Diabetes can be a devastating disease with the potential to affect many facets of life. After a diabetes diagnosis it becomes increasingly important to stay vigilant of blood sugar levels, carefully monitor food intake, and try to squeeze in an extra spin class or two.
However, diabetes does not spell doom and gloom for the rest of a patient’s life. According to the CDC, 34.2 million people in the United States live with diabetes. That’s just over one out of every ten Americans. The increasing prevalence of diabetes has drawn the attention of scientific and medical communities in recent years, leading to a significant increase in medical studies and a continued drive toward a cure.
To date, there is no official cure for diabetes. There is no one thing a patient may do, one pill they may take, or one lifestyle change that acts as a cure-all. Diabetes needs careful management, but a majority of patients diagnosed with diabetes continue to live healthy lives with consistent treatment and effective monitoring.
One such way to monitor diabetes is the Hemoglobin A1C test, also known as HbA1c or a glycohemoglobin test. The test measures blood sugar level ranges in the past three months by determining the percentage of glycated, or sugar-coated hemoglobin proteins that exist in the bloodstream. (Kind of like frosted breakfast cereal, except in the blood.) Hemoglobin is found naturally in all human beings as the protein in red blood cells responsible for carrying oxygen throughout the body. It’s really the sugar content doctors pay attention to. The test result is given in a percentage and compared to a safe target range for individuals based on various factors. For those of us who didn’t attend medical school: the higher a patient’s A1C level, the harder it is for their body to control blood sugar levels and manage subsequent diabetes complications. For example, an A1C test resulting in a high percentage may indicate a patient’s liver or kidneys are struggling to process the sugar in their system.
The A1C test results are used to estimate a patient’s average blood sugar level, or eAG (estimated Average Glucose), and aid doctors in monitoring and adjusting diabetes treatment.
Hemoglobin A1C Measurements
When the body loses blood due to a cut, abrasion, or even a bloody nose, it is able to replenish what was lost, but this process can take time. For example, donating whole blood, as opposed to plasma donation, requires waiting at least eight weeks between donations in order to allow levels to renew in the body.
The red cells in the body are continually dying and being replaced. According to the MSK Cancer Center, the average lifespan of a red blood cell is 120 days. It is this number that gives us the three-month monitoring period for the A1C test. While 120 days is approximately four months, this number is based on an average. Most cells live to at least 90 days, or three months. Consequently, the A1C test is based on the glucose attachment to the hemoglobin proteins over an approximated period of three months.
A reasonable reading for a healthy person is 5.7% or below, with 5.7-6.4% indicating prediabetes, and levels of 6.5% or more indicating diabetes. The higher one’s percentage, the greater their risk for developing type 2 diabetes.
Hemoglobin A1C Accuracy
It should be noted that all diabetes tests have a margin for error; results from blood tests can have a high degree of variance dependent upon factors such as the activity level of the person being tested. Blood sugar levels can rise and fall depending on diet, weight, sickness, stress, and exercise. Furthermore, each test measures glucose in a different way. For example, the Fasting Plasma Glucose test, or FPG test, is a blood test that requires a fast of no food or drink (except water) for eight to ten hours prior to testing. This measures the glucose in a person’s blood at that time.
The A1C test measures the amount of glucose attached to hemoglobin. By design, the test measures and averages of all the blood glucose levels over an estimated period of the previous three months. It does not reflect daily changes from meals, weight, stress, or exercise, making the A1C test one of the most accurate diabetes tests available.
Because patients with early onset diabetes often don’t show symptoms, blood tests like the A1C test are incredibly important. The test needs to be as accurate as possible, so a standard was implemented, much like the control and variable groups we remember from grade school science classes. (Others of us have blocked out the experience entirely, and continue to store our 5th grade volcano replica in our parents’ garage.) In the mid-1990s the National Glycohemoglobin Standardization Program (NGSP) standardized these tests and gave it a control comparison, significantly increasing its accuracy.
What if my test shows a higher percentage than normal? The A1C test has been standardized and is used to diagnose both onset diabetes and pre-diabetes, but is not the only tool for diagnosis. Some patients whose A1C test results in a high percentage may be in danger of contracting diabetes, but still have time to manage their health and effectively ward off the onset of symptoms through diet and exercise.
Daily Diabetes Management
In order to manage diabetes, medical professionals widely recommend a combination of lifestyle changes including exercise, avoidance of sugar and sweets, and eating foods with a low glycemic index. Diabetes can also be managed with various medications. Whichever method used, the goal is the same: to lower and maintain healthy blood glucose levels.
One effective way to lower this percentage was reported in the Journal of The American Board of Family Medicine in 2009. This study found cinnamon to be effective in reducing blood glucose levels. Researchers determined that, in addition to usual self-care, frequently ingesting cinnamon reduced serum Hb1AC in type two diabetics who measured higher than 7%.
Daily management becomes important as more and more people are diagnosed with diabetes. Even among young people today, contributing factors to lifelong problems can be curbed through informed choices and preventative care.
Patients concerned about their health, or desirous to know more about prediabetes and diabetes management and treatment, can start by seeking advice from doctor or healthcare professional.