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HbA1C undergoes the process of glycation, i.e. the attachment of carbohydrate residues. This process is intensified in people with carbohydrate disorders, including diabetes, and therefore the test is used to diagnose its complications.
Glycated hemoglobin (HbA1C) testing
Glycated hemoglobin is a test for the level of HbA1c in the blood that is performed to monitor the treatment of diabetes. By performing the test, it is possible to determine if there is any benefit from treating diabetes. While the blood sugar control performed by the patient each day is an indicator at a specific point in time, the HbA1c test shows the average blood glucose level over the last 3 months. High levels of HbA1C indicate poorly balanced diabetes, which can lead to serious complications. Red blood cells, erythrocytes, are surrounded by a membrane that lets glucose – an organic chemical compound present in specific products – pass into them. In this way, glucose is transferred to the red blood pigment in the blood, which carries oxygen, and is contained in erythrocytes. Its concentration is glycemic indexwhich is glucose in the body.
Glycated hemoglobin should be determined before visiting a dietitian. Buy the test package now. Pre-consultation tests with a dietitian – home blood analysis, thanks to which a dietitian will more easily adjust the diet to your expectations and needs. By the way, you will also check other parameters that affect the diet, such as insulin, glucose, TSH or cortisol. In turn, in order to supplement hemoglobin deficiencies, you can use the hemoglobin modulator – the YANGO dietary supplement.
Measurement glycated hemoglobin concentration is performed by a single blood sampling from the patient’s ulnar vein. The serum is analyzed. Before testing for glycosylated hemoglobin, each patient should be fasting for at least 8 hours. One test can assess whether the patient has been maintaining adequate blood glucose levels in the last 6-10 weeks.
International recommendations suggest that glycosylated hemoglobin be tested in diabetics every three months. However, in people with a stable course of the disease – every 6 months.
The waiting time for a glycated hemoglobin result is usually 1 day.
The norm of glycosylated hemoglobin
The glycosylated hemoglobin measurement result is determined according to the NGSP (percentage) or IFCC (mmol / mol) standard. HbA1C determination is also performed using the HPLC method, which, however, is not very common in Poland.
The norm of glycosylated hemoglobin for people with diabetes (according to the recommendations of the Polish Diabetes Society of 2019) depends on the patient’s health and age:
- up to 7 percent (53 mmol / mol) of total hemoglobin in a diabetic patient – this is the general goal of balancing the carbohydrate balance;
- up to 6,5 percent (48 mmol / mol) – in children and adolescents, people with short-term type 2 diabetes, and (if it does not affect the patient’s quality of life) in the case of type 1 diabetes;
- less than 6,5 percent (48 mmol / mol) – applies to women planning pregnancy and suffering from pre-pregnancy diabetes;
- less than 6 percent (42 mmol / mol) – applies to women in the second or third trimester of pregnancy (unless there is a higher risk of hypoglycaemia then);
- up to 8 percent (64 mmol / mol) – in seniors suffering from long-term diabetes, who also had a stroke, heart attack or other diseases.
Normal HbA1C level in a healthy person is about 5 percent. total hemoglobin.
Three values are primarily used to assess the state of glucose metabolism – glycosylated hemoglobin, fasting glucose (FPG), fasting glucose in 2h OGTT.
Your doctor may check your HbA1C level to:
- assessment of diabetes control in the period up to 2 months preceding the examination;
- diagnosis of diabetes mellitus and at least annually during treatment;
- before deciding to start insulin treatment,
- controlling the proper control of diabetes,
- control of diabetes in pregnant women.
The test is also performed when the blood glucose values are unstable in home measurements and when the patient is unable to control glycemia.
Interpretation of the results
Before interpreting HbA1C results, keep in mind that different laboratories have different test methods. For this reason, the values may differ from each other. Elevated glucose levels in the blood causes a non-enzymatic attachment of a glucose molecule to hemoglobin. The percentage of glycosylated hemoglobin content is a measure of the correction of carbohydrate disturbances in the period of about 2 months preceding the test. The higher the concentration, the greater the likelihood of developing diabetes metabolic and organ complications. High levels indicate uncontrolled diabetes.
In patients with blood transfusions, people with anemia, or diseases with changes in hemoglobin structure, HbA1c may not correlate with proper blood glucose levels.
Certain diseases or conditions in the body affect the result of the glycated hemoglobin test:
- low HbA1C values – the reason for such a result may be the shortened survival time of red blood cells (e.g. haemolytic anemia), as well as the first half of pregnancy;
- overstated HbA1C values – appear in patients with renal failure, hyperlipoproteinemia, chronic alcoholism, in women in the second half of pregnancy, during breastfeeding, and in patients taking large amounts of salicylates.
HbA1C levels should be reduced.
- Lowering the HbA1c level by 1 percent. causes a lower risk of side effects (retinopathy and diabetic nephropathy) by 37%, compared to 5%. lowering the occurrence of stroke, reducing the risk of death by 12%, and the risk of limb amputation by as much as 43%
- In people with type 1 diabetes, an increase in HbA1c levels by 1%. increases the risk of polyneuropathy by 10-15%.
- In patients with type 2 diabetes, intensive diabetes treatment reduces the number of polyneuropathy cases by as much as 60%. and delay its occurrence for 2 years.
Side effects of untreated diabetes
Diabetes can cause:
- stroke;
- infarction (occurs 4 times more than in healthy people);
- kidney damage;
- the so-called diabetic foot syndrome;
- diabetic retinopathy;
- circulatory complications (often fatal, in about 75% of cases);
- foot amputation;
- peripheral vascular disease;
- cataract.
The Polish Diabetes Association recommends that HbA1c testing should be performed in every diabetic patient at least ONCE a year. In clinical practice, it is recommended that HbA1c be tested every six months in most patients. This test is very important because it allows you to monitor the treatment process and its effectiveness, and whether the patient is following the recommendations. It also allows modifying the therapy so as to lower the risk of developing diabetes complications.
Glycated hemoglobin – price
The measurement of glycosylated hemoglobin concentration costs PLN 30-45 depending on the laboratory. We will also perform the examination as part of the National Health Fund, if we receive a medical referral.
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