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glycated hemoglobin

Как снизить гликированный гемоглобин


Diabetes is a major global health concern with a significant rise in prevalence. At the same time, glycated hemoglobin (A1C) helps to know how your body copes with sugar. For us, it’s an opportunity to detect a condition when the body is not functioning normally but it has not yet reached a state of disease. We’re talking about prediabetes. But for people with diabetes, this test is useful as well, mostly because it shows the risks of complications. In this article, we will talk about the situation when the test has already been done, and its results exceed healthy values. So, here you will find all about how to lower your a1c without medication.

This article was last reviewed by Svetlana Baloban, Healsens, on June 11, 2020. This article was last modified on 7 February 2020.

When talking about Normal Levels of Hemoglobin A1c we shall remember the following ranges. For diabetes-free people the normal range is between 4% and 5.6%. If your hemoglobin levels are 5.7% – 6.4%, the odds you will get diabetes are high. Levels of 6.5% or higher mean you have diabetes.

Decreasing Hemoglobin Goals

In the US, 79 million adults have prediabetes, a prevalence approximately 3 times that of diabetes.

Certainly, whether prediabetes progresses into diabetes depends on a number of variable factors. The willingness of a person to change his or her lifestyle determines treatment success. Nevertheless, a person’s genetics and well-chosen drug therapy are important factors as well.


So, the 4 pillars of effective diabetes management are:

How to Lower Your A1C without Medication

In 2002, Knowler hypothesized that lifestyle changes would prevent or delay the development of diabetes. The researchers randomly chose patients with prediabetes. Some patients received a placebo, other joined a special lifestyle changes program. It included increasing activity to at least 150 minutes/week and losing weight by at least 7%. The mean age of the participants was 51 years old. And the BMI was 34.0 kg/m2. The average follow-up was 2.8 years. As a result, the lifestyle intervention reduced the incidence by 58% compared with the placebo1group. Further analysis of this study showed that if people did not change their lifestyle, most would develop type 2 diabetes over the next 10 years.

Since then, many other studies have confirmed these conclusions. In 2013 researchers compared the effectiveness of lifestyle changes to standard care. Seven of the nine studies reported that lifestyle interventions put off the risk of diabetes by up to 10 years after a lifestyle intervention2.

However, for some people with prediabetes, a change in lifestyle is not enough.

Pharmacotherapy in Type 2 Diabetes Prevention

Evidence from pharmacotherapy preventing diabetes in patients with prediabetes was reported in 2002.

Biguanides, such as metformin, were proven by the researchers to decrease the incidence of diabetes. At the same time, this decrease isn’t as considerable as the one caused by lifestyle changes. Metformin has beneficial effects on BMI and lipid concentrations.

In 2010, Lilly and Godwin concluded after a systematic review of the literature and meta-analysis that metformin lowers risk of Type 2 diabetes by 45%3.

Glycated Hemoglobin (A1C) Tracking in Healsens

Metformin is currently the only medication recommended by the ADA for prediabetes treatment. According to the ADA, it is typically prescribed for patients who are at high risk of developing diabetes. So, if people fail in lifestyle modification therapy and their glucose is progressing, metformin is a reasonable second choice.

However, despite metformin’s widespread use, the medication is not for all patients. So, the ACE/AACE recommends a two-pronged approach to treating prediabetes. At first, intensive lifestyle intervention. Namely lifestyle modification training such as 150 minutes per week of physical activity as well as 7% of weight loss if BMI exceeds 25 kg/m24, followed by the prevention of CV complications for abnormal blood pressure and cholesterol.

Fiber in Diet to Lower Your A1C

Increased fiber in diet is associated with a reduction of glycated hemoglobin (HbA1c), improved lipid profile, and loss of body weight in type 2 diabetes patients5. An increased fiber content decreases the glycemic index of foods.

In addition, foods containing dietary fibers are also a rich source of magnesium. To underline, that magnesium is a co-factor for enzymes involved in glucose metabolism. In turn, dietary magnesium lower the incidence of type 2 diabetes. Studies also say that dietary fiber is associated with a reduced risk of diabetes which can be explained through markers of inflammation. We are talking about markers like interleukin-6 and tumor necrosis factor α6.

Moreover, some researches showed that when total dietary fiber was separated into cereal, fruit, and vegetable fiber groups, it appeared that cereal fiber reduced the incidence of developing type 2 diabetes the most7.

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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. Glycated Hemoglobin A1C test is a simple laboratory screening test that can provide a direct measure of how your body is processing sugar in the blood.

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.


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.

Glycated Hemoglobin A1C blood test, which reflects chronic blood glucose values, is routinely used in monitoring glycemic control. It’s also called HbA1c test, hemoglobin A1C, and glycohemoglobin. The significant reduction in microvascular complications with lower A1C has led to the recommendation that A1C be used for screening and diagnosis of diabetes. 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. The convenience of this test enables detecting diabetes in millions of people who have it but are not currently diagnosed with it.

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. Thus HbA1C higher than 6.3 is a red flag for diabetes free people. It means that it’s time to reevaluate their eating habits and choose low-glycemic-index foods and avoiding foods with high sugar contents.


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:

  1. 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.
  2.  In the absence of the above factors, diabetes testing is recommended to all people older than 40.
  3. 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.
  4. 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.

People who have diabetes need this test regularly to see if their levels are staying within range.

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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. The investigators concluded that HbA1c testing has a higher sensitivity for identifying patients at risk for diabetes vs FPG.

What Are Normal Levels of Glycated Hemoglobin A1c?

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 there to help you with HbA1C screening test schedules regarding all the above factors. Follow us to get news about ways of drug-free control and lowering of HbA1C levels if needed. You can also download our app to use diagrams which will help you monitor changes.

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits


Follow us on Facebook|| Instagram || Telegram || Twitter || Youtube

Source: ©️2019 Healsens B.V. All right reserve


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