Diabetes Control and Your HgA1C Blood Test
Do you know what your last HgA1C reading was?
If you answered no, then you're like most patients we see. But we think that 100% of patients should know what it is, what it means, and why it's important.
Diabetes is a significant contributor to vision loss, along with contributing to many other health care conditions. With the increase of diabetes in Canada, this condition has become a major area of concern for physicians and other health care providers like optometrists.
Diabetes is a chronic disease that must be monitored and treated over many years and decades. As such, family doctors and diabetic specialists will use blood tests like the Hemoglobin A1C (HgA1C or HbA1C) to screen for, diagnose, and monitor a patient’s diabetes.
What is Diabetes?
Simplistically, diabetes is the body’s inability to transfer sugar from the bloodstream into our cells. Sugar is the gas that runs our bodies. Without it, our cells slowly start to die, but too much of it is also bad.
Diabetes causes a rise of free-flowing sugar throughout your blood because the body is unable to transfer this sugar into the cells efficiently. Having high blood sugar levels is known as hyperglycemia. Because free-flowing blood sugar binds itself to the red blood cells of the body (hemoglobin or hemoglobin), a hemoglobin A1C test can give your doctors an accurate picture of the overall blood sugar levels within your body.
When blood sugar binds to a red blood cell, it is referred to as being glycated. Once glycated the red blood cell does not revert to a non-glycated state. As red blood cells live for approximately 3-4 months (100-120 days), the test can determine the number of glycated red blood cells over that period. As such, your doctor or diabetes specialist will typically schedule you for regular blood work every 3-months or 4-months.
HgA1C test results are provided as a percentage value. So a HgA1C test result of 6.5 means that 6.5% of your red blood cells are glycated. Higher blood sugar levels produce a larger quantity of glycated cells and a higher HgA1C percentage.
So what are normal, at-risk, or diabetic ranges for your HgA1C readings? The graph below outlines the accepted range of blood sugars. These values are used primarily for initial diagnosis and not long-term management.
Note: These are standard values used to diagnosis diabetes. one high test result does not make for a diagnosis unless other symptoms are present.
If you are diagnosed with diabetes. You and your doctor will work together to determine the ideal range your HgA1C readings should be in. Although the chart above depicts average ranges, these may not always be possible or safe. Most physicians aim for a HgA1C range between 5.0%-7.0%
The HgA1C test is useful in providing long-term information on how well your current diabetes management is working. A stable or decreasing reading indicates that your current treatment and lifestyle adjustments are working well. While a slow rise in your reading may suggest that either your medications are becoming ineffective, the condition is advancing, or that lifestyle modification needs to be re-evaluated.
HG1C TREND CHART - GREEN DOTS ILLUSTRATE TEST RESULTS ALL WITHIN THE SAME RANGE, INDICATING STABLE BLOOD SUGAR CONTROL. RED DOTS ILLUSTRATE READINGS THAT ARE SLOWLY RISING OVER TIME, INDICATING POOR BLOOD SUGAR CONTROL.
HgA1C test results are fairly accurate now with the standardization of lab procedures, but results can vary slightly from test to test even if all other variables are consistent. Your family doctor or diabetic specialist will take this into account when analyzing the lab results. One high or low reading does not usually cause a whole lot of excitement or reason to adjust your current treatment plan. It’s the trends that both you and your doctors need to analyze, and it’s these patterns that will help determine any adjustments in your diabetic treatment plan or lifestyle plan that need to be made.
The best thing about the HgA1C blood test is that you can’t cheat it.
You can’t beat the test by just having 1 or 2 good days of well-controlled blood sugar levels in a month, or by following your doctor’s or dietician’s guidelines perfectly for 2 or 3 days before taking the test. The opposite is also true, having 1 or 2 bad days in a month is not going to be the end of the world. The test looks at overall day-to-day control and is a way to ensure that patients and doctors are managing their diabetes.
Graph: HgA1c test vs random blood glucose readings. Random blood glucose test measure sugar for a specific moment in time. hgA1c blood tests give a longterm average.
The HgA1C blood test along with regular at-home blood sugar tests can help to keep you on track to having excellent control over your diabetes, which can improve your long-term health. If you are having problems controlling your blood sugar levels, talk to your family doctor, talk to your diabetic specialist, talk to a dietician and personally re-evaluate your daily activities and dietary choices. Remember, you alone are responsible for your personal health. Your physicians and caregivers are here to guide you in the right directions and provide the support to make it possible.
Please remember. If you have diabetes, it's also important to see a Stonewire optometrist every year for a dilated retinal examination to ensure that your eyes are healthy and free of diabetic eye disease. You can learn more about our diabetic services and why diabetic eye care is important here. Eye Exam - Diabetic Care