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HBA1c FILE

The document defines glycated hemoglobin and explains that it is used to measure average blood glucose levels over the previous months. Higher glycated hemoglobin levels indicate poorer blood glucose control and have been associated with health issues. The test works by hemoglobin reacting with glucose in the blood over 120 days to form glycated hemoglobin, and the amount formed corresponds to average blood sugar levels.

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16 views4 pages

HBA1c FILE

The document defines glycated hemoglobin and explains that it is used to measure average blood glucose levels over the previous months. Higher glycated hemoglobin levels indicate poorer blood glucose control and have been associated with health issues. The test works by hemoglobin reacting with glucose in the blood over 120 days to form glycated hemoglobin, and the amount formed corresponds to average blood sugar levels.

Uploaded by

murad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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GLYCATED HEMOGLOBIN

Definition:

Glycated hemoglobin (glycosylated hemoglobin, hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also
HbA1c) is a form of hemoglobin which is measured primarily to identify the average plasma glucose
concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's
exposure to plasma glucose. Normal levels of glucose produce a normal amount of glycated hemoglobin. As the
average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way.
This serves as a marker for average blood glucose levels over the previous months prior to the measurement.

In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels,
have been associated with cardiovascular disease, nephropathy, and retinopathy. Monitoring the HbA1c in type-1
diabetic patients may improve treatment.

The Test is Performed to:

1-It is used to measure your blood sugar control over several months. It can give a good estimate of how well you
have managed your diabetes.

2-The test may be used to screen for diabetes.

Principle:

In the normal 120-day lifespan of the red blood cell, glucose molecules react with hemoglobin, forming glycated
hemoglobin. In individuals with poorly controlled diabetes, the quantities of these glycated hemoglobins are much
higher than in healthy people.

Once a hemoglobin molecule is glycated, it remains that way. A buildup of glycated hemoglobin within the red
cell, therefore, reflects the average level of glucose to which the cell has been exposed during its life-cycle.

Measuring glycated hemoglobin assesses the effectiveness of therapy by monitoring long-term serum glucose
regulation. The HbA1c level is proportional to average blood glucose concentration over the previous four weeks
to three months. Some researchers state that the major proportion of its value is related to a rather shorter period
of two to four weeks.
Illustrated diagrammatically

Haemoglobin in the blood (red, rectangle) combines with glucose in the blood (green, circle) to form
glycosylated haemoglobin.

This reaction occurs over a 10 week period.

Controlled diabetes, not much glucose, not


Uncontrolled diabetes, more glucose, much
much glycosylated haemoglobin
more glycosylated haemoglobin

Measuring A1C:

There are a number of techniques used to measure A1C.

Laboratories use:

 high-performance liquid chromatography (HPLC): The HbA1c result is calculated as a ratio to total
haemoglobin by using a chromatogram.
 immunoassay
The approximate mapping between HbA1c values given in DCCT percentage (%) and eAG (estimated average
glucose) measurements is given by the following equation: [16]

eAG(mg/dl) = 28.7 × A1C − 46.7


eAG(mmol/l) = 1.59 × A1C − 2.59
Data in parentheses are 95% confidence intervals
HbA1c eAG (estimated average glucose)
(%) (mmol/mol) (mmol/L) (mg/dL)
5 31 5.4 (4.2–6.7) 97 (76–120)
6 42 7.0 (5.5–8.5) 126 (100–152)
7 53 8.6 (6.8–10.3) 154 (123–185)
8 64 10.2 (8.1–12.1) 183 (147–217)
9 75 11.8 (9.4–13.9) 212 (170–249)
10 86 13.4 (10.7–15.7) 240 (193–282)
11 97 14.9 (12.0–17.5) 269 (217–314)
12 108 16.5 (13.3–19.3) 298 (240–347)

Normal Results

An HbA1c of 6% or less is normal.

If your it is above 6.5%, you may be diagnosed with diabetes.

If you have diabetes, try to keep your level at or below 7%. But you and your health care provider must decide
what a normal level is for you.

Abnormal Results Mean

Abnormal results mean that your blood glucose levels have been above normal over weeks to months.

If your level is above 7%, your diabetes control may not be as good as it should be.

High values mean you are at greater risk of problems from having diabetes. If you can bring your level down, you
lower your chances of long-term complications.

Ask your doctor how often you should have your level tested. Usually, doctors recommend testing every 3 or 6
months.
Two examples

Below are two examples of people who have their HbA1c measured. One is poorly controlled, one well
controlled.

A graph of glucose changes over 9 weeks. Here the glucose changes between 5-9. This
The glucose (green line) changes between results in an HbA1c level of 7% at the end of
7-12. This results in an HbA1c level of 10% the 9 weeks. Well controlled.
at the end of the 9 weeks (red line). Poorly
controlled.

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