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Hemoglobin A1C

Also Known as: HbA1c, glycohemoglobin, glycosylated hemoglobin , A1c, , glycated hemoglobin, 

What is a Hemoglobin A1c test?

The amount of blood sugar (glucose) attached to hemoglobin is measured by a hemoglobin A1c (HbA1c) test. The part of your red blood cells that transports oxygen from your lungs to the rest of your body is called hemoglobin. The average amount of glucose bound to hemoglobin over the previous three months is determined by an HbA1c test. It's a three-month average because that's the usual lifespan of a red blood cell. 

The type of sugar that your body uses as its primary energy source is glucose. Glucose is produced or received by your body from the food you eat. With the help of a hormone called insulin, glucose enters your bloodstream and is taken up by your body's cells. Your blood glucose level can rise to dangerous levels if your body cannot produce enough insulin or if your body's cells are unable to accept insulin. This could progress to diabetes, a dangerous disease that, if not managed properly, can harm your body's organs. HbA1c is formed when glucose binds to hemoglobin in the blood.  HbA1c is a measurement of the percentage of hemoglobin A connected to glucose in the blood compared to the total quantity of hemoglobin A in the blood. If your HbA1c levels are high, you may have diabetes, a chronic disease leading to major health problems like heart disease, kidney disease, and nerve damage.

What is the test used for?

In adults, an HbA1c test can be used to check for diabetes or prediabetes. Prediabetes is a condition in which your blood sugar levels indicate that you are at risk of developing diabetes. An HbA1c test can help you monitor your diabetes and glucose levels if you already have it.

The HbA1c test isn't used to diagnose diabetes in children or gestational diabetes, a kind of diabetes that only affects pregnant women. An HbA1c test may also be less accurate for detecting diabetes if you have anemia or another form of blood disorder. Your health care provider may recommend alternative tests if you have one of these conditions and are at risk for diabetes.

Why and when do you need this test?

Adults over 45 should be checked for diabetes and prediabetes, according to the Centers for Disease Control and Prevention (CDC). If your results are normal, the test should be repeated every three years. If your results indicate that you have prediabetes, you should have your blood sugar checked every 1-2 years. You should also seek medical advice about taking steps to lower your risk of developing diabetes.

If you are under 45 years old and have certain risk factors, you may need this test. These are some of them:

  • Obese ( Overweight) 
  • Hypertension (High blood pressure) 
  • Past history of heart disease
  • Lack of physical activity 

If you have diabetes symptoms, you may also need an HbA1c test. These are some of them:

  • Increased thirst
  • Weakness and feeling of tiredness
  • Blurred vision
  • Frequent feeling of hunger
  • Weight loss
  • Irritability
  • Ketones ( waste products of  muscle and fat breakdown ) in urine
  • Numbness and tingling sensation in the extremities
  • Slow-healing of sores and wounds
  • Frequent urination

What kind of sample is required for the test?

A small needle will be used to obtain a blood sample from a vein in your arm by a health care provider. A small amount of blood will be collected into a test tube or vial once the needle is inserted. When the needle goes in or out, it may sting a little. It normally takes less than five minutes to complete this process.

Do you need to prepare for the test?

An HbA1c test does not require any special preparation.

Are there any risks to this test?

A blood test is a relatively low-risk procedure. There may be some little pain or bruising where the needle is inserted, but most symptoms will disappear quickly.

What do the test results mean?

The HbA1c findings are expressed as a percentage. The following are some common findings.

HbA1c below 5.7 % is considered normal.

HbA1c levels between 5.7 and 6.4 % indicate prediabetes.

HbA1c of 6.5 % or greater indicates diabetes.

The American Diabetes Association recommends keeping your HbA1c levels below 7% if you have diabetes. Depending on your overall health, age, weight, and other factors, your health care physician may make various suggestions for you. 

If your test results indicate that you have prediabetes, you are at an increased risk of developing diabetes in the future. Your doctor may suggest that you adjust your diet, exercise routine, and other aspects of your lifestyle to lower your risk of diabetes or delay the onset of the disease. If you've been diagnosed with diabetes, your doctor may advise you on how to track and manage your condition over time. Using blood glucose testing at home, repeating HbA1c tests on a regular basis, and adopting lifestyle adjustments are all steps to take frequently. You may also be given medication to help you manage your blood sugar.

However, other than diabetes, certain health factors or conditions can result in a greater or lower HbA1c test result. A higher HbA1c test can be caused by a number of factors, including:

  • Anemia
  • Iron, vitamin B12, or folate deficiency
  • Certain drugs
  • Obesity 

A low HbA1c test can be caused by a number of factors, including:

  • Pregnancy
  • Chronic liver disease
  • Blood transfusion 
  • Sickle cell disease
  • Hemolysis, certain hemoglobinopathies 
  • Hypersplenism
  • Acute and chronic blood loss

While the HbA1c test can be used to detect diabetes, doctors do not usually make this diagnosis based on the results of only one test. Your doctor may request that your HbA1c test be repeated or that your results be compared to those of other tests. Additional diagnostic tests, such as blood glucose tests, may be ordered by your doctor.  It's important to discuss the results of a diagnostic HbA1c test with your doctor to comprehend what they mean for you. Your doctor will explain how your hemoglobin A1c values fit into the reference ranges, what more tests may be required, and what steps you should take next in your health management.

Should you have any questions regarding your results, you should consult your healthcare provider.

Related Tests: Glucose random, glucose fasting, glucose tolerance test, comprehensive metabolic panel

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