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In
the Spotlight
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| May
08, 2000 |
The
ABCs of Hemoglobin A1c: Controlling Your Blood Sugar
By Lee Phillips, MD
PersonalMD.com Medical Contributor
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 The
hemoglobin A1c test (also called H-b-A-1-c) is a simple lab test and is
the best way for a physician to tell if your blood sugar is under control.
It shows the average amount of sugar (glucose) that has been in your blood
over the previous three months. Anyone with diabetes should have a hemoglobin
A1c test at least twice a year; more often if their blood sugar stays
too high or if your doctor makes any change in your treatment plan.
The hemoglobin A1c test measures the amount of sugar sticking to the hemoglobin
in the red blood cells. To do the test, a small sample of blood is taken.
The blood sample is sent to a laboratory for testing, and the laboratory
sends the results to your doctor. Sugar in the bloodstream, that is not
used for energy, becomes attached to the hemoglobin (the part of the cell
that carries oxygen) in red blood cells. This process is called glycosylation
(pronounced gli-kos-a-lay'-shen). Once the sugar is attached, it stays
there for the life of the red blood cell, which is about 120 days. The
higher the level of glucose in the blood, the more it builds up in the
cells. The hemoglobin A1c goal for people with diabetes is less than 7%.
In people without diabetes, the HbA1c should to be 4.5% to 6.7%.
What's the importance of HbA1c?
The findings
of a major diabetes study have shown the importance of maintaining a low
hemoglobin A1c. People with diabetes who keep their hemoglobin A1c levels
close to 7% have a much better chance of delaying or preventing problems
that affect the eyes, kidneys and nerves than people with hemoglobin A1c
levels of 8% or higher. The buildup of extra glucose in cells is one of
the causes of damage seen in diabetes. The study also showed that lowering
hemoglobin A1c levels by any amount improves a person's chances of staying
healthy. A change in treatment is almost always needed if your hemoglobin
A1c is over 8%.
How does HbA1c compare to blood sugar readings?
People with high daily blood sugar readings most of the time will usually
have a high hemoglobin A1c test result. You can multiply your hemoglobin
A1c value by 25 to get your average daily blood glucose value. For example,
a hemoglobin A1c level of 7% means an average blood sugar of about 150
mg/dl during the previous three months.
Self-monitoring of blood glucose helps one see how food, physical activity
and diabetes medicine affect blood sugar. A finger-stick test using a
blood glucose meter measures the actual level of sugar in the blood. The
meter reading is reported in milligrams per deciliter (mg/dl).
The readings from these tests can help you manage your diabetes day by
day or even hour by hour. Common causes of high blood sugar include eating
too much food or eating the wrong foods, lack of physical activity, stress,
a need to change medicines and infection or illness. By finding the source
of the problem, your doctor can decide if and how to change your treatment
plan to meet the hemoglobin A1c goal of less than 7%. Self-monitoring
of blood glucose gives a snapshot of control, while the hemoglobin A1c
test gives the big picture of control over the past three months. Together,
these tests give a complete picture of blood sugar control.
Copyright
© 2000 PersonalMD.com. All rights reserved.
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