How the A1C Test Works

Glucose is essentially fuel for the body. Glucose is vital for the normal growth, development, and maintenance of cells, the fundamental building blocks of the body.  After the digestion of a meal occurs, glucose travels through your bloodstream waiting for the presence of insulin to help the glucose enter your body’s cells.

In patients with a diabetes diagnosis, glucose builds up in the bloodstream because insulin is not present or isn’t functioning properly to allow the glucose to enter cells. A blood test, carried out at a lab or by a home-use A1C glucose test, tests for the presence of glucose, or sugar, in your blood over a period of time.  It tests this by measuring the amount of hemoglobin A1C in your blood.  Please note that the A1C home test kit is different than your standard home-use blood glucose meter. Right now there is one home kit on the market called the Bayer A1C Now At Home kit.

Hemoglobin is a protein in red blood cells that transports oxygen from lungs through your blood to your body’s tissues and organs.  Hemoglobin can do this because it is made up 4 protein chains that each can bind, or stick, to other molecules in the blood, transporting them through the body.  Just like sticky sugar, glucose molecules stick to one of hemoglobin’s protein chains and these glucose molecules stay stuck for the lifespan of the red blood cell, about 90-120 days.  For this reason, A1C test results provide the glucose average for the last 120 days.

But you don’t need to wait 120 days to detect a change in A1C levels because glucose changes from the past 30 days are easier to detect on the hemoglobin molecule than the older – 90-120 day old- glucose molecules.  So if there has been a significant change in your average blood sugar levels, this can be detected within 1 month.

The A1C test is important because if gives doctors an idea of a diabetic patient’s progress over an extended time period, giving them information on how well controlled their diabetes is.

What is a Normal A1C Level?

A1C is measured in percentage points and the average level in those without a diabetes diagnosis is between 4% and 6%.

In 1993 the Diabetes Control and Complications Trial was completed and demonstrated that tracking A1C levels could help identify those patient’s who’s risk for serious complications such as kidney failure, blindness, and nerve damage, was highest.

The American Diabetes Association (ADA) recommends that patients with a diabetes diagnosis keep their A1C level under 7% per cent.  Every percentage point of A1C is equal to roughly 35mg/dl of average blood glucose, a significant amount.  For every percentage point down, there is a 10% decrease in risk for serious diabetes-related microvascular complication.

Diabetes Mellitus, known to most simply as diabetes, is a metabolic disorder that affects the amount of insulin your body can make to convert glucose into energy for your body’s cells.

When we eat, food is broken down into glucose molecules that act as fuel for all our body’s cells.  But to access this fuel, insulin, a hormone secreted by the pancreas, needs to be present to help get the glucose cross a cell’s wall.  Without insulin, your cells can’t access the essential energy required for the growth, development, and maintenance of your body. The glucose that can’t get to your cells then builds up in your blood.  Eventually this excess glucose leaves the body in urine.

Because of this, a common test for diabetes includes the blood glucose test.  After a diabetes diagnosis, regular finger prick testing of blood glucose levels using a glucose meter is required for proper management of the disease.

There are three types of diabetes

Type 1: This is a genetic autoimmune disorder where the body produces no insulin at all.  This is a chronic condition usually diagnosed in childhood.   There is no cure for Type 1 Diabetes but it can be managed with daily insulin injections. Those with Type 1 diabetes require regular insulin injections through their life.

Type 2: Is a form of diabetes where your body does not produce enough insulin or the insulin produced is not working properly (called insulin resistance).  Type 2 Diabetes is considered preventable.  Risk factors for developing Type 2 Diabetes include:

• Overweight, especially for those carrying extra weight around the waist.  The fat centered on the abdomen secretes hormones called adipokines that interfere with how your body tolerates glucose.
• Age – the older you are the more likely you are to be diagnosed
• History of heart disease or stroke.
• Family history of diabetes.
• History of gestational diabetes.

Type 2 Diabetes is a chronic condition, usually diagnosed in adulthood.  This form can be improved through diet and exercise, limiting the need for insulin shots and other drug treatment.

Gestational Diabetes: Is a form of diabetes that develops during pregnancy.  Often gestational diabetes resolves after birth, however research suggests mothers who suffer gestational diabetes are more likely to develop Type 2 diabetes later on.

Preventing Complications

It is very important to properly and actively manage your diabetes. Treatment, especially when paired with healthy lifestyle in the case of Type 2 Diabetes, is very effective.  There are very serious short-term consequences that can arise from diabetes that is not adequately controlled, such as hypoglycemia and coma.  Long-term complications include increased risk of cardiovascular disease, blindness, chronic kidney failure, nerve damage, erectile dysfunction and gangrene of the feet that can lead to amputation.

The good news is that effective treatment combined with monitoring by you under the guidance of a doctor will help you gain control of this disease.

For people who do not have diabetes the normal result range from 4-6%. For those people who have diabetes, their goal is to get a value which is less than 7%. This may be a difficult for some diabetic patients, but there are ways on how to lower your values. Periodic monitoring of your glucose levels is a great way for you to start in lowering your A1c. You can make a chart of your glucose levels to get an idea on how you are controlling your blood sugar. You can bring your chart with you whenever you visit your doctor. Another way to lower your values is through diet and exercise. Through proper diet and exercise you can develop more muscle mass and this burns glucose faster than other forms of tissue. Some diabetics are given medications. Continue taking your medication, either your oral or insulin injections, preferably at the same each day. It results to better glucose control and can minimize the incidence of high sugar levels.

We should all be careful when it comes to our health. We should always take the necessary tests in order to monitor our health. Caution and great care should always be exercised to reach our goal of living a healthy life.

Though checking your glucose level repeatedly using a glucometer every day allows you to know the amount of insulin shots or medications you need and how much food to ingest, this assessment is isolated and can only give you so much. The A1c blood test, on the other hand, permits a far more extensive sugar reading. This hemoglobin-glucose test is preferred and widely used. It’s an indication of a person’s average blood sugar level over the past 2 or 3 months. Therefore, your physician will probably ask for this blood test 4 times each year. The test also allows your doctor to know just how effective your treatment regimen is working in the long run.

Generally, sugar compounds are likely to adhere to hemoglobin of your Red Blood cells (RBCs) and this bound form is clinically termed as A1c. The more sugar you have in your blood, the more it sticks to hemoglobin which can precisely show how often blood sugar has gone up and how significant. For many people with Diabetes, a satisfactory A1c result is less than 7 and for anyone who has a higher outcome, the physician may propose a few changes in the plan for treatment to get the A1c figure down. A reduced result can effectively improve your chance to a healthier life and prevent serious complications.