WHAT IS HbA1C?
INTRODUCTION
Diabetes mellitus is a disorder in which sugar (glucose) in blood exceeds normal levels. The
Transport of glucose from the blood stream to the cells does not function properly resulting in
Increased levels of sugar in the blood.
The reason for this could be that your pancreas is not producing enough quantity of insulin
or the insulin that’s produced is not being utilized properly.
HbA1C IS VERY USEFUL INDICATOR TO KNOW THE HISTORY OF BLOOD GLUCOSE LEVELS.
Haemoglobin A1C
(HbA1c)
HbA1C gives you an idea of your blood glucose control over the last 60 to 90 days.
Haemoglobin has the tendency to bind with the glucose present in the
Blood to form Glycated Hemoglobin or HbA1c.
RELATION BETWEEN HbA1C AND BLOOD GLUCOSE
The life of a red blood cell is approx 120 days. During its life it keeps circulating in blood and finally is destroyed in the liver and spleen.
During this period of 120 days, the RBCs keep binding with the glucose present in the blood.
The extent of binding depends upon the amount of glucose-higher the glucose in blood (poor diabetes control ) higher is the binding and thus higher is the HbA1c.
Thus HbA1c can provide a true picture of your last 60 to 90 days blood glucose level.
HbA1C and Diabetes complications:
If HbA1C levels are high it means that the average blood glucose value for the last 60 to 90 days was continuously higher.
A consistently high HbA1C indicates a poor control of diabetes and can lead to lots of long term
Complications.
DIABETIC COMPLICATIONS
- Diabetic Retinopathy
- Stroke /Cerebral Haemmorhage
- Weakening of gums.
- Loss of sensation/numbness of fingers.
- Cardiac problems
- Diabetic nephropathy
- Excessive sweating
- Erectile dysfunction
- Diarrhea/constipation.
In a famous study done in the US
The same study also found that a 1% decrease in HbA1c value can reduce the chances of complications by 40%(neuropathy, nephropathy and neurological complications)
TARGETS OF CONTROL
HbA1c 5.8 --- 5.8-6.5 --- 6.5-7.0 ----- 7.0-8.0 --- 8%
IS HbA1C GOOD FOR ALL ?
There are some diabetic patients who cannot depend on HbA1c:
Pregnant women with Diabetes: During pregnancy the weight and the amount of water in the body keeps fluctuating every day which results in a lot of variations in blood glucose. In such cases HbA1c does not give a true picture of the daily variations in blood glucose.
Patients with Hemolytic anaemia, patients on dialysis and patients with cirrhosis of liver.In such patients the life of the RBC is shortened and hence the HbA1c value is always lower than actual. For such patients another similar test called Glycated Albumin can be done. This test gives blood glucose value for the past 1-2 weeks.
FREQUENTLY ASKED QUESTIONS
Q.I check my blood glucose once in a month and the value is normal. However when I did my HbA1c, the doctor told me that the value is high. Is it possible?
A. Blood glucose test done in a lab shows the value at that point of time. This value is affected by the food eaten, exercise done just before the test. HbA1c gives the average blood glucose value for the
last 60 to 90 days and hence gives a more truer picture of the blood glucose control.
Q.How often should I do a HbA1c test?
A.HbA1c gives the average blood glucose value for the past 1-2 months. Hence it is advisable to do a test once every 2-3 months.
Q.For the last 1 month I have been doing regular exercise and strictly controlling my diet.However there is no change in my HbA1c value. What is the reason for this?
A. Though there will be a marginal reduction in the HbA1c value, the full benefit will be seen only after 3 months.In case you want to see the impact of exercise and diet test yourself with a blood glucose meter
regularly. It will help you to monitor the progress you have made.
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