HbA1c is a term commonly used in relation to diabetes. This guide explains what HbA1c is, how it differs from blood glucose levels and how it’s used for. It’s often viewed as the number to rule all numbers. But hemoglobin A1c (HbA1c) test results can be misleading and don’t tell the full story. Hemoglobin A1c (HbA1c) has been a standard test of long-term average blood glucose control for patients with type 2 diabetes (T2D) for more.

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This guide explains what HbA1c is, how it differs from blood glucose levels and how it’s used for diagnosing diabetes.

HbA1c goals are very individual, which makes sense. Advantages Disadvantages Indicative of chronic glycaemia and reflective of tissue glycation status.

The utility and convenience of HbA1c compared with measures of plasma glucose for the diagnosis of diabetes needs to be balanced against the fact that it is unavailable in many countries, despite being a recognized valuable tool in diabetes management.

As I learned in my teens, the HbA1c test shines a light on things I was trying to hide. Ethnic Diabbetes in HbA 1c There is also evidence which indicates that HbA 1c will detect a different population as having diabetes to that identified by plasma glucose. Hemoglobin A1c targets for glycemic control with pharmacologic therapy for nonpregnant adults with type 2 diabetes mellitus: Browse all sections Diabetes symptoms Newly diagnosed Diabetes guides Diabetes tests Diabetes information Diabetes checks Type 1 diabetes Type 2 diabetes Prediabetes Gestational diabetes Types of diabetes Blood glucose care Blood glucose meters Blood glucose testing.

A value of less than 6.

New (More Moderate) Guidelines for HbA1c Levels

This also brings into question the validity of any single chosen cut-off and whether risk prediction may be expressed in any other way.

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Red blood cell survival time is reduced in any haemolytic anaemia, and it can also be reduced in chronic renal failure, severe liver disease and anaemia of chronic disease.


Unlike nb1ac glucose, HbA 1c shows minimal pre-analytical variability.

There is also a relationship with cardiovascular outcomes associated with lower levels of HbA 1c. Join the Diabetes Newsletter. Diagnostic criteria for diabetes; the American Diabetes Association Ref.

Dust off those old math lessons and think about how averages work. Finger prick tests must be confirmed by laboratory venous HbA1c in all patients. In considering the diagnosis of diabetes, we are primarily concerned with defining a disease state rather than establishing a reference interval for health.

The hemoglobin A1C HbA1c test is frequently used in people with type 2 diabetes as a measure of how their blood sugar is controlled. Overall, the performance of HbA1c has been similar to that of fasting or 2-h plasma glucose. When applying HbA 1c testing for the diagnosis of diabetes, some medical conditions may affect the test and cause falsely high or low readings Table 5. For many years it was the sole basis for improved harmonization of HbA1c assays. Although it gives equal or almost equal sensitivity and specificity to a fasting or post-load glucose measurement as a predictor of prevalent retinopathy 17it is not available in many parts of the world.

Twitter Created with Sketch. Whether it is the glucose or HbA1c assay that is used, consistent and comparable data that meet international standards are required.

HbA1c reflects average plasma glucose over the previous eight to 12 weeks The case for HbA 1c as a diagnostic test for diabetes has therefore been submitted to a very rigorous examination based upon the principles of evidence based medicine. You should get the results quickly. Fasting is defined as no caloric intake for at least 8 h.

How do HbA1c test results work? Night time hypos Avoiding diabetic complications Bringing down high blood glucose levels How to treat a hypo. Information on the diagnostic criteria for diabetes is below. The glucose load is poorly tolerated by a significant number of people, with nausea, vomiting, delayed gastric emptying and issues of venous access all potentially contributing to an invalid test result. If such tests fail to confirm the diagnosis of diabetes, it will usually be advisable to maintain surveillance with periodic re—testing until the glycaemic status becomes clear.

The evidence base in support of HbA 1c as a diagnostic test for diabetes mellitus is focused on predicting a clinical outcome, considered to be the pinnacle of the Stockholm Hierarchy applied to reference intervals and clinical decision limits. Additionally, your doctor should know if you have any conditions that may affect your HbA1c, such as sickle cell anemia, heavy bleeding, very low iron levels, kidney failure or liver disease.


Requests for permission to reproduce or translate WHO publications — whether for sale or for noncommercial distribution — should be addressed to WHO Press, at the above address fax: Inan expert committee shifted the emphasis away from the bimodal distribution to focus more on clinical outcomes.

An individual HbA1c should take into account your ability to achieve the target based on your day to day life and whether you are at risk of having regular or severe hypos. More convenient, as patient not required to fast and only one blood sample taken. Travel insurance quote Get an instant and free travel insurance quote – kids under 23 go free, too!

Short-term variability in measures of glycemia and implications for the classification of diabetes. Policy-makers are advised to ensure that accurate blood glucose measurement be generally available at the primary health care level, before introducing HbA1c measurement as a diagnostic test.

What is HbA1c? – Definition, Units, Conversion, Testing & Control

If one only is abnormal then a further abnormal test result, using the same method, is required to confirm the diagnosis. ALL children and young people patients of any age suspected of having Type 1 diabetes patients with symptoms of diabetes for less than 2 months patients at high risk who are acutely ill e. This means getting your HbA1c checked regularly. Other authors, rather than accepting a single cutoff have advocated for separate rule out and rule in criteria applying the same cut-offs suggested by the Melbourne studies.

So — A higher blood sugar for a longer time means more sugar on more cells — which means a higher HbA1c. A healthcare professional should do this for you, though you can pay for a kit and do it yourself.