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Why Is HbA1C Test Required For Diabetes Patients?

Creator: Dr. Narayanasamy Senduran
Published: 2016-05-10T14:55:28

1 min read

Why Is HbA1C Test Required For Diabetes Patients?

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1 min read

HbA1c test, otherwise called glycated hemoglobin test, indicates the mean blood sugar level over three months. This article explains why this test gives a more reliable result.

Written by

Dr. Narayanasamy Senduran

Medically reviewed by

Dr. K. Shobana

May 10, 2016

August 1, 2023

HbA1C Level is a critical indicator that tells the long term Glycemic state and also its control during the treatment.

The HbA1C Test

The HbA1C test nowadays is included in the basic health/diabetic checkup for its importance in indicating the individual's glycemic state (i.e, mean blood sugar levels) over a period of last 3 months rather than the daily fluctuating sugar levels which are measured at home daily with glucometer.

HbA1C is actually called glycated hemoglobin i.e, hemoglobin protein saturated with glucose molecule and it is measured in percentage.

This is the best surveillance test for diabetic patients on treatment as it tells the efficacy of ongoing treatment.

This test helps to diagnose the stage of insulin resistance in a future diabetic patient (usually type 2) with which development of diabetes can be prevented with appropriate life style modifications and diet.

This test indirectly helps in preventing end organ's damage like to eye (diabetic retinopathy), heart, kidney etc, which occurs due to long standing diabetes.

Normally in an adult HbA1C levels range from 4% to 5.6%.

However this test is not mainly intended to confirm the diagnosis rather helps monitor the long term sugar control.

Anything above the normal reference range warrant further diabetic evaluation to confirm the diagnosis (especially in patients of type1 diabetes).

If the levels are deranged i.e, increased, appropriate treatment plan will be initiated as in case of confirmed type 1 diabetes, with insulin and as in case of confirmed type 2 diabetes with life style modifications, oral hypoglycemic agents initially and later addition of insulin if sugar levels are not controlled.

It is recommended to get HbA1C test done every 3 months for patients diagnosed with diabetes or at least every 6 months for persons with tendency/risk for future prediabetic state or diabetes. However patients on treatment already should keep testing the blood sugar at home or in the clinic as suggested by the doctor, for providing a better treatment or any alteration in regimen according to the diet/daily sugar level changes.

Hence bottom line is, "keeping HbA1C levels within or near normal ranges will help avoid the complications of diabetes".

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Frequently Asked Questions

1. Why Is HbA1c Measured in Diabetes?

Adults can get an HbA1c test to see if they have diabetes or prediabetes. When a person has prediabetes, their blood sugar levels indicate a high risk of developing diabetes. An HbA1c test can help monitor a person's condition and glucose levels if they already have diabetes.

2. Why Is an HbA1c Test Important?

The Centers for Disease Control (CDC) advises screening for diabetes and prediabetes in adults over the age of 45. The test should be repeated every three years if the results are normal. HbA1c should be checked every one to two years in adults if the findings indicate prediabetes.

3. What Occurs if HbA1c Is Elevated?

A person may have diabetes if their HbA1c values are high. Diabetes is a chronic disorder that can result in major health issues like heart disease, kidney disease, and nerve damage.

4. What Can Be Done to Lower HbA1c as Quickly as Possible?

HbA1c can be lowered quickly by taking the following steps-
- Dietary Changes- Steer clear of processed carbs and sugary foods. Instead, increase the consumption of fruits, vegetables, and fiber. A Mediterranean diet that includes fruits, vegetables, nuts, legumes, whole grains, and fish is also helpful. Lean meat, fruits, vegetables, and nuts in the paleo diet can also help lower blood sugar and HbA1c levels.
- Lifestyle Modifications- This includes losing weight, exercising daily, quitting smoking, getting more sleep, and de-stressing.
- Supplements- Supplements and medications prescribed by doctors can be taken to lower blood sugar levels and HbA1c.

5. What Are the Drawbacks of the HbA1c Test?

The drawbacks include the following-
- Keeping fast before blood collection.
- Test findings vary significantly between laboratories and have a low concordance.
- The need for several blood samples if taken two hours after eating (postprandial), and the inconvenience of the patient in consuming glucose.

6. What Time Should the HbA1c Test Be Performed?

A blood test performed in the morning before consuming food is more accurate. A fasting blood glucose test should be taken eight to ten hours before the person eats or drinks anything other than water.

7. What Distinguishes Glucose Tests From HbA1c Tests?

Hemoglobin A1c and blood sugar are related. However, they also differ. The blood glucose meter calculates the amount of glucose in the blood at the precise moment the user pricked their finger. HbA1c evaluates glycated hemoglobin levels in the blood, whereas a glucose test examines the quantity of glucose currently in the system.

8. What Approach Is Ideal for HbA1c?

The high-performance liquid chromatography (HPLC) method is regarded as the gold standard for the analysis of HbA1c, although not all laboratories may use it due to several restrictions.

9. Can HbA1c Levels Be High Without Diabetes?

HbA1c levels in the blood can be increased in certain situations, but that does not necessarily suggest a person has diabetes. According to a study, a single HbA1c result higher than 6 % was discovered in the general population with no history of diabetes.

10. Why Is HbA1c Regarded as the Benchmark?

For evaluating how well diabetes is being managed, glycated hemoglobin HbA1c is regarded as the gold standard. The quantity of blood sugar (glucose) bound to hemoglobin is determined by the hemoglobin A1c (HbA1c) test. The component of red blood cells called hemoglobin transports oxygen from the lungs to the rest of the body. It is a crucial blood test that provides a reliable indication of how effectively diabetes is being managed.

11. Does Having a High HbA1c Automatically Indicate Diabetes?

No. Diabetes is not the only condition that can impact HbA1c levels. The following conditions may result in high HbA1c values-
- Although type A hemoglobin, also known as adult hemoglobin, is what most individuals have, some people have a different kind of hemoglobin. This is referred to as hemoglobinopathy, which can provide HbA1c values that are falsely high or low.
- Hemolytic anemia, blood loss, chronic liver illness, and chronic renal disease can produce falsely low HbA1c results, while iron deficiency and iron deficiency anemia can produce falsely high results.
- Additionally, several vitamins and medications can have an impact on the outcomes.

12. What Causes an Abrupt Rise in HbA1c?

HbA1c can rise due to sleep difficulties, gum disease, H. pylori infections, chronic inflammation, and anemia. High levels are also associated with obesity and metabolic syndrome, frequently leading to type 2 diabetes.

13. Which Drug Reduces HbA1c the Best?

Any medication that promotes hemolysis can lower the HbA1c by shortening the average lifespan of erythrocytes and consequently increasing the fraction of younger cells in the blood. Antiretroviral drugs, Dapsone, and Ribavirin have all been found to lower the HbA1c level.

Sources

Dr. Narayanasamy Senduran

General Practitioner

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