A1C test is an easier and faster means of diagnosing diabetes and identifying pre-diabetes, according to The American Diabetes Association’s new Clinical Practice Recommendations.
The new recommendations, being published as a supplement to the January issue of Diabetes Care, also call for the addition of A1C test as a means to diagnose diabetes.
“We believe that use of the A1C, because it doesn’t require fasting, will encourage more people to get tested for type 2 diabetes and help further reduce the number of people who are undiagnosed but living with this chronic and potentially life-threatening disease. Additionally, early detection can make an enormous difference in a person’s quality of life,” stated Richard M. Bergenstal, MD, President-Elect, Medicine & Science, American Diabetes Association.
Unlike many chronic diseases, type 2 diabetes actually can be prevented, as long as lifestyle changes are made while blood glucose levels are still in the pre-diabetes range, he added. A1C test has been recommended for years as a measure of how well people are doing to keep their blood glucose levels under control.
A1C is measured in terms of percentages. A1C test measures a person’s average blood glucose levels over a period of up to three months and previously had been used only to determine how well people were maintaining control of their diabetes over time. A person without diabetes would have an A1C of about 5 percent.
Under the new recommendations, which are revised every year to reflect the most current available scientific research, an A1C of 5.7 – 6.4 percent would indicate that blood glucose levels were in the prediabetic range, meaning higher than normal but not yet high enough for a diagnosis of diabetes.
That diagnosis would occur once levels rose to an A1C of 6.5 percent or higher. Most people with diabetes maintain a goal of keeping A1C levels at or below 7 percent in order to properly manage their disease.
Research shows that controlling blood glucose levels helps to prevent serious diabetes-related complications, such as kidney disease, nerve damage and problems with the eyes and gums, the American Diabetes Association recommended.
FPG (Fasting Plasma Glucose) and the OGTT (Oral Glucose Tolerance Test) are the other diagnostic tests for diabetes. Both FPG and OGTT require overnight fasting.
A1C is a simple blood test and does not require fasting and allows patients this option could increase willingness to get tested. Thus it reduces the number of people who have type 2 diabetes but don’t yet know it.
A1C is a simple blood test and does not require fasting. It tests the level of glucose in hemoglobin A1C, the main fraction of glycosylated hemoglobin (glycohemoglobin).
Hemoglobin A1C is hemoglobin to which glucose is bound. (Hemoglobin, the substance in the red blood cells that carries oxygen to the cells of the body.) Since the glucose stays attached to hemoglobin for the life of the red blood cell (normally about 120 days), the level of hemoglobin A1C reflects the average blood glucose level over the past 4 months.
The level of hemoglobin A1C is increased in the red blood cells of persons with poorly controlled diabetes mellitus. Hemoglobin A1C is tested to monitor the long-term control of diabetes mellitus.
The normal level for hemoglobin A1C is less than 7%. Levels above 9% show poor control, and levels above 12% show very poor control. It is commonly recommended that hemoglobin A1C be measured every 3 to 6 months in diabetes.
The A1C test is important in diabetes a
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