HbA1c (Hemoglobin A1c)
Understanding HbA1c (Hemoglobin A1c)
What is HbA1c (Hemoglobin A1c)?
An HbA1c (Hemoglobin A1c) test, also known as a glycosylated hemoglobin test, measures the average amount of sugar in the blood over 2-3 months. This test helps diagnose diabetes and monitor its treatment. It is typically done as part of routine health checkups.
Diabetes is a chronic condition that affects the body's ability to process blood sugar properly, leading to high blood sugar levels. The signs and symptoms of diabetes can include increased thirst, frequent urination, blurred vision, fatigue, and slow healing of wounds. However, some individuals with diabetes may not experience any symptoms at all. Hemoglobin, a protein found in red blood cells, carries oxygen throughout the body. When glucose (sugar) molecules in your bloodstream attach to hemoglobin, a process called glycation occurs that causes the formation of glycosylated hemoglobin or HbA1c.
An HbA1c (Hemoglobin A1c) test provides an overall picture of your long-term blood sugar control, making it essential for managing diabetes. This test can help diagnose and monitor prediabetes and diabetes, allowing for early intervention and treatment to prevent or delay the onset of complications such as nerve damage, kidney disease, and vision problems.
The American Diabetes Association (ADA) recommends an HbA1c target of less than 7% to reduce the risk of complications. Individual targets may vary based on factors such as age, duration of diabetes, and the presence of other health conditions.
No special preparation is required before taking an HbA1c test. Test result ranges are approximate and may differ slightly between labs depending on the methodology and laboratory guidelines. Talk to your doctor about your specific test results. Narrate your complete medical history to help them correlate your clinical and laboratory findings. The test results will help the doctor determine your medical condition, recommend lifestyle modifications such as diet and exercise, decide whether or not medications are required to manage your condition and formulate your overall treatment plan.
What is HbA1c (Hemoglobin A1c) used for?
- As part of routine health check-ups to estimate average blood glucose levels.
- If you have symptoms of altered blood glucose levels such as weight gain, weight loss, blurred vision, frequent urge to urinate, or confusion.
- For assessing risk for diabetes and prediabetes and for monitoring diabetes treatment.
- To screen pregnant women for gestational diabetes.
What does HbA1c (Hemoglobin A1c) measure?
An HbA1c (Hemoglobin A1c) test precisely measures the percentage of sugar-coated or glycated hemoglobin in your blood. The test results represent the proportion of hemoglobin in your blood that has been glycated.
Hemoglobin, a vital protein found in red blood cells, is responsible for transporting oxygen throughout the body. Hemoglobin A is the most abundant form of hemoglobin, and when blood sugar levels increase, a higher proportion of hemoglobin A becomes glycated. As red blood cells have a lifespan of approximately 120 days, the sugar molecules remain attached to the hemoglobin for the duration of the cell's life. Consequently, the HbA1c test offers insight into your average blood sugar levels over the past 8 to 12 weeks.
Interpreting HbA1c (Hemoglobin A1c) results
Interpretations
Normal: Below 5.7% (39 mmol/mol approx.)
Prediabetic: 5.7% - 6.4% (39 to 46 mmol/mol approx.)
Diabetic: Above 6.5% (above 48 mmol/mol approx.)
Less than 5.7% Glycated Hemoglobin indicates normal levels of blood sugar. Increased risk of developing Diabetes is found in Prediabetic patients with blood sugar levels between 5.7% and 6.4%. Patients with a HbA1c level greater than 6.5% are usually diagnosed with Diabetes.
Answers to Patient Concerns & Frequently Asked Questions (FAQs) about HbA1c (Hemoglobin A1c)
Frequently Asked Questions about HbA1c (Hemoglobin A1c)
Q. Why is an HbA1c (Hemoglobin A1c) test performed?
Q. How often should I get an HbA1c test done?
Q. What is the best time to get an HbA1c test?
Q. Can an HbA1c test be used for both Type 1 and Type 2 diabetes?
Q. What factors can affect the accuracy of an HbA1c test?
Q. Is there any risk associated with an Hb1Ac test?
Q. Can my HbA1c be normal/low despite high blood sugar levels?
Q. What are the symptoms of hypoglycemia?
Q. What are the risk factors for diabetes?
Q. When can false results appear in an HbA1c test?
Q. When is the HbA1c test insufficient to determine elevated blood sugar levels?
Q. What are the common complications of diabetes?
Q. What other tests can be prescribed by your doctor in case of abnormal result?
Q. Can the average blood glucose value (ABG) values be same for two people?
Q. How is an HbA1c test different from a blood glucose test?
Q. What are the benefits of lowering your HbA1c level?
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References
- Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights. 2016 Jul 3;11:95-104. [Accessed 22 May 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933534/
- Your Diabetes Care Schedule [Internet}. CDC; 19 Apr. 2023 [Accessed 22 May 2023]. Available from: https://www.cdc.gov/diabetes/managing/care-schedule.html
- Unnikrishnan R, Anjana RM, Mohan V. Drugs affecting HbA1c levels. Indian J Endocrinol Metab. 2012 Jul;16(4):528-31. [Accessed 22 May 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401751/
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