People with diabetes must know…
The HbA1c is a measure of the average blood sugar (both high & low levels) over a 3 month period and it is an important indicator of the degree of blood sugar control. In simple terms, it is the amount of sugar (glucose) attached to hemoglobin molecules in the red blood cells. As the life of a red blood cell is approximately 90 – 120 (3-4 months) days, the HbA1c value predicts average blood sugar of past 3 – 4 months. Thus, if there is a large amount of sugar circulating in the blood, the HbA1c will be high & vice versa.
It is recommended for people with diabetes to check HbA1c at least 2 times a year & more frequently for those with uncontrolled sugar levels. This blood test doesn’t require fasting state & can be done at any time of the day.
HbA1c is expressed as a percent (%). Following are the mean blood sugar levels with respect to HbA1c score –
Although HbA1c measures average blood glucose over the past 3-4 months, more recent glucose levels (recent 4-6 weeks) impact the result more. Hence it is sometimes recommended to measure HbA1c levels 6 weeks after a change in therapy (medicines / insulin) to see the effectiveness of the treatment.
Abnormal HbA1c could mean-
1. An altered meal plan / activity patterns
2. Inadequate dose / inappropriate type (class) of medicine
3. Need for addition of insulin or insulin dose adjustment (if already on insulin)
Conditions like Anemia, profound blood loss, recent blood transfusion, high triglyceride levels, jaundice, chronic alcoholism etc. can lead to inaccurate results.
Since HbA1c measures average of blood sugar, it cannot predict the daily fluctuations / variations in the sugar levels. Thus checking blood sugar level periodically at different times of the day remains equally essential & cannot be replaced by HbA1c checking alone. Both these measurements should support each other helping ensure appropriate blood sugar control for a good quality life.