2 diabetes. Repeat the A1C test as often as your doctor recommends, usually every 1 to 2 years.
• If you don’t have symptoms but your result shows you have prediabetes or diabetes, get a second test on a different day to confirm the result.
• If your test shows you have diabetes, ask your doctor to refer you to diabetes self-management education and support services so you can have the best start in managing your diabetes.

Managing diabetes:
If you have diabetes, get an A1C test at least twice a year, more often if your medicine changes or if you have other health conditions. Talk to your doctor about how often is right for you.

How to Prepare for Your A1C Test

The test is done in a doctor’s office or a lab using a sample of blood from a finger stick or from your arm. You don’t need to do anything special to prepare for your A1C test. However, ask your doctor if other tests will be done at the same time and if you need to prepare for them.

Your A1C Result

Diagnosing Prediabetes or Diabetes

A normal A1C level is below 5.7%, a level of 5. 7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.

Managing Diabetes
Your A1C result can also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you’re used to seeing on your blood sugar meter:

What Can Affect Your A1C Result?

Get your A1C tested in addition to—not instead of—regular blood sugar self-testing if you have diabetes.

Several factors can falsely increase or decrease your A1C result, including:

• Kidney failure, liver disease, or severe anemia.
• A less common type of hemoglobin that people of African, Mediterranean, or Southeast Asian descent and people with certain blood disorders (such as sickle cell anemia or thalassemia) may have.
• Certain medicines, including opioids and some HIV medications.
• Blood loss or blood transfusions.
• Early or late pregnancy.

Let your doctor know if any of these factors apply to you, and ask if you need additional tests to find out.

Your A1C Goal

The goal for most people with diabetes is 7% or less. However, your personal goal will depend on many things such as your age and any other medical conditions. Work with your doctor to set your own individual A1C goal.

Younger people have more years with diabetes ahead, so their goal may be lower to reduce the risk of complications, unless they often have hypoglycemia (low blood sugar, or a “low”). People who are older, have severe lows, or have other serious health problems may have a higher goal.

A1C: Just Part of the Toolkit

A1C is an important tool for managing diabetes, but it doesn’t replace regular blood sugar testing at home. Blood sugar goes up and down throughout the day and night, which isn’t captured by your A1C. Two people can have the same A1C, one with steady blood sugar levels and the other with high and low swings.

If you’re reaching your A1C goal but having symptoms of highs or lows, check your blood sugar more often and at different times of day. Keep track and share the results with your doctor so you can make changes to your treatment plan if needed.

Top of Page

• CDC’s Division of Diabetes Translation
• Diabetes Basics
• Blood Sugar Testing
• Diabetes Features & Spotlights
• CDC Diabetes on Facebook
• @CDCDiabetes on Twitter

A1C Test and A1C Calculator

Your A1C test result (also known as HbA1c or glycated hemoglobin) can be a good general gauge of your diabetes control, because it provides an average blood glucose level over the past few months.

Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you check blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target of 7% or lower recommended by the American Diabetes Association (ADA) for many adults who are not pregnant. For some people, a tighter goal of 6.5% may be appropriate, and for others, a less stringent goal such as 8% may be better.¹ Talk to your doctor about the right goal for you.

A1C calculator*

The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management.

See how average daily blood sugar may correlate to A1C levels.² Enter your average blood sugar reading and click Calculate.

*Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes.

What is A1C?

Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a sample of hemoglobin A1C cells—a component of your red blood cells.

Here’s how it works:

• Some blood sugar (or glucose) naturally attaches itself to A1C cells as they move through your bloodstream. When this happens, the cell is considered “glycated.”
• Once a cell has been glycated, it stays that way. And since each A1C cell has a lifespan of about 4 months, your A1C sample will include cells that are a few days, a few weeks and a few months old. As a result, the test covers a span of about 2 to 3 months.
• The more sugar in your blood, the higher the percentage of glycated A1C cells you’ll have—that percentage is your A1C test result.³

Self-monitoring blood glucose and A1C

A1C is important, but it’s not a substitute for frequent self-monitoring. Only regular blood sugar checks show you how meals, activity, medications and stress affect your blood sugar at a single moment in time, as well as over the course of a day or week.

Without regular self-testing to provide day-to-day insights, an A1C result can be confusing. Because it gives a long-term view, a person with frequent highs and lows could have an in-range A1C result that looks quite healthy.⁴

The only way to get a complete picture of your blood sugar control is by reviewing your day-to-day self-checks along with your regular A1C tests, and working closely with your healthcare team to interpret the results.

How often do I need an A1C test?

This calculator only estimates how the A1C of someone who self-monitors quite frequently might correlate with their average meter readings. But many factors can affect blood glucose, so it’s critical to have your A1C checked by your doctor regularly.

The ADA recommends an A1C test at least 2 times a year for those who are in good control. For those who have changed their therapy or who are not in good control and not meeting glycemic goals, an A1C test is recommended quarterly. Your doctor will help you decide what’s right for you.¹

Benefits of lowering your A1C test result

Keeping your A1C test results low can significantly reduce the risk of long-term diabetes complications such as nerve problems, damage to your eyes, kidney disease and heart problems.³

¹American Diabetes Association. Standards of medical care in diabetes—2017 [position statement]. Diabetes Care. 2017;40(1): S1-S135. Available at: http://care.diabetesjournals.org/content/diacare/suppl/2016/12/15/40.Sup…. Accessed July 28, 2017.

²Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008;31(8): 1473-1478. Available at http://care.diabetesjournals.org/content/31/8/1473.full.pdf. Accessed July 28, 2017.

³American Diabetes Association. A1C and eAG. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-gl…. Accessed July 28, 2017.

⁴Tylee TS, Trence DL. Glycemic variability: looking beyond the A1C. Diabetes Spectrum. 2012;24(3): 149-153. Available at http://spectrum.diabetesjournals.org/content/25/3/149.full. Accessed July 28, 2017.

Glycosylated hemoglobin – what is it, the norm in women and men

It is very important in the management of patients with diabetes to achieve optimal blood glucose levels. The patient can control the level of glucose in the blood independently (with portable glucometers) or in the laboratory.

The result of a single determination of glucose in the blood shows the concentration of glucose at the time of taking, therefore, it is not possible to make any assumptions about the state of the patient’s carbohydrate metabolism between measurements. It is possible to assess the patient’s carbohydrate metabolism over a long period of time only by measuring the concentration of glycated hemoglobin in the blood, according to the recommendations of the Committee for the Control of Diabetes and its Clinical Complications (DCCT).

According to DCCT studies, it has been shown that the risk of development and progression of long-term complications of type 1 diabetes is closely related to the degree of effectiveness of glycemic control, expressed in the content of glycated hemoglobin in the blood [10]. Specialists from the UK have shown that a decrease in the patient’s blood glucose, assessed by the concentration of HbA1c, reduces the incidence of microangiopathies in type 2 diabetes mellitus [4].

Characteristics of indicator

Glycosylated hemoglobin (the term “glycated hemoglobin” is also used) is formed as a result of the non-enzymatic addition of glucose to the N-terminal regions of the β-chains of hemoglobin A1 _{globin and is designated as HbA1c. The concentration of HbA1c is directly proportional to the average concentration of glucose in the blood. In healthy people, the concentration of HbA1c in the blood is from 4.80 to 5.90%, in patients with diabetes its level is 2-3 times higher (depending on the degree of hyperglycemia).}

The resulting HbA1 accumulates inside the erythrocytes and persists throughout the life of the erythrocyte. The half-life of erythrocyte circulation in the bloodstream is 60 days, thus, the HbA1c concentration reflects the patient’s glycemia level 60-90 days before the study [2, 3].

A huge number of studies using traditional methods for measuring glucose content have confirmed the relationship between HbA1c and the level of glycemia of the patient [12-14]. Results of studies conducted by DCCT in 90s, served as the basis for confirming the hypothesis that the level of HbA1c reflects the level of glucose in the blood and is an effective criterion for monitoring patients with diabetes mellitus.

Standardization of methods for the study of glycosylated hemoglobin

In the early 90s, there was no interlaboratory standardization of methods for measuring glycosylated hemoglobin, which reduced the clinical effectiveness of this test [15-17]. In this regard, the American Association of Clinical Chemistry in 1993 formed a subcommittee on the standardization of methods for measuring glycated hemoglobin. As a result of his work, the National Glycosylated Hemoglobin Standardization Program (NGSP) was developed. Manufacturers of test systems for measuring glycated hemoglobin have been required to undergo rigorous testing to ensure that the results correspond to data obtained by reference DCCT methods. In case of a positive result of the check, the manufacturer is issued a “DCCT certificate of conformity”. The American Diabetes Association recommends that all laboratories use only NGSP-certified tests [7].

There are currently many methods for studying glycosylated hemoglobin:

• liquid chromatography;
• affinity chromatography;
• electrophoresis;
• column techniques;
• immunological techniques.

When a laboratory chooses an analyzer for glycated hemoglobin testing, preference should be given to analyzers based on the DCCT reference method, which is liquid chromatography. The use of standardized test methods enables the laboratory to obtain results that can be compared with data obtained using reference methods and published by DCCT. Such a comparison maximizes the reliability of the research results.

It is extremely important that the attending physician use in his work the results of studies obtained only in those laboratories that conduct the study of glycosylated hemoglobin using NGSP certified methods.

Study of HbA1c concentration in the laboratories of the Citylab Association

The concentration of glycosylated hemoglobin (HbA1c) in the laboratories of the Citylab Association is determined by the reference method (DCCT) of high performance liquid chromatography (HPLC), (the method is certified by NGSP), on D 10 analyzers from Bio-Rad, which is the world leader in the production of glycosylated hemoglobin analyzers. hemoglobin. This study is 23-10-002 – Glycosylated hemoglobin.

Mean blood glucose assessment

The DCCT study group demonstrated the clinical relevance of HbA1c as an estimate of mean blood glucose concentration (over 60-90 days). In these studies, patients had their daily glucose profile recorded every 3 months (seven measurements daily). The resulting profile was compared with the level of HbA1c. Over 36,000 studies have been conducted over 9 years. Empirically, a linear relationship between the average glucose content and the HbA1c level was obtained:

Average glucose concentration (mg / 100 ml) = 30.9 x (HbA1c) -60.6, where:

HbA1c is the concentration of glycosylated hemoglobin.

Simply put, a 1% change in HbA1c corresponds to a 30 mg/100 ml (1.7 mmol/L) change in mean glucose.

Note: This relationship was obtained in the study of glucose concentration in capillary blood. The concentration of glucose in the blood serum is approximately 15% higher.

The diagram (Fig. 1) [11] 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: The concentration of glucose is indicated in mmol / l, in brackets 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 type 2 diabetes when taking insulin or oral hypoglycemic drugs.

To convert glucose concentration in mg/100 ml to SI units (mmol/l), the following formula is used:

Glucose (mg/100 ml) x 0.0555 = Glucose (mmol/l)

Recommended testing frequency

The American Diabetes Association recommends that for patients whose therapy has been successful (stable carbohydrate metabolism), an HbA1c test should be performed at least 2 times a year, while in case of a change in diet or treatment, the frequency of testing should be increased to 4 times a year [ 7]. In the Russian Federation, according to the Targeted Federal Program “Diabetes Mellitus”, HbA1c testing should be carried out 4 times a year for any type of diabetes [1].

According to the American Diabetes Association, women with diabetes in the pre-pregnancy period need a special monitoring regimen. It is recommended to reduce the level of HbA1c in order to create optimal conditions in the body of the future mother for conception and fetal development. At the beginning, HbA1c should be tested monthly. When carbohydrate metabolism is stabilized with appropriate therapy, HbA1c testing should be performed at intervals of 6-8 weeks prior to conception [5, 6].

Modern studies have shown that many patients do not comply with the recommended interval between studies [8], however, experts have come to a common opinion that regular studies of HbA1c levels significantly reduce the risk of complications in patients with diabetes mellitus.

Interpretation of test results

The goal of hypoglycemic therapy in diabetes mellitus is to normalize blood glucose levels. DCCT studies have shown that intensive treatment prevents the patient from developing long-term complications such as retinopathy, nephropathy and neuropathy, or significantly delays their clinical manifestation. If patients strictly adhere to a regimen aimed at normalizing carbohydrate metabolism, the incidence of retinopathy decreases by 75%, nephropathy – by 35-36%, and the risk of polyneuropathy decreases by 60% [10].

Below are the therapeutic goals in 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 [1, 18]

Table 2.

Therapeutic goals in the treatment of type 2 diabetes mellitus [1, 19]

Note: In parentheses are glucose values ​​in mg/100 ml.

The federal target program “Diabetes mellitus” [1] adopted the values ​​recommended by the European Committee for Diabetes Recommendations [18, 19].

When evaluating the results of treatment in patients with concomitant diseases, young people, the elderly, pregnant women and patients with an unusual pattern of diabetes mellitus, other criteria for stabilizing carbohydrate metabolism should be used.

In case of an inadequate level of carbohydrate metabolism in a patient, additional measures are necessary, which depend on the clinical picture of the patient’s disease, such measures may include:

• enhanced patient education on self-monitoring of glucose levels;
• organization of patient support groups;
• regular examination by an endocrinologist;
• changes in drug therapy;
• more frequent testing of glucose and HbA1c.

Conclusions

1. The HbA1c study allows to assess the level of glycemia in a patient with diabetes mellitus for 60-90 days prior to the study.
2. This study provides an opportunity to monitor the course of the disease and control the adequacy of the treatment.
3. An HbA1c test should be performed to assess the risk of complications in a diabetic patient.

References

1. Dedov I.I., Shestakova M.V., Maksimova M.A. Federal target program “Diabetes mellitus”. // Moscow, 2002, 84 p.
2. Peters – Harmel E., Mathur R. Diabetes mellitus. Diagnosis and treatment. // Practice, 2008.
3. Popova Yu.S. Diabetes. // Krylov, 2008.
4. AD. Implications of the United Kingdom Prospective Diabetes Study (Position Statement). // Diabetes Care 1999, (SI), 27-31.
5. AD. Standards of Medical Care for Patients With Diabetes Mellitus (Position Statement). // Diabetes Care 1999, (SI), 32-41.
6. AD. Preconception Care of Women With Diabetes (Position Statement). // Diabetes Care 1999, (SI), 62-63.
7. AD. Tests of Glycemia in Diabetes (Position Statement). // Diabetes Care 1999, (SI), 77-79.
8. Auxter S. Another Study Shows Laboratory Tests are Underutilized. // Clin Lab News 1998, 24(9): 24-5.
9. Bodor G., Little R., Garrett N. et al. Standardization of Glycohemoglobin Determinations in the Clinical Laboratory: Three Years Experience. // Clin Chem 1992; 38:2414-18.
10. DCCT Research Group. The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long – Term Complications in Insulin – Dependent Diabetes Mellitus. // Engl J Med 1993; 329:977-86.
11. Goldstein D.E., Little R.R. Bringing Order to Chaos: Standardizing the Hemoglobin A1c Assay. // Contemp Int Med 1997; 9(5): 27-32/
12. Gonen B.A., Rubinstein A.H., Rochman H. et al. Hemoglobin A1: An Indicator of the Metabolic Control of Diabetic Patients. // The Lancet 1977, Oct 8; 2(804): 734-7.
13. Koenig R.J., Peterson C.M., Kilo C. et al. Hemoglobin A1c as an Indicator of the Degree of Glucose Intolerance in Diabetes. // Diabetes 1976, 25(3): 230-2.
14. Koenig R.J., Peterson C.M., Jones R.L. et al. Correlation of Glucose Regulation and Hemoglobin A1c in Diabetes Mellitus. // Engl J Med 1976, 295(8): 417-20.
15. Little R.R., England J.D., Wiedmeyer H.M. et al. Interlaboratory Standardization of Glycated Hemoglobin Determinations. // Clin Chem 1986; 32:358-60.
16. Little R.R., England J.D., Wiedmeyer H.M. et al. Interlaboratory Comparison of Glycated Hemoglobin Results: College of American Pathologists (CAP) Survey Data. // Clin Chem 1991; 37:1725-29.
17. Little R.R., England J.D., Wiedmeyer H.M. et al. Interlaboratory Standardization of Measurements of Glycohemoglobin. // Clin Chem 1992; 38:2472-78.
18. European Diabetes Policy Group. Guidelines for a desktop guide to Type 1 (insulindependent) Diabetes Mellitus. – International Diabetes Federation European Region. – 1998.
19. European Diabetes Policy Group. Guidelines for a desktop guide to Type 2 Diabetes Mellitus. – International Diabetes Federation European Region. – 1998 – 1999.

What is glycated hemoglobin, what does it mean in a blood test and what is its norm

Many people do not know why they donate glycated hemoglobin. In fact, this is an important indicator with which you can track the development of diabetes. According to this coefficient, it is easy to detect the disease at the earliest stages, and begin treatment.

What does glycated hemoglobin mean?

Often, even people with diabetes do not know what glycated hemoglobin is. Everything is very simple. When a person consumes carbohydrates, sugars enter the bloodstream. They pass through the erythrocyte membrane. Their amino acids react with sugars to form glycated hemoglobin. The compound is very stable, its concentration persists for 120 days, after which the red blood cells are destroyed.

All people have glycated hemoglobin. The difference between healthy and diabetic people is only in its concentration. This indicator displays how correctly carbohydrate metabolism processes are going on in the body. If there are failures and the sugar level is elevated, then the indicator will be more than normal.

These figures can be used to detect latent diabetes, because the parameter displays the sugar level not at a specific moment when it is easy to lower it, but for 3 months. It is important during treatment, to monitor the patient’s condition.

Therefore, what is glycated hemoglobin in a blood test, every person should know, especially those who are already at risk or have diabetes.

How to donate blood for glycated hemoglobin?

The glycated hemoglobin test does not require any specific preparation. It is taken in the morning, blood is taken from a vein. Thyroid disease, systematic intake of vitamins, anemia can affect the results.

Eaten food does not distort the result, just like alcohol, stress the day before, SARS and influenza.

What is the norm of glycated hemoglobin?

In order not to worsen your condition, you need to know not only what glycated hemoglobin in the blood means, but also to know your norm.

The indicator depends on age:

1. For adolescents and people under 30 years old, an indicator that does not exceed 6. 5% is considered the norm.
2. In middle age (from 30 to 50 years old), the parameter should not exceed 7%.
3. For elderly people who are over 60 years old, an increase of up to 7.5% is acceptable, but no more.

In a healthy child, the indicator is the same as in adults. Its normal range is from 4.5 to 6%. If deviations from these norms are found, it is necessary to undergo an additional examination to determine why the blood sugar level is elevated. Usually, with indicators of 6.1-6.4% (doctors call this condition prediabetes), health control needs to be strengthened.

If there is no suspicion of diabetes, then it is enough to undergo such a test once every 2-3 years. If the indicator is fixed at an elevated level, this means that the test must be carried out every year. Depending on the progression of the disease, a doctor may recommend that a patient with diabetes be tested every 3 or 6 months.

What is the norm for diabetics?

For physicians, the glycated hemoglobin value can tell a lot. Determination of its level provides more thorough control of sugar and correction of the diet, treatment regimen, dosage of drugs. For those diagnosed with diabetes, levels of less than 8% are normal. A parameter that is higher than this value indicates the possibility of serious complications. But you can’t lower it too sharply, it will only get worse, because. the body is already accustomed to a high concentration of glucose.

At a young age, you should strive to keep it within 6.5-7%, on average from 7 to 7.5%, after 50 make sure that the figure is not higher than 7.5-8%.

How to reduce the level of glycated hemoglobin?

It should be remembered that glycated hemoglobin determines to bring these numbers back to normal. It shows the average glucose level over 3 months, not at a specific point in time. Therefore, this indicator at home can be reduced only by reducing excess weight and improving metabolism.

And for this you need: