Glycosylated hemoglobin, not simply reflecting blood glucose levels, can tell you much more!
1.What is glycated hemoglobin test?
Glycated hemoglobin (HbA1c), is formed when hemoglobin – the oxygen-carrying protein contained in the red blood cells of the blood – is encapsulated by blood sugar. The amount of glucose bound to hemoglobin is proportional to the total glucose content of the blood system, so the higher the blood glucose level, the higher the level of HbA1c. Red blood cells have a life span of only 120 days, so by measuring HbA1c, doctors are able to determine the average blood glucose level for about a 2-3 month cycle.
HbA1c testing is especially important for people with diabetes because the higher the HbA1c level, the greater the risk of developing complications from diabetes. After diabetes is diagnosed, HbA1c is also used to assess how effective a treatment regimen is in controlling blood glucose levels.
2. What is the difference between glycosylated hemoglobin test and blood glucose test?
The HbA1c test does not require fasting, it reflects the average blood glucose level over 2-3 months and is a more stable test for assessing the effectiveness of long-term blood glucose control. This means that glycosylated hemoglobin levels are less prone to daily fluctuations brought on by stress and disease, whereas the blood glucose test only represents the blood glucose concentration in the blood at the time of the test.
3. What is the target glycosylated hemoglobin?
For most patients diagnosed with diabetes, an HbA1c level of less than 7% is a common therapeutic goal, but it is up to the physician to tailor the goal to the individual patient. HbA1c values do not reflect a specific diabetic complication, meaning that any complication can occur at any level of the HbA1c test. Of course, the closer the glycosylated hemoglobin value is to normal, the better.
4.What are the benefits of lowering glycated hemoglobin?
Studies have shown that if HbA1c levels in diabetic patients are reduced by 1%, serious complications in the eyes, kidneys and nervous system will be reduced by 25%.
In addition, a study published in the BMJ showed that patients with type 2 diabetes who had a 1% reduction in HbA1c levels were 19% less likely to develop cataracts; 16% less likely to suffer heart failure; and 43% less likely to suffer amputation or death from vascular disease.
Therefore, a lower HbA1c level means a lower average blood glucose level and a lower risk of developing complications.
5. Who should have a glycated hemoglobin test?
①Everyone with type 2 diabetes should have an HbA1c test at least once a year.
Some patients may require more frequent HbA1c testing, especially if there has been a recent change in treatment regimen or if medical personnel need to monitor the patient’s condition more frequently.
③For people who do not have diabetes, experts recommend that glycosylated hemoglobin screening should be considered for people over 45 years of age, especially if combined with overweight/obesity. Screening should also be considered if you are younger than 45 but overweight and have one or more additional risk factors for diabetes.
6. What are the limitations of the glycosylated hemoglobin test?
Although the HbA1c test is usually reliable and has been widely used, the test may not be accurate in the following groups.
① Decreased hemoglobin amount due to excessive blood loss (which can result in a low HbA1c test value);
②Iron deficiency anemia (which can result in high HbA1c values);
(iii) Hemoglobin gene mutation or abnormal hemoglobin: common in African-American, Mediterranean, or Southeast Asian populations;
④Recent history of blood transfusion or other forms of hemolytic anemia (which can cause low HbA1c test results);
⑤ Pregnancy.
7.How can I control my glycated hemoglobin level?
Anyone can control HbA1c levels by adopting a healthy lifestyle that will benefit people by reducing long-term diabetes complications (such as heart disease, stroke, kidney failure, and nerve pain caused by diabetes). To lower glycated hemoglobin levels, efforts need to be made to
Healthy diet.
People with diabetes and prodromal diabetes need to consume low-calorie and nutrient-rich foods such as fruits, vegetables, dietary fiber, high-quality protein and moderate amounts of monounsaturated/polyunsaturated fatty acids; they should also limit their intake of saturated fatty acids, carbohydrates and deeply processed foods.
For example, consuming whole wheat bread and brown rice instead of white bread and white rice will help reduce the blood sugar spike after meals. If necessary, consult a dietitian for food selection and diet planning; a daily diet diary or calorie counter can also be used to track daily food intake.
Consistent exercise.
By exercising consistently, blood sugar will be transferred from the bloodstream to the cells to produce energy for the body, thus lowering blood sugar levels. In addition, exercise will improve the body’s sensitivity to insulin.
Everyone should incorporate physical activity into their daily life. For people without diabetes, exercise will help prevent the onset of prodromal diabetes and type 2 diabetes; for people who already have diabetes, exercise can help maintain good blood sugar levels.
The American Diabetes Association recommends that 30 minutes a day, at least five days a week, or a total of 150 minutes a week of moderate to vigorous aerobic exercise (moderate intensity is the degree to which you can talk normally but cannot sing while exercising, while vigorous intensity means you cannot talk normally without pausing the activity).
Maintain a healthy weight.
If the patient is overweight, efforts can be made to lose weight through diet and exercise, which will significantly lower blood glucose levels and HbA1c values.
Regular monitoring.
It is generally recommended that glycosylated hemoglobin monitoring be performed at 2-3 months to assess the control of diabetes. However, HbA1c testing is not a complete substitute for blood glucose monitoring, and patients treated with insulin and other medications, for example, need regular blood glucose monitoring to ensure that their blood glucose does not get too low.