Dr. Shah Pathology Endocrine Lab
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Dr. Shah Pathology Endocrine Lab

Type 2 Diabetes and A 1c (Glycosylated Hemoglobin)

What is type 2 diabetes ?
Diabetes is a disease in which levels of glucose (sugar) in the bloodstream are too high. The body produces glucose from the foods you eat. It also produces the hormone insulin, which carries glucose from the bloodstream to the body’s cells where it is used for energy. In type 2 diabetes, too little insulin is produced, or the body cannot use insulin properly, or both. This results in a build up of glucose in the blood.
People with diabetes are at risk for developing serious health problems (complications). If your blood sugar levels stays too high for too long, complications can include :

  • Blindness
  • Kindey disease and failure
  • Nerve damage that may result in amputation (loss of toes, fingers, or legs)
  • Heart attack and stroke

Many people with type 2 diabetes can control their blood sugar levels with diet, exercise and oral medications (pills). Others may need insulin shorts.

What is an A1c test ?

The A1c test is a blood test used to diagnose and to aid in its management. A level of 6.5% or more indicates diabetes. The test measures your average blood sugar over the past two to three months and shows how well your treatment plan is working overall. It does not take the place of daily blood sugar measurements, Which show the level of sugar in your blood at that moment. Blood sugar levels change throughout the day  depending on what and when you eat, whether or not you exercise, and which medications you may be taking.
When there is too much glucose in the blood, the extra glucose entersred  blood cells and attaches to hemoglobin – a protein that carries oxygen to the cells of the body – creating glycated hemoglobin. Alc works by measuring the percentage of glycated hemoglobin in the blood. The higher your A1c level is, the poorer your blood sugar control and the more  likely you are to develop complications of diabetes.

What should your A1c level be ?

Most people with diabetes should keep their A1c result below 8 percent (about 170 mg/dL or less).

If your A1c result is :                          Then your daily average blood glucose is  around :
(in mg/dL)   
12.0 %                                                             298
11.0 %                                                             269
10.0 %                                                             240
9.0  %                                                              212
8.0 %                                                               183

Target area for people with diabetes

7.0 %                                                               154
6.0 %                                                               126
5.0 %                                                               183

Source : Diabetes Care 31 : 1473 – 1478, 2008

Studies have shown that people who keep their A1c below 7 percent greatly reduce their of developing long term complications of diabetes. An average blood sugar for a person without diabetes is 4 to 6 percent (about 65 to 135 mg/dL).
Experts recommend that you have your A1c measured four times a year. You can have the test less often if you are controlling your diabetes without medications.

What should you do with this information?

If you have diabetes, follow your doctor’s advice about how often you need an A1c test. Work with your doctor to find the best treatment plan for keeping your blood sugar in your target range. Whether or not you need diabetes medications or insulin, adopting a healthy lifestyle that includes eating well, losing weight if needed, exercising, drinking less alcohol, and not smoking will help you better manage your diabetes.