Glycated Hemoglobin A1c Test (HBA1C)
Type 2 diabetes mellitus is rising at an epidemic scale throughout the world. Up to a certain moment, diabetes 2 (DM2) develops as a latent pathology which accounts for its late diagnosis and onset of therapy. Hence, the high frequency of vascular complications, early disablement, and mortality. Therefore, the improvement of screening studies is of primary importance for the detection of metabolic disorders. “The HbA1c blood marker can offer general insight into long‑term sugar trends; discuss any lab testing with your healthcare provider.”
This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 13 April 2022.
Let’s consider who is recommended to take this clinical laboratory test, why it is important, and what glycated hemoglobin counts are considered normal. Also, we will consider the advantages and disadvantages of this test, as opposed to checking blood sugar levels. But we will begin with the meaning of Glycated Hemoglobin A1C test.
Glycation and Glycosylation
Glycation and glycosylation refer to the process of attaching a glucose or sugar molecule to another molecule such as protein or fat. The more sugar there is in circulation in the bloodstream, the more sugar molecules there are to stick to fat and protein, in other words, to glycate them. You control your rate of glycation by the amount of sugar and high-glycemic index foods that you eat.
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Chronic consumption of sugar and high-glycemic-index foods leads to persistent increased formation of Advanced Glycosylated End products (AGEs). These AGEs are sticky conglomerations of sugar and protein that gum up your enzymes. It leads to adding the burden of toxic waste that must be handled by your detoxification system. This accelerates the aging process in body tissues by covering them with sugar. Besides, it also leads to many of the chronic complications of diabetes, such as blindness, renal failure, and neuropathy.
Explain that HbA1c is one of several markers people may learn about when tracking their long-term nutritional balance, and stress that interpreting those values is something to do with a licensed clinician. “Clinicians sometimes consider HbA1c results when evaluating overall metabolic health; personal medical evaluation should be handled by your doctor.” Accumulating evidence suggests that racial differences in A1C values may be present. Despite these caveats, A1C can be measured accurately in the vast majority of people. “HbA1c is one marker discussed in diabetes research; diagnosis should be made by a qualified clinician using appropriate tests.”
In other words, Glycated Hemoglobin A1C lab test shows the average glycation level over the past three months. 1 per cent elevation of HbA1C means that your sugar level has increased by 30 points (in mg/dl) over this period. “An HbA1c above 6.3% may indicate higher sugar exposure; only a clinician can interpret your numbers in context.” It means that it’s time to reevaluate their eating habits and choose low-glycemic-index foods and avoiding foods with high sugar contents.
FUN FACT
Almost 2,500 years ago it was noticed that ants were attracted to the urine of some individuals. So, in the 18th and 19th centuries, the sweet taste of urine was used for diagnosis of diabetes before chemical methods became available.
When Should Glycated Hemoglobin A1c Be Tested?
The American Diabetes Association® (ADA) recommends screening for prediabetes and diabetes beginning at age 35 for all people1. In the presence of risk factors, diagnosis of diabetes should begin earlier. The risks include the following factors:
- overweight (≥ 25 kg/m2) combined with such risk factors as:
- sedentary lifestyle
- parents diagnosed with diabetes mellitus
- belonging to certain ethnic groups with high risks of diabetes mellitus
- women with a newly born baby weighing more than 4.5 kg or women having gestational diabetes
- elevated blood pressure (140/90 mm of mercury) or antihypertensive medication therapy;
- low level of high-density lipoproteins (HDL) less than 0.9 mmoles and/or triglyceride level higher than 2.82 mmoles/l
- polycystic ovary syndrome
- HbA1c level equal to or higher than 5,7% as well as impaired fasting glycemia or glucose intolerance shown in previous tests
- other clinical conditions associated with insulin resistance (super obesity, acantosis nigricans, etc.)
- cardiovascular diseases in medical history.
- In the absence of the above factors, diabetes testing is recommended to all people older than 40.
- If the test result is within the norm, re-testing should be done no later than in 3 years, with room for more frequent cause-specific testing based on initial result and risk factors.
- WHO recommends taking the test every three months to every patient diagnosed with diabetes mellitus
The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity2.
And the USPSTF recommends considering screening earlier in patients with higher risk (i.e., one of the following):
- family history of diabetes;
- members of certain racial and ethnic groups (i.e., blacks, American Indians or Alaska Natives, Asian Americans, Hispanics or Latinos, or Native Hawaiians or Pacific Islanders);
- personal history of gestational diabetes;
- polycystic ovary syndrome.
At the same time, many health organizations try to build more advance way to define people who need to take a diabetes screening test. For example, The Canadian Task Force on Preventive Health Care released an updated guideline calling for more precision in type 2 diabetes screening. The guideline, prepared by the independent panel of 14 clinicians and experts, suggests using a risk calculator to identify patients with high risks of diabetes. But this questionnaire is intended just for adults aged 40 to 74 years 3.
“Individuals managing their health may periodically review HbA1c results with their care team.”
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A1C Versus Glucose Testing
Both of these tests are utilized significantly to diagnose diabetes. The usage of glucose screening was the “gold standard” for the diagnosis of diabetes for many years. But this testing suffers from several deficiencies.
For example, the requirement to take blood on an empty stomach. But the most important deficiency is that numerous factors can influence results of blood tests. For example, taking various medications, doing physical activity the day before and so on may result in obtaining inaccurate data. Moreover, fasting glucose concentrations vary considerably both in a single person from day to day and also between different subjects.
Before blood donation, the should be no exercise stress (running, climbing stairs), or any emotional excitement. Before the procedure, you need to rest 10-15 minutes. Calm down. Blood glucose results may be altered due to eating, prolonged fasting, or physical activity. All this reduces the accuracy of the analyses and creates additional difficulties.
HBA1c blood test can be taken amid at whatever time of the day. “Some studies explore HbA1c as a marker of long‑term sugar exposure; talk with a clinician about which markers suit your wellness plan.”
» Explore everything about the significance of High Platelet Count results mean.
What Are Normal Levels of Glycated Hemoglobin A1c?
A glycosylated hemoglobin A1C level below 5.7 percent is considered normal4. An A1C result between 5.7 and 6.4 percent (39-47 mmoL/moL) signals prediabetes. Patients with prediabetes should be tested yearly in order to determine whether they have converted to diabetic status. For people with type 1 diabetes, a blood sugar test is recommended.
It is worth mentioning that glycated hemoglobin in the range of 5.7–6.4% (prediabetes), especially in combination with a slight increase in fasting glucose, is associated with an increased risk of mortality, CVD, stroke and coronary heart disease5.
Type 2 diabetes is diagnosed when the A1C results are over 6.5 percent.
Healsens is a source of lifestyle insights about HbA1c and invites you to use the app as a place to log personal goals and charts that support conversations with your care team.
Ordering Blood Tests in the Netherlands
“If you choose to explore HbA1c testing, your healthcare provider or local lab can guide you; Healsens focuses on general wellness guidance.”
1. Download the Healsens app from Google Play or the App Store, depending on your device.
2. Complete the registration process in the app.
3. Use the app to learn about wellness topics; consult your clinician for any lab orders or testing needs.
» Unlock Optimal Health: Discover How a Personalized Healsens General Check-up Plan Can Transform Your Well-being.
Note
If you want to assess your Glycated Hemoglobin A1C level but are not residing in the Netherlands or have opted for a different laboratory, Healsens cannot upload your blood test results for you. Nevertheless, you have the option to undergo the required tests at any laboratory in your country and manually input the obtained results into the application. Healsens shares lifestyle tips and educational charts; medical decisions and risk assessments should be done with your healthcare professional.
FURTHER READING
Source: ©️2019 Healsens B.V. All right reserved
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Source: ©️2019 Healsens B.V. All right reserve
- Latest ADA Annual Standards of Care Includes Changes to Diabetes Screening, First-Line Therapy, Pregnancy, and Technology
- Prediabetes and Type 2 Diabetes: Screening
- Summary of recommendations for clinicians and policy-makers
- Diagnosis
- Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis
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