HbA1c and Diabetes

HbA1c

Sample for HbA1c

1. A random blood sample can be taken.
2. There is no need for a fasting blood sample.

Indication of HbA1c

1. The gold standard for checking diabetes.
2. It measures your average blood glucose level over 3 months period.

Precautions for HbA1c

1. Hemoglobinopathy can affect the result.
2. Ascorbic acid may give false low values.

Pathophysiology of HbA1c

1. In adults, 98% of the hemoglobin is HbA in the RBCs. Hemoglobin A2 is about 2.5%, and Hemoglobin F is only 0.5%
2. About 7% of the HbA consists of HbA1, which can strongly bind glucose, and the process is called glycosylation.
3. This glycosylation process in the initial stages is labile and then becomes stable and is not reversible.
4. This process of glycosylation takes place when RBCs are exposed to blood glucose.
5. HbA1 after glycosylation consists of:
   1. HbA1a.
   2. HbA1b.
   3. HbA1C.
6. HbA1c combines with glucose more strongly.
7. About 70% of HbA1c is glycosylated.
   1. At the same time, only 20% of HbA1a and HbA1b are formed.
8. This glycosylated hemoglobin HbA1c is the blood RBCs life span is 120 days.
9. This glycosylated hemoglobin reflects the average blood sugar level for 100 to 120 days. So please no need to advise before that period.

HbA1c structure

Normal HbA1c

1. Non-diabetic HbA1c = 4% to 5.9%
2. Controlled diabetes = <7%
3. Fair diabetic control = 8% to 9%
4. Poor diabetic control = >9%

Another reference

Another reference

For diabetic patients:

1. In newly diagnosed cases of diabetes, try to keep HbA1c below 7%.
2. In anemic patients, HbA1c will be inaccurate.
3. The target range of blood glucose:
   1. Before a meal, blood glucose should be between 70 to 130 mg/dL
   2. 2-hours after meals, blood glucose should be <180 mg/dL.

Chat.openai.com recommendations about HbA1c:

1. HbA1c gives the mean glucose level over a period of 3 months.
2. HbA1c diagnoses diabetes mellitus when the level is 6.5% or higher. This is recommended by the American Diabetes Association.
3. HbA1c should be kept within the range to avoid diabetes complications.
4. HbA1c helps in the management of medications. When HbA1c is not in the range, then medicine adjustment will be made.
5. American diabetes association recommendations are to keep HbA1c below 7%.