HbA1c: The Gold Standard in Diabetes Monitoring and Diagnosis
Diabetes management has evolved over the years with the help of HbA1c which has become an essential diagnostic and monitoring parameter. This is a very basic blood test which gives a Diabetes management has evolved over the years with the help of HbA1c which has become an essential diagnostic and monitoring parameter. overall picture of the patient’s blood glucose control during the past two to three months and hence helps the healthcare workers to have a better insight of the diabetes control as compared to the conventional point of time blood sugar measurements.
Understanding HbA1c: The Science Behind the Test
Hemoglobin A1c is a refined biochemical marker that depicts the diabetes control of an individual over a period of time. Glycated hemoglobin refers to the association of glucose molecules with hemoglobin present in the red blood cells. The more the blood glucose levels in the body, the more is the glycation of hemoglobin. This goes on while in the circulation for the 120 days that is the lifespan of a RBC thus providing a history of glucose exposure. HbA1c is understood by medical personnel because it does not depict the day-to-day changes as in the case of the standard blood glucose tests. Thus, while blood sugar levels vary depending on the last meal, stress or medication, HbA1c is a more stable and reliable parameter of glycemic control. It is usually stated as a percentage and the normal values are considered to be between 4% and 5. 6 %. Diabetic and prediabetic patients will have values which are higher, indicating that the blood sugar levels have been high for some time.
Diagnostic Criteria and Clinical Significance
Many healthcare systems in various countries have recognized HbA1c as a vital parameter for diagnosis of diabetes and prediabetes. The American Diabetes Association has set certain diagnostic thresholds as follows: The values less than 5.7% are considered to be normal, the values between 5.7% and 6.4% are considered to be prediabetes and the values equal to or more than 6.5% indicate diabetes. These cut off points help in making a accurate and proper diagnosis in any given health institution. HbA1c has its importance not only in the diagnosis of the disease. This test is especially useful in diabetic patients since it gives an overall picture of the patient’s condition. HbA1c measurements are therefore performed at regular intervals by the healthcare providers to determine the efficacy of the management plans, alterations in medication, changes in lifestyle and the patient’s compliance. It is recommended that the HbA1c should be measured at least twice a year in stable patients and every three months in patients whose management is being changed or who have inadequate glycaemic control.
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