The HbA1c test, also known as the Haemoglobin A1c or Glycated Haemoglobin test, is an important blood test that gives a good indication of how well your diabetes is being controlled.
It is measured primarily to determine the three-month average blood sugar level and can be used as a diagnostic test for diabetics. The test is limited to a three-month average because the average lifespan of a red blood cell is four months. In diabetics, higher amounts of glycated haemoglobin indicates poorer control of blood glucose levels, which is associated with cardiovascular disease, nephropathy, neuropathy, and retinopathy.
Several techniques are used to measure Haemoglobin A1c. Laboratories use high-performance liquid chromatography (the HbA1c result is calculated as a ratio to total haemoglobin using an immunoassay; enzymatic assay; capillary electrophoresis; or boronate affinity chromatography.
Glycated haemoglobin testing is recommended for both checking the blood sugar control in people who might be pre-diabetic and monitoring blood sugar control in patients with more elevated levels, termed diabetes mellitus. Hba1c level well below 7, indicates a good control on diabetes and hence it’s suggested to take HbA1c test every 3 months for better monitoring.
Laboratory results may differ depending on the analytical technique, the age of the subject, and biological variation among individuals. Higher levels of HbA1c are found in people with persistently elevated blood sugar, as in diabetes mellitus. While diabetic patient treatment goals vary, many include a target range of HbA1c values. A diabetic person with good glucose control has a HbA1c level that is close to or within the reference range.
Diagnostic Standard for HbA1C in Diabetes
HbA1C
<5.7%
Normal
5.7-6.4%
Prediabetes
Diabetes
The guidelines advise that the Glycated Haemoglobin test be performed at least twice a year in patients with diabetes who are meeting treatment goals (and who have stable glycaemic control) and quarterly in patients with diabetes whose therapy has changed or who are not meeting glycaemic goals. Glycated haemoglobin measurement is not appropriate where a change in diet or treatment has been made within 6 weeks.
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