What is a normal A1C level. How often should you get an A1C test. What factors can affect your A1C results. How does A1C relate to average blood glucose levels. Why is A1C important for managing diabetes.

What is A1C and Why is it Important?

The A1C test, also known as hemoglobin A1C or HbA1c test, is a crucial tool in diagnosing and managing diabetes. This simple blood test measures your average blood sugar levels over the past three months, providing valuable insights into your overall glucose control.

The importance of A1C lies in its ability to:

• Diagnose prediabetes and diabetes
• Monitor long-term blood sugar control in people with diabetes
• Assess the risk of diabetes complications
• Guide treatment decisions and medication adjustments

How Does A1C Work?

When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin. This provides a more comprehensive picture of your glucose levels compared to daily blood sugar tests, as it reflects your average blood sugar over a longer period.

Normal A1C Levels and Diagnostic Criteria

Understanding what constitutes a normal A1C level is essential for interpreting your test results. The American Diabetes Association provides the following guidelines:

• 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 of 5.7% to 6.4%, the higher your A1C, the greater your risk of developing type 2 diabetes. This information can serve as a wake-up call to make lifestyle changes and prevent the progression to full-blown diabetes.

A1C and Estimated Average Glucose (eAG)

Your A1C result can also be reported as estimated average glucose (eAG), which is expressed in the same units (mg/dL) as your daily blood sugar readings. This can help you better understand the relationship between your A1C and day-to-day glucose levels.

Who Should Get an A1C Test and When?

Regular A1C testing is essential for both diagnosing diabetes and monitoring its management. The frequency of testing depends on various factors:

For Diabetes Screening:

• Adults over 45 should get a baseline A1C test
• Adults under 45 who are overweight and have one or more risk factors for prediabetes or type 2 diabetes should also be tested
• If results are normal, repeat the test every 3 years
• For those with prediabetes, testing should be done every 1 to 2 years

For Diabetes Management:

• People with diabetes should get an A1C test at least twice a year
• More frequent testing may be necessary if medication changes or other health conditions are present

Always consult with your healthcare provider to determine the most appropriate testing schedule for your individual needs.

Factors That Can Affect A1C Results

While the A1C test is generally reliable, several factors can influence its accuracy. It’s crucial to be aware of these potential confounding factors to ensure proper interpretation of your results:

• Kidney failure, liver disease, or severe anemia
• Certain hemoglobin variants more common in people of African, Mediterranean, or Southeast Asian descent
• Blood disorders such as sickle cell anemia or thalassemia
• Certain medications, including opioids and some HIV medications
• Recent blood loss or blood transfusions
• Pregnancy (early or late stages)

If any of these factors apply to you, inform your healthcare provider. They may recommend additional tests to ensure accurate assessment of your blood sugar control.

Setting and Achieving Your A1C Goal

For most people with diabetes, the general A1C goal is 7% or less. However, it’s essential to understand that A1C goals should be individualized based on various factors:

• Age
• Duration of diabetes
• Presence of other medical conditions
• Risk of hypoglycemia
• Individual preferences and lifestyle factors

Younger individuals may have lower A1C goals to reduce the long-term risk of complications, while older adults or those with a history of severe hypoglycemia may have higher targets. Work closely with your healthcare team to establish an appropriate A1C goal that balances effective diabetes management with your overall health and quality of life.

Strategies for Improving Your A1C

If your A1C is above your target range, there are several strategies you can employ to bring it down:

1. Maintain a balanced diet rich in whole grains, lean proteins, and vegetables
2. Engage in regular physical activity
3. Take medications as prescribed
4. Monitor blood glucose levels regularly
5. Manage stress through relaxation techniques or counseling
6. Get adequate sleep
7. Attend diabetes education classes to improve self-management skills

Remember that small, consistent changes can lead to significant improvements in your A1C over time.

A1C Testing: Procedure and Preparation

The A1C test is a simple procedure that can be performed in a doctor’s office or laboratory. Here’s what you can expect:

• A small blood sample is taken, either through a finger prick or from a vein in your arm
• The sample is analyzed to determine the percentage of glycated hemoglobin
• Results are typically available within a few days

One of the advantages of the A1C test is that it doesn’t require any special preparation. You don’t need to fast or adjust your diet before the test. However, it’s always a good idea to ask your healthcare provider if any other tests will be performed simultaneously and if they require any specific preparation.

Combining A1C with Other Diabetes Management Tools

While A1C is a valuable tool for assessing long-term glucose control, it’s important to remember that it should be used in conjunction with other diabetes management strategies. Daily blood glucose monitoring, for instance, provides crucial information about short-term fluctuations and helps you make immediate adjustments to your diet, activity, or medication.

Consider using a combination of the following tools for comprehensive diabetes management:

• Regular A1C testing
• Daily blood glucose monitoring
• Continuous glucose monitoring (CGM) systems
• Blood pressure and cholesterol checks
• Regular foot and eye exams

By utilizing multiple tools and strategies, you can gain a more complete picture of your diabetes management and make informed decisions about your care.

The Role of A1C in Preventing Diabetes Complications

Maintaining good A1C control is crucial for preventing or delaying the onset of diabetes-related complications. Higher A1C levels are associated with an increased risk of various health issues, including:

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

By keeping your A1C within your target range, you can significantly reduce the risk of these complications and improve your overall health and quality of life.

The Importance of Consistent A1C Monitoring

Regular A1C testing allows you and your healthcare team to track your progress over time and make necessary adjustments to your diabetes management plan. Consistent monitoring can help:

• Identify trends in your blood sugar control
• Evaluate the effectiveness of your current treatment plan
• Guide decisions about medication adjustments or lifestyle changes
• Motivate you to maintain good diabetes self-management habits

Remember that A1C is just one piece of the diabetes management puzzle. It’s essential to work closely with your healthcare team to develop a comprehensive approach that addresses all aspects of your health and well-being.

Understanding A1C Variability and Its Implications

While A1C provides valuable information about your average blood glucose levels, it’s important to understand that two people can have the same A1C result but very different day-to-day blood sugar patterns. This concept is known as glycemic variability.

Why Glycemic Variability Matters

Glycemic variability refers to the swings in blood glucose levels throughout the day and night. Emerging research suggests that high glycemic variability may contribute to diabetes complications independently of average glucose levels. This means that even if your A1C is within target range, frequent highs and lows could still impact your health.

To get a more complete picture of your glucose control, consider the following strategies:

• Use continuous glucose monitoring (CGM) to track patterns and identify trends
• Keep a detailed log of your blood sugar readings, meals, physical activity, and medication
• Discuss your day-to-day glucose patterns with your healthcare provider, even if your A1C is at goal

By addressing both your A1C and glycemic variability, you can work towards more stable blood sugar control and potentially reduce your risk of complications.

A1C and Personalized Diabetes Care

As our understanding of diabetes continues to evolve, there’s a growing emphasis on personalized care. A1C goals and management strategies should be tailored to each individual’s unique circumstances, taking into account factors such as:

• Age and life expectancy
• Duration of diabetes
• Presence of other health conditions
• Risk of hypoglycemia
• Personal preferences and quality of life considerations

Work closely with your healthcare team to develop a personalized diabetes management plan that aligns with your goals and lifestyle. Remember that your A1C target may change over time as your health status or life circumstances evolve.

The Future of A1C Testing and Diabetes Management

As technology and medical research advance, we can expect to see new developments in A1C testing and diabetes management. Some areas of ongoing research and innovation include:

• More accurate and convenient A1C testing methods
• Integration of A1C data with other health metrics for comprehensive analysis
• Artificial intelligence algorithms to predict A1C trends and guide treatment decisions
• Personalized medicine approaches based on genetic and metabolic profiles

Stay informed about new developments in diabetes care and discuss emerging options with your healthcare provider to ensure you’re receiving the most up-to-date and effective treatment possible.

In conclusion, understanding your A1C levels and working towards your personalized target is a crucial aspect of diabetes management. By combining A1C monitoring with other diabetes management tools and strategies, you can take control of your health and reduce the risk of complications. Remember that diabetes management is a journey, and with the right knowledge, support, and tools, you can achieve optimal health and well-being.

All About Your A1C

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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.

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Ways to Lower Your A1C

For some, home blood sugar testing can be an important and useful tool for managing blood sugar on a day-to-day basis. Still, it only provides a snapshot of what’s happening in the moment, not the full picture of what’s happened in the long term, says Gregory Dodell, MD, an assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai in New York City.

For this reason, your doctor may occasionally administer a blood test that measures your average blood sugar level over the past three months. Called hemoglobin A1C, or A1C, this test can show you how well your type 2 diabetes management plan is working.

Here’s what you should know about it and ways to make sure your A1C is in a healthy range.

   Poll

How often do you get your A1C tested?

How Often Do You Need to Take an A1C Test?

If your blood sugar levels have remained stable and your A1C is within your target range, the American Diabetes Association (ADA) recommends getting the test two times a year. If your therapy has changed or you are not meeting your blood sugar targets, the ADA recommends getting the test four times per year. This simple blood draw can be done in your doctor’s office.

The A1C test results provide insight into how your treatment plan is working and how it might be modified to better control the condition. Often, your blood sample is sent out to a lab, though some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes.

While in-office tests can be used to monitor the disease, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that most point-of-care tests should not be used for diagnosis. That can only be done by lab tests certified by the NGSP, an organization that standardizes A1C test results. Any in-office test results pointing to a change in your health should be confirmed by conventional lab tests.

What Do Your A1C Results Mean?

The A1C test measures the glucose (blood sugar) in your blood by assessing the amount of what’s called glycated hemoglobin. “Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin,” Dr. Dodell says.

According to the ADA, an A1C level below 5.7 percent is considered normal; between 5.7 and 6.4 signals prediabetes; and over 6.5 percent indicates type 2 diabetes. For many people with type 2 diabetes, the goal is to reduce A1C levels.

Your A1C goal is specific to you. Several factors come into play, such as your age, how advanced the diabetes is, and whether you have any other health conditions. If you can keep your A1C number below your goal — which, for many people with diabetes, is less than 7 percent, says Dodell — you can reduce the risk of complications, such as nerve damage and eye problems.

What Are Some Top Tips for Lowering A1C?

Your A1C score is a helpful tool, Dodell says, but it is not the only indicator of how healthy you are.

For example, you could hit your A1C goal but still have wide fluctuations in your blood sugar levels, which is more common among people who take insulin. You’ll need to bring these day-to-day fluctuations under control, since they can lower your quality of life and increase your risk of complications, he says.

Think of your diabetes as you would a job, Dodell says. It takes work, but the time and effort you put into it can result in good control and an improved quality of life. “The key to reaching your A1C goal is trying to follow a healthy lifestyle,” he says.

Making these changes can help you improve your day-to-day blood sugar management and lower your A1C.

1. Start an Exercise Plan You Enjoy, and Do It Regularly

Find something you enjoy doing that gets your body moving, whether it’s taking your dog for a walk, playing a sport with a friend, or riding your bike.

The ADA recommends getting 150 minutes of moderate exercise per week, says Jordana Turkel, a certified diabetes care and education specialist (CDCES) and registered dietitian at Park Avenue Endocrinology & Nutrition in New York City.  Different types of exercise (both strength or resistance training and aerobic exercise) can lower your A1C by making your body more sensitive to insulin, Turkel says. She encourages her patients not to go more than two days in a row without exercising and to aim for two days of strength training per week.

Be sure to check with your healthcare provider before embarking on an exercise plan, though. Together, you can come up with an individualized plan.

And if you monitor your blood sugar daily, check it before and after exercise. As the ADA explains, exercise improves insulin sensitivity and lowers your blood sugar levels. In certain circumstances, though, stress hormones produced during more intense exercise can also increase blood sugar levels. In addition, other factors, such as what you eat before exercise and the timing of your workout, may also affect your numbers.

2. Eat a Balanced Diet With Proper Portion Sizes

It’s best to check with a CDCES or registered dietitian/nutritionist to determine what a balanced diet and appropriate portion sizes mean for you. But a great rule of thumb is to fill half of your plate with veggies, a quarter with protein, and a quarter with whole grains, says Turkel. If you like fruit, limit your portion to a small cup, eaten with a little protein or lean fat to help you digest the carbohydrates in a way that is less likely to spike your blood sugar.

Also, avoid processed foods as much as possible, and try to avoid sugary sodas and fruit juice, which are high in carbs and calories, and thus can lead to spikes in blood sugar and contribute to weight gain, according to the ADA.

3. Stick to a Regular Schedule, So You Can More Easily Follow a Healthy Diet 

Skipping meals, letting too much time pass between meals, or eating too much or too often can cause your blood sugar levels to fall and rise too much, Cleveland Clinic points out. This is especially true if you are taking insulin or certain other diabetes drugs. Your doctor can help you determine the best meal schedule for your lifestyle.

4. Follow the Diabetes Treatment Plan Your Healthcare Team Recommends

Diabetes treatment is very individualized, noted a February 2022 article in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. After all, factors including how long you’ve lived with the disease, your socioeconomic status, and any other conditions you’re living with can play a role in the best treatment approach for you.

Your healthcare team will help you determine which steps to take to successfully manage diabetes. Always talk to your doctor before making any changes, such as starting a diet very low in carbohydrates or beginning a new exercise regimen. This is especially important before making any medication or insulin changes.

5. Check Your Blood Sugar Levels as Your Doctor Has Directed

Work with your doctor to determine if you should check your blood sugar — and how often. You may be tempted to pick up an A1C home testing kit, but Dodell says having your A1C checked by your doctor every three to six months is sufficient. A better idea is to use a continuous glucose monitor. He recommends checking your “time in range” to see if you are at the optimal level. For many people that is 70 to 180 milligrams per deciliter (3.9 to 10 millimoles per liter), according to ADA guidelines.

Understanding your A1C levels is an important part of your overall diabetes management. If you have any questions about your A1C or what it means, don’t hesitate to ask your doctor.

Additional reporting by Mikel Theobald

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 glycosylated 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 methods.

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 Citilab 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 manufacture of glycosylated hemoglobin analyzers. 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.

With 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

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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.
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18. European Diabetes Policy Group. Guidelines for a desktop guide to Type 1 (insulindependent) Diabetes Mellitus. – International Diabetes Federation European Region. – 1998.
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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: