As we know, patients with diabetes may experience long term vascular and neurologic problems if their insulin levels are not monitored and controlled. Glucose levels that are maintained at near-normal levels on a daily basis, as shown by a low A1c, “delays the onset and slows the progression of diabetic retinopathy, nephropathy and neuropathy”. Of course, regular finger stick blood glucose is the standard test used for daily sugar control; however, the A1C is utilized for evaluating how well the patient is doing with their daily blood glucose testing and their regular diabetic control.
The hemoglobin A1C test (also known as HbA1c or just A1C) or glycated hemoglobin or glycosylated hemoglobin test measures your average blood glucose control for the past 2-3 months. When a patient checks their blood glucose with their meter at home or in the doctor’s office they get a reading of what their blood glucose level is right now. The A1C test will tell them what their average control has been over the last 2-3 months. This result lets a patient know, on average, how well their diabetes treatment plan has been working over the past 3 months.
Hemoglobin is a protein found in your red blood cells. Hemoglobin carries oxygen from your lungs to all of the cells in your body. Hemoglobin will also bind with sugar. Normally, about 5% of all hemoglobin is bound to sugar (glycated). When someone is hyperglycemic (has too much sugar in their blood) this percentage increases, sometimes up to 25%. The A1C test will measure this percent.
The A1C test will provide a 3 month average of the amount of hemoglobin bound to sugar. This number reflects the average blood glucose level of an individual over the life span of a red blood cell, which is approximately 3-4 months. Patients with diabetes should check their A1C about every 3 months. If their sugars are fairly stable, than twice a year may be adequate. Patients should check with their doctor to see how often they should be checking their A1C level. Normal A1C is 5% and the American Diabetes Association recommends keeping A1C less than 7%. The numbers may be a little different for teens and children.
The A1C is a great measure of how a patient’s diabetic regimen is working for them; however, it does not replace the need for daily self-testing. Close monitoring and effective therapy will significantly decrease and delay the onset of long term diabetes complications that involve micro-vascular blood flow and nerve function.
About the Author
Dr. Steve Leuck is currently a community pharmacist in a hospital out-patient pharmacy, where he educates and motivates patients to participate in their own pharmaceutical care. He is also owner of AudibleRxTM where OBRA 90 based Medication Specific Counseling SessionsTM are available in audio format.
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