What is HbA1c(A1c) test , How to control HbA1c? What is a normal HbA1c level?

What is HbA1c(A1c)?

HbA1c is a blood test that shows your average blood sugar levels over the past 2 to 3 months. sometimes it is also called just A1c or haemoglobin A1c.

It can be performed at any time and doesn't require any preparations. It can be done in fasting or post-meal condition. It is different from a finger prick test. A finger prick test is a snapshot of blood sugar levels at a specific time and on a specific day.

What is its complete form?

HbA1c stands for glycated haemoglobin. Your red blood cells(RBCs) contain haemoglobin which plays important role in the delivery of oxygen. The total life span of RBCs is 90 to 120 days. Haemoglobin remains glycated for about 90 to 120 days and its value is proportional to the average blood glucose level during this period.

What it is used for?

This test is used to diagnose diabetes and monitor diabetic patients for blood sugar control. It is also used to review medications and diet plans.  Your doctor decides whether you fall into the normal, prediabetic or diabetic category based on your HbA1c levels.

What is the normal range?

A young healthy person usually has HbA1c  between 30 to 33mmol/mol (4.9 to 5.2%).

According to the 2010 American Diabetes Association(ADA) Standards of Medical Care in Diabetes, a normal HbA1c value is less than 39mmol/mol (<5.7%).

If your HbA1c value is 39 to 46mmol/mol (5.7 to 6.4%) then you fall in the prediabetics category.

HbA1c above 46mmol/mol (>6.4%) is in the diabetic range.

What is the recommended value for diabetic patients?

If you are diabetic, the International Diabetes Federation and the American College of Endocrinology recommend HbA1c values below 48 mmol/mol (<6.5%), while the American Diabetes Association recommends HbA1c below 5.3mmol/mol (<7%). 

What is the importance of HbA1c?

If your HbA1c is higher than the recommended values then you must consult your healthcare provider. High HbA1c is directly related to the development of diabetes-associated complications. 

How to lower HbA1c?

Lots of things can cause your HbA1c to change. You can visit your local healthcare provider or your diabetic team to review your medications and diet plan. Here are some things that can decrease your HbA1c levels,

• Visit your healthcare provider and review your medications
• Regular exercise
• Follow a diabetes diet plan
• Avoid alcohol intake
• Stop smoking
• Cut down carbohydrate intake
• Keep track of your caloric intake
• Eat a fresh, healthy and balanced diet
• Maintain a healthy weight

How often do I need the test?

It depends on your diet, medications, local health guidelines, and type of your diabetes. Always consult your healthcare provider and diabetes team for consultation and further information.

Usually, this test is done after 3 to 4 months.

It is always advised to consult your healthcare provider. This is information is provided here only for education and awareness purposes.

What is diabetes? What are symptoms of diabetes? How it is diagnosed and what is the trearment?

Diabetes mellitus

Overview

Diabetes mellitus is a chronic condition that is diagnosed when you have raised blood sugar levels. The main cause of diabetes is an absolute or relative deficiency of insulin in your body. Most of your food turns into sugar(glucose) in your body. Whenever you eat your blood sugar level rises which signal the pancreas to release insulin.

Insulin is a hormone that helps in regulating blood sugar levels. Insulin helps your body in consuming sugar. When there is a deficiency of insulin blood sugar level rises. There are different types of diabetes mellitus such as type 1 diabetes, type 2 diabetes, gestational diabetes, and some rare types(MODY and LADA). 

Types of Diabetes

Type 1 diabetes: 

Type 1 diabetes(previously known as insulin-dependent) is a disease of childhood. Your body's defence mechanism turns against your own pancreatic cells resulting in the destruction of insulin-secreting tissue. There is no insulin to process your blood sugar. This is called absolute deficiency of insulin. As a result blood sugar level rises.

Type 2 diabetes: 

Type 2 diabetes(previously called insulin-independent) is basically diabetes in adulthood and is usually diagnosed by the age of 35 years old. It runs in families because it has a strong genetic preponderance. It is caused by a relative deficiency of insulin which means your cells don't respond to insulin or there is resistance to the effects of inulin. As a result, cells are unable to process blood sugar and blood sugar level rises. It is also strongly associated with Obesity and metabolic syndrome.

Gestational diabetes:

It is defined as high blood sugar levels during pregnancy. It can happen at any stage of pregnancy but it is more common in second and third trimesters. 

Some hormones produced by the placenta have insulin-blocking effects. Women suffering from this condition may experience complications during pregnancy and delivery. Both mother and child have an increased risk of developing diabetes in the future. It is diagnosed by prenatal screening rather than symptoms.

What are the symptoms of diabetes?

There is a long list of symptoms because there are several types of diabetes.

Symptoms of type 1 and type 2 diabetes

• Failure to thrive
• Increased urination(polyuria)
• Increased thirst(polydipsia)
• Constant hunger(polyphagia)
• Fatigue
• Weight loss 
• Vision problems
• Loss of muscle bulk
• Losing weight without trying
• Body aches and fatigue
• Sores that heal very slow
• Getting a lot of infections such as vaginal, gum, and skin infections

Symptoms of gestational diabetes

There are no specific symptoms of gestational diabetes. Some women may experience symptoms the same as described for diabetes type 1 and type 2. This is usually diagnosed on prenatal screening. It happens to millions of pregnant females who experience this condition during their pregnancy.

How to diagnose diabetes?

It is diagnosed by taking a blood sample. A fasting blood sugar level is required to diagnose type 1 and type 2 diabetes. But if your random blood sugar levels are off the charts then a fasting sample is not required. WHO also recommends testing for HbA1c levels for diagnosis. 

To diagnose gestational diabetes, a screening test is done at 24 and 28 weeks of pregnancy. OGTT is the screening test for this condition which takes two hours.

What are the treatment options for diabetes?

Type 1 and Type 2 diabetes:

Insulin is the primary drug of choice for type 1 diabetes as there is an absolute deficiency of insulin. 

There are multiple options to treat type 2 diabetes. Your doctor may advise you to reduce your weight, exercise regularly and cut down your carbs to control your blood sugar levels in type 2 diabetes. Some patients can maintain a normal blood sugar level by modifying their diet and lifestyle. If these measures fail to control blood sugar levels then your doctor may start oral hypoglycemic drugs with or without insulin to maintain normal blood sugar levels.

Insulin and some oral hypoglycemic drugs can be used to treat gestational diabetes.

Following advice is given to every diabetic patient,

• Maintain a healthy weight
• Follow a diet plan
• Exercise regularly
• Eat healthy and fresh food
• Cut down your carbohydrate intake
• keep a record of your blood sugar levels

Do I have diabetes?

If you have any doubts or questions please let us know. It is always advised to consult your local healthcare provider for further information and assessment.