When an individual is diabetic, the need to keep one’s blood sugar or glucose in the normal level is essential to manage the disease. Frequent monitoring of one’s blood sugar at home is a great way to keep track of it in order to guide treatment of diabetes. However, to know the overall condition of blood sugar, one test will surely help – the HbA1C test, also known as glycosylated hemoglobin test.

What is HbA1C?
HbA1C test or the glycosylated hemoglobin A1C test reflects the average blood glucose control for the past two to three month period. It gives a good estimate of how well diabetes is managed over time. HbA1C measures the amount of glucose in the blood. It also shows the amount of glucose that sticks to the red blood cell, which is proportional to the amount of glucose in the blood.

According to Dr. Martin J. Abrahamson of the Joslin Diabetes Center, HbA1C is essential in measuring how effective one manages diabetes. It helps confirm self-testing results or blood test results by doctors. It also judges if the treatment plan works and reveals how healthy choices such as engaging in physical activities, maintaining a regular menu plan and taking medicines faithfully make a difference in diabetes control.

How is it done?
This test can be done on a sample of blood obtained from a fingertip or from a small vial of blood drawn from the arm and tested in a lab. For infants or young children, the area where the blood will be collected is cleansed with antiseptic and punctured with a sharp needle or a lancet. A bandage may be applied to the puncture site if there is any bleeding.
No special preparation is needed for, the test. You do not need to fast (stop eating) for it.

How often should it be done?
The HbA1C test for people with diabetes is necessary to measure how well the blood sugar is controlled over a period of time. In general, the higher the HbA1C value, the higher the susceptibility of developing diabetes complications. This holds true especially when HbA1C among diabetics increases on more than one occasion. HbA1C testing is usually recommended every three to six months. Non-diabetics generally have HbA1C values between four to six percent but normal ranges may vary with each laboratory. Expert organizations like the American Association of Clinical Endocrinologists and the International Diabetes Federation recommend HbA1C targets of less than 6.5 percent to prevent the complications of diabetes. However this target may not apply to all individuals, so consult your doctor about your HbA1C target and results.

What conditions may provide falsely high or low results?
Several conditions affect the HbA1C test results.Among the medical conditions that affect HbA1C results include anemia, sickle cell disease and chronic kidney disease.

Red blood cells (RBC) have a short life span. They only last up to 90 days.Those suffering from hemolytic anemia (premature destruction of red blood cells) are affected by falsely low HbA1C results because the RBC has less time to interact or bind with glucose molecules. High levels of vitamin C and E in the blood also decrease the HbA1C results.
Medical conditions such as iron-deficiency anemia and other forms of genetic abnormalities that occur in the hemoglobin may increase HbA1C results. Other factors that may provide high HbA1C results are alcoholism, taking large doses of aspirin, chronic use of opiate-containing drugs, having high levels of blood triglycerides, uremia* and high levels of bilirubin in the blood.

It is also important that the HbA1C be performed by a laboratory that uses a reliable assay. HbA1C testing in the Philippines unfortunately has not yet been standardized with many assays yielding inaccurate results. The International Federation of Clinical Chemistry and Laboratory Medicine is working on global standardization of HbA1C. Have your test done using an assay that has been certified.

Don’t be complacent about your condition. The HbA1C test won’t be enough to ensure control of diabetes. It is only one of the tests you need to do in order to manage the disease. Bear in mind to continually check your blood sugar at home or with your doctor. Aside from blood glucose monitoring, proper diet, regular exercise, medication and doctor visits will do wonders in bringing more than your blood sugar to normal level and manage diabetes.

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