Understanding Your Hba1c
You’ve heard about a diabetes test called a hemoglobin A1C. It’s sometimes shortened to HgbA1c or HbA1c or just A1C. Hopefully, you know what yours is. But do you know what it means and what to do with the information? Hemoglobin is what makes red blood cells red. It consists of several proteins wrapped around an iron-based molecule called heme. Heme attaches to oxygen and carries it to the cells. That’s why iron is important in our diets. We need iron to make heme to carry oxygen, so our cells can breathe. Glucose (sugar) molecules are also floating along in our blood. Glucose attaches itself to all kinds of proteins, including the hemoglobin in red blood cells (RBCs). When glucose levels are high, many more of them will attach. Hemoglobin coated with glucose is called “glycated” or “glycosylated” hemoglobin. Glycation (“sugar-coating”) may not harm an RBC, but it does tell us if the cell has encountered much glucose during its lifetime. The more glucose has been in the blood, the more RBCs will be glycated. This is what an HbA1c test measures. A1C isn’t measuring what your blood glucose level is at the moment. It measures how high glucose has been over the last two months or so. RBCs only live about 100–120 days in the bloodstream. Once they become glycated, they stay glycated for life, so the number of glycated RBCs (HbA1c) gives a good picture of how much glucose has been in the blood recently. The A1C test has several advantages over other tests such as a fasting blood sugar (FBS). You don’t have to fast for an A1C. It can be taken at any time of day. It doesn’t matter what you ate the day before or on the day of the test, because it’s not measuring your current sugar. Normally, between 4.2% and 5.6% of RBCs will be glycated. The America Continue reading >>
Hba1c Normal Range
The hemoglobin A1c, also known as the HgbA1c or glycated hemoglobin level, is a measurement of the amount of sugar found on hemoglobin. Because red blood cells containing hemoglobin live only about 120 days, the test only measures how “sugar-coated” the red blood cell hemoglobin has been over the previous 2-3 months. The test is done at the doctor’s office but doesn’t replace the normal blood sugar testing that a person does at home. Hemoglobin is a protein found inside the red blood cells in the bloodstream. Hemoglobin normally carries oxygen in the bloodstream to the cells of the body and exchanges it for carbon dioxide. When the blood sugar is elevated, the hemoglobin takes on the sugar and becomes glycated. If the average blood sugar has been high over the last 3 months, this will be reflected in a high hemoglobin A1c level. Normal Levels for Hemoglobin A1c People who don’t have diabetes will have a hemoglobin A1c level of between 4 and 5.6 percent. If the hemoglobin A1c level is between 5.7-6.4 percent, this indicates prediabetes and indicates that a person is at risk for diabetes. Any hemoglobin A1c level of greater than 6.5 percent is a presumptive diagnosis of diabetes. The goal for diabetics is to have the hemoglobin A1c level less than 7 percent. At this level, there is less risk for having complications of diabetes mellitus. If the hemoglobin A1c level is chronically elevated above 7.0 percent, it means the individual is at a high risk for developing complications of diabetes, such as diabetic nephropathy, diabetic retinopathy, diabetic neuropathy, and heart disease complications. Reference: The Hemoglobin A1c test for diabetes. Accessed 5/16/16. Continue reading >>
Definition HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes.Â Alternative Names Glycated hemoglobin; Glycosylated hemoglobin; Hemoglobin - glycosylated; A1C; GHb; Glycohemoglobin How the test is performed A blood sample is needed. Some methods only require a quick finger stick. Others may need a sample of blood from a vein. For information on how this is done, see: Venipuncture. How to prepare for the test No special preparation is needed. How the test will feel When the needle is inserted, you may feel a slight pinch or some stinging. Afterward, there may be some throbbing. Why the test is performed Your doctor may order this test if you have diabetes. It shows how well you are controlling your diabetes. The test may also be used to screen for diabetes. Normal Values An HbA1c of 5.6% or less is normal. The following are the results when the HbA1c is being used to diagnose diabetes: Normal: Less than 5.7% Pre-diabetes: 5.7% to 6.4% Diabetes: 6.5% or higher If you have diabetes, you and your doctor or nurse will discuss the correct range for you. For many people the goal is to keep your level at or below 6.5 - 7%. Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens. What abnormal results mean Abnormal results mean that you have had high blood sugar levels over a period of weeks to months. If your HbA1c is above 6.5% and you do not already have diabetes, you may be diagnosed with diabetes. If your level is above 7% and you have Continue reading >>
What Is A1c?
A1c stands for glycated hemoglobin, a molecule that forms when the oxygen transporting-protein hemoglobin naturally bonds with glucose in the blood. This ‘glycated’ molecule is also commonly expressed as hemoglobin A1c, and measuring it gives clinicians a marker of your average blood sugar over the preceding 8 to 12 weeks. How is A1c measured? An A1c test is a clinical test that involves taking a sample of blood, often from the arm but sometimes from the finger, and using a specialist machine to measure the level of glycated hemoglobin. Hemoglobin is a protein found within your red blood cells that helps to carry oxygen around the body. In the presence of glucose, hemoglobin bonds to glucose so people with higher levels of glucose in the blood for extended periods of time will have higher levels of glycated hemoglobin until those red blood cells reach the end of their life, which typically takes 90 days. The A1c test therefore gives a good indication of how high your blood glucose levels have been over the past 3 months. When are A1c tests run? A1c tests are run so you and your health team can monitor how well your diabetes is being controlled. Your doctor may give you your results as an A1c percentage or may give your results as estimated average glucose (eAG) which is given in mg/dL (milligrams per deciliter). A1c tests may also be used in assessing risk of type 2 diabetes for people not diagnosed with diabetes. Target A1c levels Targets for A1c are as follows: For people without diabetes, the range is 4 to 5.9% (eAG 68 to 123 mg/dL) For non-pregnant adults with diabetes, an A1c level of 7% (eAG 154 mg/dL) is considered good control, although some people that are not at risk of hypoglycemia may prefer their numbers to be closer to that of non-diabetics For childre Continue reading >>
Tips To Lower Your Hba1c Levels
Regularly monitoring blood sugar levels is the number one rule for diabetics. This may mean testing blood in the day, in the evening or after a meal. However, there are many factors that influence blood sugar levels which may cause slightly inaccurate readings. This is why doctors ask for a HbA1c test to gauge changes in glucose levels and effects of treatment. So what is HbA1c? The HbA1c blood test is a check for the average blood sugar level over a three month period. This is a great way to judge the effectiveness of diabetic treatment and is a better indicator of a person’s risk for chronic illness. The higher the value the, higher is the blood sugar level and risk of ailments. The ideal HbA1c value is below 6.4%. For diabetics though the number is generally higher than 6.5% but should not exceed 7%. Lowering HbA1c test levels is one of the most important factors in diabetes treatment. How can I lower my HbA1c number? Follow a healthy meal plan: Include lots of fresh vegetables and fruits in your diet. These are high in nutrition and low in calories. Also, natural fiber got from these fruits and vegetables help keep blood glucose levels normal. Add vegetables like carrot, beans, tomatoes and broccoli to your diet. Fruits such as apples, grapefruit and watermelon are also good for glucose levels. Nuts and seeds are also loaded with anti-oxidants and omega-3 which keep your immunity and overall health good. However, always consume nuts in moderation as they are high in fat. Note: Certain fruits and vegetables may interfere with diabetes medication. Always talk to your doctor or nutritionist before adding anything new to your diet. Eliminate junk food: Junk and processed food like fried foods, desserts and store-bought foods all raise blood sugar and should be avoided Continue reading >>
HbA1c If you have diabetes, it's important to keep tight control of your blood sugar. The Hemoglobin A1c test, or HbA1C test, is one way to find out if you are in control. Hemoglobin is an important part of the red blood cell. Red blood cells live about three months. During the life of a red blood cell, sugar molecules, also floating around in your blood, tend to want to stick to the hemoglobin of your red blood cells. Identifying these sugar molecules allows us to get an approximate three-month average of how high persons blood sugars have been. The HbA1c test helps us diagnose a patient suspected of having diabetes and monitors the blood sugar of a diabetic patient. Now, how do we screen for diabetes? If your doctor suspects you have diabetes, your physician will order this simple blood test. A normal HbA1c level is less than 6.0%, which is a three month blood sugar average of around 126 milligrams per deciliter, written like this in your lab results. (126 mg/dl) A HgbA1c level of 5.7 to 6.4% means you are pre-diabetic or borderline-diabetic. If your HgbA1C is 6.5% or higher, you are considered to be a diabetic. That correlates roughly to a 3-month blood sugar average of 140. So, if you are a diabetic, what level should your HbA1c be? Through a combination of a good diabetic diet that controls for carbohydrates, proteins, fats and calories, the American Diabetes Association currently recommends a HbA1C goal of less than 7%. I should also point out that the American Association of Clinical Endocrinologists recommends an even stricter control of diabetes - with a recommended goal of less than 6.5%. What we do know is diabetes causes permanent and irreversible damage to the nerves, blood vessels and body organs, like your eyes, kidneys, heart and also your feet. So, it's Continue reading >>
Association Of High Normal Hba1c And Tsh Levels With The Risk Of Chd: A 10-year Cohort Study And Svm Analysis
This study aimed to determine the association between the clinical reference range of serum glycated hemoglobin A1c (HbA1c) and thyrotropin (TSH) and the risk of coronary heart disease (CHD) in non-diabetic and euthyroid patients. We examined baseline HbA1c and TSH in 538 healthy participants, and then analyzed the associations and potential value of these indicators for predicting CHD using Cox proportional hazard and support vector machine analyses. During the median follow-up of 120 months, 39 participants later developed CHD. The baseline HbA1c and TSH within the reference range were positively associated with CHD risk. No correlation and interaction were found between the baseline HbA1c and TSH for the development of CHD. Disease event-free survival varied among participants with different baseline HbA1c quintiles, whereas disease event-free survival was similar for different TSH tertiles. The combination of these baselines showed sensitivity of 87.2%, specificity of 92.7%, and accuracy of 92.3% for identifying the participants who will later develop CHD. Relatively high but clinically normal HbA1c and TSH levels may increase the risk of CHD. Therefore, the combination of these indicators can serve as a biomarker for identifying healthy individuals from those who would later develop CHD. Coronary heart disease (CHD) has one of the highest mortality rates among adults worldwide, especially in developed areas, such as Europe, North America, and China1,2,3. Early prediction combined with subsequent prevention or medical intervention for CHD is the best approach to reduce mortality. Age, gender, family history, blood pressure, cholesterol, and cigarette smoking are the independent risk factors for CHD3,4. Previous studies successfully used these risk factors to predict Continue reading >>
- Researchers identify gene variants linked to both type 2 diabetes and CHD risk
- Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators
- Diabetic by HbA1c, Normal by OGTT: A Frequent Finding in the Mexico City Diabetes Study
Diabetic By Hba1c, Normal By Ogtt: A Frequent Finding In The Mexico City Diabetes Study
The agreement between glucose-based and hemoglobin A1c (HbA1c)–based American Diabetes Association criteria in the diagnosis of normal glucose tolerance, prediabetes, or diabetes is under scrutiny. A need to explore the issue among different populations exists. All 854 participants without known diabetes had both oral glucose tolerance test (OGTT) and HbA1c measurements on the same day of the 2008 phase. We found by OGTT normal glucose tolerance (NGT) in 512 (59.9%) participants, prediabetes [impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT)] in 261 (30.5%), and diabetes in 81 (9.4%). In total, 232 in the NGT group (45.3%) and 158 in the prediabetes group (60.5%) had HbA1c ≥6.5%. Body mass index, waist circumference, and blood pressure were significantly different among OGTT-defined diabetic status groups but not in the HbA1c-diagnosed group. We identified 404 participants in the NGT group with confirmed NGT throughout all phases of the Mexico City Diabetes Study. Of these, 184 (45.5%) had HbA1c ≥6.5%. In a vital/diabetes status follow-up performed subsequently, we found that, of these, 133 remained nondiabetic, 3 had prediabetes, 7 had diabetes, and 13 had died without diabetes; we were unable to ascertain the glycemic status in 5 and vital status in 23. The patient was a 47-year-old Japanese man whose parents were first cousins. He lacked secondary sexual characteristics owing to normosmic CHH. Exon segments for the KISS1R gene in this patient were screened for mutations. Functional analyses were performed using HEK293 cells expressing KISS1R mutants. Molecular dynamics simulations were performed to compare the ligand-KISS1R mutant complex with those of wild-type KISS1R variants. A homozygous mutation (c.440C>T, p.P147L) in KISS1R was identi Continue reading >>
Haemoglobin A1 And Haemoglobin A1c
Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. Synonym: glycosylated haemoglobin Glycated haemoglobin (HbA1c) laboratory tests are used to diagnose diabetes mellitus and to assess control in diabetes mellitus. For further information regarding HbA1c monitoring and targets, see the separate Management of Type 1 Diabetes and Management of Type 2 Diabetes articles. Chromatography of normal adult blood divides into two parts: HbA (HbA0) 92-94%. HbA1 (6-8%) where the B chain has an additional glucose group. HbA1 itself consists of three different glycations, the HbA1c subgroup being the most useful, usually measured by isoelectric focusing or electrophoresis. The glycation of haemoglobin occurs at a variable (non-linear rate) over time, during the whole lifespan of the red blood cell (RBC), which is normally 120 days. This means the relative proportion of glycated haemoglobin at any one time depends on the mean glucose level over the previous 120 days. Normal levels (laboratory normal 'range') will differ depending on whether HbA1 or HbA1c is measured, and on the method used - use your laboratory's reference range (EDTA (FBC) bottle). HbA1c is usually a reliable indicator of diabetic control except in the following circumstances: Situations where the average RBC lifespan is significantly less than 120 days will usually give rise to low HbA1c results because 50% of glycation occurs in days 90-120. Common causes include: Increased red cell turnover: blood loss, haemolysis, haemoglobinopathies and red cell disorders, myelodysplastic Continue reading >>
What Are The Normal A1c Levels For Children?
The A1c blood test is one of the laboratory tests used to diagnose diabetes and an important measure of average blood sugar levels in someone who has diabetes. This test determines the amount of glucose or sugar that has attached to the blood's hemoglobin -- the oxygen-carrying protein in red blood cells -- during the 3-month lifespan of these cells. Target A1c levels have been established to help healthcare providers, as well as children with diabetes and their families, understand the blood sugar goals needed to reduce the risk of the long-term complications of diabetes. While there are some situations where the A1c result may not be reliable, as a rule this test is accurate and an essential part of a child's diabetes management program. Video of the Day Normal A1c Levels Diagnostic criteria for children is similar to the guidelines used in adults, and the A1c is one of the tests used to diagnose diabetes. A1c levels are reported as a percentage, and often the estimated average glucose (eAG) -- a number calculated from the A1c reading -- is also included with the results. Using the same units as a blood glucose meter, the eAG makes understanding the A1c result a bit easier by comparing the A1c to average blood sugar levels. A normal, nondiabetic A1c level is below 5.7 percent, which reflects an eAG below 117 mg/dL. The level used to diagnose diabetes is 6.5 percent and above, which reflects an eAG of 140 mg/dL or higher. A1c levels above normal but below the diabetes range fit into a prediabetes range. Target A1c Levels Along with its role in diagnosing diabetes, the A1c test is performed between 2 and 4 times per year to estimate average blood sugar levels over the previous 3 months. This test is used to monitor the effectiveness of diabetes treatment and to determin Continue reading >>
Introduction Hemoglobin A1c test (HbA1c, A1c, or Hb1c) is used to determine the average concentration of glucose in the blood plasma. Hemoglobin is the protein in red blood cells that carries oxygen throughout the body. HbA1c is formed when glucose combines with the hemoglobin in red blood cells to form glycated hemoglobin. Test Purposes This test is important: To diagnose diabetes To monitor a person’s diabetes and to aid in treatment decisions To help identify those at an increased risk of developing diabetes Diabetes mellitus is a condition characterized by hyperglycemia (high blood glucose) resulting from the inability to use blood glucose for energy. In diabetes type one, the pancreas does not produce or does not secrete insulin. The blood glucose cannot be stored and processed for use by certain cells in the body. In diabetes type two, either the pancreas does not make enough insulin or the cells cannot use insulin properly. Diabetic complications involving the eyes, kidneys, nerves and blood vessels of the heart, brain and extremities is normal for both forms of the disease diabetes. The level of HbA1c is proportional to the concentration of glucose in the blood plasma and red blood cell life span in the life cycle, usually covering a period of 120 days (three months). If high levels of glucose, hemoglobin A1c test will also be high. Therefore, the HbA1c test provides precise measurements of blood glucose in three to four months back. Thus, for patients who have been diagnosed with diabetes mellitus, HbA1c testing will be done two to three months to assess the effectiveness of treatment for these patients. Figure 1: Formation of glycated haemoglobin Method of Test Nowadays, there are various different methods used to conduct the HbA1c test. Generally, these tes Continue reading >>
Hba1c Test - What Is A Normal Range?
An HbA1ca test is blood test which indicates how much of the oxygen carrying red pigment in red blood cells is affected by glucose. The result is usually expressed as a percentage. An HbA1c below 6.5% indicates good glucose control over the previous eight to twelve weeks. A high value of around 10% would mean that on average the blood levels have been high over the previous two to three months. A blood glucose level shows the level of glucose at a particular time, for example, before breakfast. The HbA1c gives a measure of glucose control over a much longer time period - two or three months. This is useful because, of course, blood results can vary enormously over the day and what is important is that, on average, the levels are not too high. HbA1c test levels show a strong correlation with complications of diabetes so that patients with values less than 6.5% have a much reduced risk of complications compared to those with high values. For most people with diabetes, NICE (National Institute for Health and Clinical Excellence) recommends an HbA1c normal range to be below 6.5%. However targets do need to be individualised for the particular person bearing in mind the risk of hypoglycaemia, quality of life and any other factors such as co-existing medical conditions. In all cases, the patients’ views must be taken into account and the risks of high blood glucose levels balanced by the risks of the treatment. Continue reading >>
The Normal A1c Level
You want to control your diabetes as much as possible. You wouldn’t be reading this if you didn’t. So you regularly check your A1C level. This is the best measurement of our blood glucose control that we have now. It tells us what percentage of our hemoglobin – the protein in our red blood cells that carry oxygen – has glucose sticking to it. The less glucose that remains in our bloodstream rather than going to work in the cells that need it the better we feel now and the better our health will continue to be. Less glucose in the bloodstream over time leads to lower A1C values. As we are able to control our diabetes better and better, the reasonable goal is to bring our A1C levels down to normal – the A1C level that people who don’t have diabetes have. But before we can even set that goal, we have to know what the target is. The trouble with setting that target is that different experts tell us that quite different A1C levels are “normal.” They tell us that different levels are normal – but I have never heard of actual studies of normal A1C levels among people without diabetes – until now. The major laboratories that test our levels often say that the normal range is 4.0 to 6.0. They base that range on an old standard chemistry text, Tietz Fundamentals of Clinical Chemistry. The Diabetes Control and Complications Trial or DCCT, one of the two largest and most important studies of people with diabetes, said that 6.0 was a normal level. But the other key study, the United Kingdom Prospective Diabetes Study or UKPDS, which compared conventional and intensive therapy in more than 5,000 newly diagnosed people with type 2 diabetes, said that 6.2 is the normal level. Those levels, while unsubstantiated, are close. But then comes along one of my heroes, Dr. Continue reading >>
- What Is a Normal Blood Sugar Level?
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
Understanding The New Hba1c Units For The Diagnosis Of Type 2 Diabetes
In the absence of overt symptoms of hyperglycaemia, the diagnosis of diabetes has been based on plasma glucose concentrations that are associated with an increased risk of its specific microvascular complications, in particular retinopathy.1,2 The precise criteria have always been determined by consensus among experts and are based principally on several large observational cohort studies. The criteria have been repeatedly modified over time as more high quality data have become available. Most recently many international diabetes societies have adopted the measurement of glycated haemoglobin (HbA1c) as a legitimate diagnostic test for the diagnosis of diabetes using a “cut point” for the diagnosis of ≥6.5%.3–5 Recently there has been a change in the reporting units for HbA1c from percent to mmol/mol that has been driven by the International Federation of Clinical Chemistry (IFCC) and is linked to the standardisation of routine assays for HbA1c to a new reference method.6 The validity of the process has been accepted by many international diabetes societies (American Diabetes Association, Canadian Diabetes Society, European Association for the Study of Diabetes and International Diabetes Federation) as well as by the New Zealand Society for the Study of Diabetes (NZSSD).7 A NZSSD Working Party, made up of members representing clinicians, academics, laboratory staff, general practitioners and population health experts, has developed and now published a new position statement for the diagnosis of diabetes.7 This article explains the changes in use of HbA1c recommended in that statement and expands on the evidence behind these modifications. New units All methods used to measure HbA1c in New Zealand are now standardised through traceability to the IFCC reference me Continue reading >>