Hemoglobin A1C Test

What is the Hemoglobin A1C test?

Those who have diabetes could only check how much sugar they have in their blood by either daily pricks of the finger or by urine tests. Yes, these two tests were accurate. But they could only be used temporarily.  Besides, they lack the ability to be used to completely evaluate blood sugar.

This is attributed to the fact that blood sugar does not have a fixed amount at any point in time in the day. Hormones, activities and the time of the day hence determine how much sugar is in the blood.

You can have a high blood sugar by 3am and you’re not even aware of it.

But something more reliable can be used to assess the sugar content of your blood. And guess what that is? It is the hemoglobin A1c test. Unlike the other two tests that you need to fast before your blood sugar can be assessed,  A1c tests don’t need you to fast. It can be done at any time of the day.

With the hemoglobin A1c test, average blood sugar can be measured for a time span of two to three months. This test was first employed to monitor diabetes patients in the 1980s. A1c tests can be used to diagnose diabetes and even prediabetes.

You don’t have to worry over your having a very high fasting blood sugar when your blood sugar is normal. When you have a normal sugar content in your blood, it rules out every thought of type 2 diabetes.

The A1c test can also be called the HbA1c test, hemoglobin A1c test, glyco-hemoglobin test, glycosylated hemoglobin test, A1C, or glycated hemoglobin test.

What exactly does the hemoglobin A1C test measure?

A1c measures the quantity of hemoglobin that is attached to glucose. Hemoglobin is found in red blood cells. It is a protein that has a very strong ‘affinity’ for oxygen. Hemoglobin lives an average of three months.

If hemoglobin lives for three months, it means the glucose that binds to it will also live for three months. You can, therefore, find out how much glucose is present in your body when you know how much hemoglobin is present in your body. When hemoglobin is high, it means your blood glucose is also high. And when hemoglobin amount is normal, blood glucose will also be normal.

How does the hemoglobin A1C test work?

Hemoglobin A1c tests keep track of your mean blood sugar content within the space of three months. Rather than give accuracy on blood sugar on a daily basis, it gives your doctor a general overview of your blood sugar level for the past three months. If your sugar content was high for instance last month or week but had become normal when checked today, your hemoglobin level will still retain its blood content as of the last time the test was done. This is because the amount of glucose attached to the hemoglobin remains the same.

What do the numbers mean?

If you don’t have diabetes, 5% of your hemoglobin will be glycated. An average A1c level is, give or take 5.6% as submitted by the National Institute of Diabetes and Digestive and Kidney Diseases.

Anything between 5.7 to 6.4 % is an indicator of prediabetes. When its value is 6.5% or more, you will be diagnosed with diabetes.

The American Diabetes Association has come up with a calculator that can be used to check the correlation between glucose levels and A1c levels.

Your blood glucose can be assessed at least twice every year using the hemoglobin A1c test.

What factors can affect my test result?

If you have had diabetes for a long period of time, you will know that A1c tests haven’t been that reliable until now. This is so because different laboratories got different results from different types of A1c tests. But not so again! The National Glycohemoglobin Standardization Program has come up with test results that are more accurate.

Those who manufacture A1c kits have now upgraded to meet the standards of those used for major studies on diabetes. Hence, more consistencies have been recorded so far from most A1c tests results. In fact, you can readily get one kit for A1c tests for home use.

But let me point out that accuracy for A1c is relative. It is even so for blood glucose tests.

There are times an A1c test result can be 50% lower or higher than what is actually the normal.

You having for instance, an A1c of 6 might imply that you have a range between 5.5 to 6.5.

You can have a blood glucose test result that shows you are diabetic but an A1c test ‘saying’ otherwise i.e. A1c test showing a normal value. It is hence common to see your doctor repeat these tests before you can be confirmed to have diabetes.

There are some instances when you can get results that are false due to other health conditions like severe anemia, liver disorders, or kidney failure. It has also been found that your ethnic background can influence your A1c test results. For instance, Southeast Asians, Africans, and those of Mediterranean descent have a hemoglobin type that is less common. This can interfere with the accuracy of A1c test results.

Heavy menstrual flow can also produce false test results in women.

What if your hemoglobin A1C number is high?

If you have high A1c levels, it might be traced to a high risk of these conditions:

• cardiovascular diseases i.e. heart attack, stroke
• kidney disease
• eye damage that may result in blindness
• numbness in the feet as a result of damaged nerves
• nerve damage
• Slow healing of wounds
• infection

If your diabetes is still in the early stage, adjustment in your lifestyle can make you experience a remission. One of such adjustments are enrolling for an exercise program and shedding off some pounds of flesh.

If you have had either diabetes or prediabetes for a long while, elevated A1c results would mean that you should consider taking medications if you haven’t been on any. But if you have been on medication already and there are no corresponding improvements, you might have to change medications.

Lifestyle changes and a ‘close eye’ on your blood sugar level on a daily basis will be of great help.  You can find out which treatment plan is best for you from your doctor.

The takeaway

The A1c test only provides your average blood sugar content in three months. It indicates how much glucose is bound to hemoglobin.

It can achieve two goals – one, check blood sugar; two, diagnose and screen prediabetes and diabetes.

It is recommended that all diabetic patients should have an A1c test at least twice a year.