Savitha Shama M.D. is board certified in Internal Medicine. She has been practicing in the Metro Atlanta area for the past six years. Dr Shama completed her residency training at the Grady Memorial Hospital under the Morehouse Internal medicine residency program. She is a graduate of Govt. Medical College, Mysore, India.
Hemoglobin A1C In Diabetes Management

A hemoglobin A1C test will help in determining the average blood sugar in the preceding 2 - 3 months...

Are you a diabetic? If so do you know what your hemoglobin A1C (also called glycosylated hemoglobin) is?

It is not uncommon how often patients walk in to a doctor’s office with history of long standing diabetes and not know what hemoglobin A1C means. Diabetes is a disease characterized by abnormal carbohydrate metabolism leading to hyperglycemia (high blood sugar levels). It is associated with relative or absolute impairment of insulin secretion and varying degrees of insulin resistance. Treatment of diabetes includes management of blood sugars, and aggressive management of cardiac risk factors like hypertension, lipid lowering, smoking cessation, and diet and lifestyle modifications.

So what does hemoglobin A1C mean? What should be your target for hemoglobin A1C, and what is the significance of hemoglobin A1C in the whole picture of diabetes management?
Well, it is a simple blood test that helps determine the blood sugar level. And it is important to understand the difference between the home blood test done daily and the hemoglobin A1C test. The home blood test gives you the reading of your sugar levels at the time of testing. And your sugar levels fluctuate through the day and from day to day. A hemoglobin A1C test will help in determining the average blood sugar in the preceding 2 - 3 months. The excess sugar that circulates in blood gets attached to the hemoglobin found in the red blood cells (glycosylation of the hemoglobin). The average life span of red blood cell is about 120 days and hence calculating the glycosylated hemoglobin makes it possible to know the average blood sugar levels over the preceding 2 - 3 months period.

What should your target hemoglobin A1C number be?
American Diabetes Association recommends working towards the goal of hemoglobin A1C of 7.0 or lesser although American Association of Clinical Endocrinologists recommends hemoglobin A1C of 6.5 and lesser. Regular checking of hemoglobin A1C every 3 months helps to determine any departures from the target range in timely fashion and help in treatment recommendations.

So what is the significance of Hemoglobin A1C in the whole picture?
The following facts may really help you to understand the importance of glycemic control (blood sugar control). The number one cause of blindness among adults aged 20 to 74 in USA is diabetic eye disease. The incidence of blindness is 25 times higher in patients with diabetes than general population. And the single most leading cause of end stage kidney disease is diabetes. About 20 to 40 percent of diabetics may get affected with kidney disease. Multiple studies have shown that there is a direct correlation between the glycemic control and the onset and progression of diabetic eye disease and kidney disease. It was not clear about the relationship of glycemic control and the risk for cardiovascular events. Until just recently US researchers have published data from studies showing progressively increased incidence of cardiovascular events with every 1 percent increase in hemoglobin A1C. So to improve outcomes and quality of your life, prevent complications of diabetes discussed above by maintaining the glycemic control to the recommended range of Hemoglobin A1C of 7.0 or lesser.

Recommendations may vary on individual basis. Consult your physician and partner with your physician in diabetes management and enjoy a healthful life.

*Disclaimer: The contents are meant for informative, educational purposes only. Formal recommendations can only be made by physicians involved in your care. Please check with your physician before acting on any part of this article.