HbA1C – The Glycated Haemoglobin

The HbA1c test gives the average levels of blood glucose over 2-3 months. It is a better indicator for blood sugar control.

Increased levels of HbA1c indicates the occurrence of type 2 diabetes and is also used to monitor and control the sugar levels for a diabetic patient. Too much of the sugar in the blood damages the blood vessels which can lead to serious infections in eyes, feet and other vital organs.

The A1c test measures how much glucose is bound to the haemoglobin and the following levels should be interpreted:

Result	Range	%
Normal	<36mmol/mol	<4% - 5.6%
Pre-Diabetic	36mmol/mol – 47mmol/mol	5.7% - 6.4%
Diabetic	>=48mmol/mol	>=6.5%

HbA1c is different from the finger prick test. The later tells you about the glucose levels in your blood at the given point in time at a particular day when you perform the test, whereas the former will give you details about the average glucose level in your blood for 2-3 months. One must note that the glucose level in the blood keeps changing after exercise, food intake; rising more with sweet foods, lifestyle changes, etc. Therefore Hb1Ac is used as a quality control for the glucose levels in the human body for an average period of 3 months.

Who should go for this test?

1. Diabetic patients should undergo this test atleast twice a year to keep their sugar levels in total control
2. Healthy people should go for a yearly check-up
3. Women should take it up when planning a baby
4. People who have sugar rich foods and are physically inactive; people who have sedentary lifestyle should also take this test atleast twice a year
5. People who are obese
6. People who have history of heart disease or high BP

This test does not require fasting and can be performed after a meal.

HbA1c results can vary and change because of:

1. Your lifestyle and frequent changes in it
2. Infections or diseases like kidney and liver disease, anaemia
3. Intake of medicines like steroids, HIV drugs, vitamins like C and E
4. Stress and depression
5. High cholesterol levels

How to reduce HbA1c levels in the blood?

1. For diabetic patients, alteration of doses of medicines will help control HbA1c levels
2. Regularly exercising and becoming physically active
3. Cutting down on sugar rich foods and introducing healthy snacks and diet
4. Quitting smoking – carbon monoxide inhaled during smoking reduces the oxygen carrying capacity of the blood due to which the heart has to pump more blood to supply adequate oxygen for proper functioning of the vital organs

References

1. https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/hba1c
2. http://www.diabeticretinopathy.org.uk/prevention/what_is_the_hba1c.htm
3. https://www.diabetes.co.uk/what-is-hba1c.html
4. https://www.webmd.com/diabetes/guide/glycated-hemoglobin-test-hba1c
5. https://en.wikipedia.org/wiki/Glycated_hemoglobin