A1C - An Important Blood Test

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A1C - An Important Blood Test

Author: Dr. Burton S. Schuler

The glycated hemoglobin test (often called the glycosylated hemo-

globin test) or hemoglobin (A1C) is a measurement of the overall

control of the diabetic for the previous two to three months. Most

diabetic specialists feel it is now the single most important blood

test for known diabetics. The American Diabetes Association

recommends that if you are a diabetic, this test be taken every 3

months. For patients who are not yet diagnosed with diabetes, it is

becoming more popular for making the initial diagnosis of Diabetes.

The fasting blood sugar (FBS) test, which is still the most commonly

performed test for Diabetes, does not reflect the true picture of

diabetic control over a long period of time. The FBS only measures

the level of sugar in the blood at the moment it is taken from your

finger or arm. Patients have been known to " fake " the results of

their FBS by staying on their diet and medication (when they normally

won't) for several days leading up to the FBS, in order to have a

more normal result, when in fact their glucose (sugar) levels were

out of control. You can not fake the results with a glycated

hemoglobin test because it is based on 90 days, not an instant like

the FBS.

How It Works

The glycated hemoglobin test measures how much glucose is attached to

hemoglobin cells, the part of the blood that carries oxygen. As the

hemoglobin around in the blood, it picks up glucose in about the same

proportion as the glucose that exists in the bloodstream. If your

blood glucose is generally running high, the hemoglobin will have

more " glucose coating " (glycosylization). If your glucose generally

runs low, it will have less. Since the red blood cells have about a

two to three month life span in the body before they are recycled, we

can measure the " glucose coating " of a sample of hemoglobin. This

gives you an approximate average of glucose control over the last two

to three month period.

What Is The Goal Of The Glycated Hemoglobin Test?

Every person, whether or not he or she has diabetes, has a certain

amount of glycosylization present. Because of more sugar in their

blood, people with diabetes have a greater amount of glycosylization

present. A low result on the glycated hemoglobin test is a good

result. If your test is in the good control category, you can be

satisfied that your diabetes management plan is working well. If

results are in the marginal category, some fine tuning of your

treatment plan may be needed. A poor result can be improved. This

test gives you valuable feedback on how well you are controlling your

diabetes. It can also let you know when to work on improving your

diabetes management.

It's important for you to remember that normal values for the

glycated hemoglobin test may vary from laboratory to laboratory,

because different laboratories use different procedures to perform

the measurement. Be sure to ask for the " normal " range for that

particular lab. It's best to have the tests done by the same

laboratory so you can compare the results from one test to the next

to note the progress you are making. Your physician will help you

determine your goal range for glycated hemoglobin. If you are Type I

or Type II diabetic, you should be having this test every 90 days;

there is no reason that you should not. If your physician is not

running the glycated hemoglobin test on you every 90 days ask him why.