Glycated haemoglobin, also known as HbA1c or glycosylated haemoglobin, is a form of haemoglobin that is formed in a non-enzymatic glycation pathway by attachment of glucose to the N-terminal valine residue of the beta chain of haemoglobin. In healthy individuals, glucose binds to haemoglobin in red blood cells. But in patients with diabetes, the higher levels of blood glucose lead to higher levels of glycated haemoglobin being produced. Glycated haemoglobin provides an indicator of a person's average blood glucose level over the past 2-3 months, since the lifespan of a red blood cell is about 90-120 days.
Why Is Glycated Haemoglobin Testing Important?
Regular monitoring of Glycated Haemoglobin Testing levels is recommended for individuals with diabetes as it provides a reliable long-term picture of blood glucose levels. Higher glycated haemoglobin levels are associated with higher risks of diabetes related complications such as damage to blood vessels, heart disease, stroke, nerve damage (diabetic neuropathy) and eye disease (retinopathy). Regular testing allows healthcare providers to monitor how well diabetes is controlled and make adjustments to treatment if needed. The target glycated haemoglobin level recommended by international organizations is generally less than 7% for most adults with diabetes. Levels lower than this have been shown to reduce the risks of diabetes related health issues.
Who Should Get Their Glycated Haemoglobin Tested?
It is recommended that anyone diagnosed with diabetes should get their HbA1c tested at least twice a year. Testing should be done more frequently (every 3 months) for those whose therapy has changed or who are not meeting treatment goals. Testing is also important to monitor pregnant women with diabetes or those at high risk of developing diabetes. Healthcare providers may also recommend testing for those with prediabetes to monitor whether their blood glucose levels remain in the prediabetes range or progress to diabetes.
How Is The Glycated Haemoglobin Test Performed?
The glycated haemoglobin test involves a simple blood test. Only a small sample of blood is needed, usually obtained through a finger prick. The blood sample is placed into a special machine called an immunoassay analyzer which uses antibodies to measure the percentage of glycated haemoglobin molecules relative to the total haemoglobin in the blood. Results are usually available within a few hours. No special preparation or fasting is required prior to the test. The HbA1c test can be done at any time of day.
Factors That Can Affect Glycated Haemoglobin Levels
Several factors apart from blood glucose levels can influence glycated haemoglobin levels. Conditions like conditions like chronic kidney disease, liver disease, blood disorders and haemoglobinopathies like sickle cell disease can affect red blood cell turnover and lifespan, altering HbA1c levels. Medical conditions where red blood cell production is increased or decreased can also impact HbA1c. Some medications used for heart failure or high blood pressure may independently raise HbA1c levels despite good glucose control. Pregnant women may have lower HbA1c levels during their third trimester. Taking these factors into account, healthcare providers consider average blood glucose patterns over time based on multiple HbA1c test results rather than relying on a single value.
Monitoring Glycated Haemoglobin And Adjusting Diabetes Treatment
Once a baseline HbA1c level is established for an individual with diabetes, regular testing allows healthcare teams to monitor how diabetes treatment is working and make timely adjustments as needed. Glycated Haemoglobin Testing is an important tool that helps achieve and maintain optimal blood glucose control goals, reducing risks of diabetes related complications. If HbA1c levels remain high despite optimized medication and lifestyle modifications, additional diabetes treatment options may need to be considered. Conversely, if levels are falling too low, leading to hypoglycemia, treatment regimens may be adjusted to safely lower blood glucose levels over the long term. Close monitoring of HbA1c each 3-6 months helps guide ongoing management of diabetes.
Glycated Haemoglobin Testing provides a reliable and convenient way to gain insight into a person's average blood glucose levels over several months. Regular HbA1c monitoring is vital for optimal diabetes management and care planning. Combined with self-monitoring of blood glucose levels, HbA1c testing helps patients and healthcare teams work together to prevent or delay diabetes related health issues through good long-term glycemic control.
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1. Source: Coherent Market Insights, Public sources, Desk research
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