Irrespective of various theories surrounding blood sugar levels, the increasing numbers and treatment methodologies and systems, a ray of hope these days is the changed scenario that by and large most of Diabetics can be cured. Here is what our learned Doctor has to say on the same:
HbA1c - Glycosylated Hemoglobin: A normal A1C level is below 5.7%, and a level of 5.7% to 6.4% indicates prediabetes. and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.
What Can Affect Your A1C Result? The A1C test—also known as the Hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months. It’s one of the most commonly used tests to diagnose prediabetes and diabetes and is also the main test to help you and your healthcare team manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is really important if you have diabetes.
What Does the A1C Test Measure? When sugar enters the bloodstream, it attaches to haemoglobin, a protein in red blood cells. Everybody has some sugar attached to their haemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated haemoglobin.
Who Should Get an A1C Test, and When?
Testing for diabetes or prediabetes:
Get a baseline A1C test if you’re an adult over age 45—or if you’re under 45, are overweight, and have one or more risk factors for prediabetes or type 2 diabetes:
If your result is normal but you’re over 45, have risk factors, or have ever had gestational diabetes, repeat the A1C test every 3 years.
If your result shows you have prediabetes, talk to your doctor about taking steps now to improve your health and lower your risk for type 2 diabetes. Repeat the A1C test as often as your doctor recommends, usually every 1 to 2 years.
If you don’t have symptoms but your result shows you have prediabetes or diabetes, get a second test on a different day to confirm the result.
If your test shows you have diabetes, ask your doctor to refer you to diabetes self-management education and support services so you can have the best start in managing your diabetes.
Managing diabetes:
If you have diabetes, get an A1C test at least twice a year, more often if your medicine changes or if you have other health conditions. Talk to your doctor about how often is right for you.
Your A1C Result
Diagnosing Prediabetes or Diabetes
Normal
Below 5.7%
Prediabetes 5.7% to 6.4%
Diabetes 6.5% or above
A normal A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.
Your A1C result can also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you’re used to seeing on your blood sugar meter
Several factors can falsely increase or decrease your A1C result, including:
Kidney failure, liver disease, or severe anaemia.
A less common type of haemoglobin that people of African, Mediterranean, or Southeast Asian descent and people with certain blood disorders (such as sickle cell anaemia or thalassemia) may have.
Certain medicines, including opioids and some HIV medications.
Blood loss or blood transfusions.
Early or late pregnancy.
Haemoglobin is a protein only found in red blood cells. In fact, haemoglobin is what gives blood its bright red colouring. Since red blood cells live about an average of three months, the A1c test will reflect those red blood cells that are present in the bloodstream at the time of the test; this is why the A1c serves as an average of blood sugar control.
The main job of haemoglobin is to carry oxygen from the lungs to all the cells of the body. Haemoglobin becomes glycated or coated with glucose from the bloodstream. The amount of glucose that is present in the blood will attach to the haemoglobin protein, and increased glucose levels will reflect on the surface of the haemoglobin protein, thereby rendering a higher A1c level
The Diabetic Control and Complications Trial (DCCT) trial reported that a higher mean A1c level was the dominant predictor of diabetic retinopathy progression. Tighter control shown by levels of HbA1c in the 7% range or lower, was correlated with a 35-76% decrease in microvascular complications, like retinopathy, nephropathy and neuropathy, in patients with type 1 diabetes. In addition to the determination of A1c levels predicting progression of microvascular complications, the extension of DCCT into EDIC study showed benefit in the cardiovascular risk and mortality in the long term for those patients with lower levels of HbA1c.
Pathophysiology
People with diabetes need to have their A1c checked regularly to determine if their average blood glucose levels are within the target range. The American Diabetes Association (ADA) recommends that the HbA1c is checked twice a year in patients who are stable and well-controlled.
A falsely high HbA1c can be due to a lack of available iron in the blood. This condition can result from iron deficiency anaemia, infection-induced anaemia, or tumour-induced anaemia. Hemoglobinopathies such as thalassemia and B12 deficiency can also cause a falsely high HbA1c. Other causes of falsely high HbA1c levels include hypertriglyceridemia, organ transplantation, and hyperglycation in certain ethnic groups. Medications such as immunosuppressants and protease inhibitors can sometimes lead to a falsely high HbA1c.
Relationship Between A1c and Glucose Level
The HbA1c percentage equates to an average glucose level in the body that the patient experienced over the past 90 days.
A1c (%) Average Blood Glucose (mg/dL)
6 126
8 183
10 240
.
12 298
14 355
In the emerging scenario of breakthrough advances, most diabetics can be cured.
Inputs courtesy: ENT specialist with 41 years of experience preferring to remain anonymous.
HbA1c - Glycosylated Hemoglobin: A normal A1C level is below 5.7%, and a level of 5.7% to 6.4% indicates prediabetes. and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.
What Can Affect Your A1C Result? The A1C test—also known as the Hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months. It’s one of the most commonly used tests to diagnose prediabetes and diabetes and is also the main test to help you and your healthcare team manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is really important if you have diabetes.
What Does the A1C Test Measure? When sugar enters the bloodstream, it attaches to haemoglobin, a protein in red blood cells. Everybody has some sugar attached to their haemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated haemoglobin.
Who Should Get an A1C Test, and When?
Testing for diabetes or prediabetes:
Get a baseline A1C test if you’re an adult over age 45—or if you’re under 45, are overweight, and have one or more risk factors for prediabetes or type 2 diabetes:
If your result is normal but you’re over 45, have risk factors, or have ever had gestational diabetes, repeat the A1C test every 3 years.
If your result shows you have prediabetes, talk to your doctor about taking steps now to improve your health and lower your risk for type 2 diabetes. Repeat the A1C test as often as your doctor recommends, usually every 1 to 2 years.
If you don’t have symptoms but your result shows you have prediabetes or diabetes, get a second test on a different day to confirm the result.
If your test shows you have diabetes, ask your doctor to refer you to diabetes self-management education and support services so you can have the best start in managing your diabetes.
Managing diabetes:
If you have diabetes, get an A1C test at least twice a year, more often if your medicine changes or if you have other health conditions. Talk to your doctor about how often is right for you.
Your A1C Result
Diagnosing Prediabetes or Diabetes
Normal
Below 5.7%
Prediabetes 5.7% to 6.4%
Diabetes 6.5% or above
A normal A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.
Your A1C result can also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you’re used to seeing on your blood sugar meter
Several factors can falsely increase or decrease your A1C result, including:
Kidney failure, liver disease, or severe anaemia.
A less common type of haemoglobin that people of African, Mediterranean, or Southeast Asian descent and people with certain blood disorders (such as sickle cell anaemia or thalassemia) may have.
Certain medicines, including opioids and some HIV medications.
Blood loss or blood transfusions.
Early or late pregnancy.
Haemoglobin is a protein only found in red blood cells. In fact, haemoglobin is what gives blood its bright red colouring. Since red blood cells live about an average of three months, the A1c test will reflect those red blood cells that are present in the bloodstream at the time of the test; this is why the A1c serves as an average of blood sugar control.
The main job of haemoglobin is to carry oxygen from the lungs to all the cells of the body. Haemoglobin becomes glycated or coated with glucose from the bloodstream. The amount of glucose that is present in the blood will attach to the haemoglobin protein, and increased glucose levels will reflect on the surface of the haemoglobin protein, thereby rendering a higher A1c level
The Diabetic Control and Complications Trial (DCCT) trial reported that a higher mean A1c level was the dominant predictor of diabetic retinopathy progression. Tighter control shown by levels of HbA1c in the 7% range or lower, was correlated with a 35-76% decrease in microvascular complications, like retinopathy, nephropathy and neuropathy, in patients with type 1 diabetes. In addition to the determination of A1c levels predicting progression of microvascular complications, the extension of DCCT into EDIC study showed benefit in the cardiovascular risk and mortality in the long term for those patients with lower levels of HbA1c.
Pathophysiology
People with diabetes need to have their A1c checked regularly to determine if their average blood glucose levels are within the target range. The American Diabetes Association (ADA) recommends that the HbA1c is checked twice a year in patients who are stable and well-controlled.
A falsely high HbA1c can be due to a lack of available iron in the blood. This condition can result from iron deficiency anaemia, infection-induced anaemia, or tumour-induced anaemia. Hemoglobinopathies such as thalassemia and B12 deficiency can also cause a falsely high HbA1c. Other causes of falsely high HbA1c levels include hypertriglyceridemia, organ transplantation, and hyperglycation in certain ethnic groups. Medications such as immunosuppressants and protease inhibitors can sometimes lead to a falsely high HbA1c.
Relationship Between A1c and Glucose Level
The HbA1c percentage equates to an average glucose level in the body that the patient experienced over the past 90 days.
A1c (%) Average Blood Glucose (mg/dL)
6 126
8 183
10 240
.
12 298
14 355
In the emerging scenario of breakthrough advances, most diabetics can be cured.
Inputs courtesy: ENT specialist with 41 years of experience preferring to remain anonymous.
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