Glycated hemoglobin A1c - what is it? In another way, it is called glycohemoglobin (short designation: hemoglobin A1c, HbA1c) is an indicator of blood biochemistry. It reflects the level of sugar over a period of 3-4 months. This period is associated with the life span of the erythrocytes themselves. A standard blood sugar test reflects the glucose level at the time of the test.
Glycated hemoglobin - what is this analysis and what is it for? It is necessary to detect diabetes mellitus (DM) even at the stage when there are no clinical symptoms, as well as to monitor the effectiveness of the treatment, if it has already been diagnosed. But few people know what this indicator is.
With incoming products, sugar passes through the cell membrane, and its gradual connection with amino acids occurs. The result of this reaction is glycated hemoglobin. It reflects the percentage of blood hemoglobin in combination with glucose molecules. Hyperglycemia atdiabetes significantly accelerates the reaction of the compound (Maillard reaction), respectively, the level of glycohemoglobin increases. Since a red blood cell lives for about 120 days, the study shows blood sugar throughout this period.
The higher his level, the higher was the glycemia in the last 3 months. With latent diabetes, this indicates the need for treatment and examination by standard methods. With diagnosed diabetes, this indicates possible complications and also requires action.
If glycated hemoglobin is elevated, what does this tell the doctor with existing diabetes? A high level of A1c requires correction of treatment for this diagnosis. When diagnosing by determining blood sugar, there are a number of contradictions, and not a single technique can boast of its accuracy. They are due to the fact that this indicator depends on many external factors, primarily on the correct preparation for the examination.
When talking about the analysis of glycated hemoglobin, it means that the doctor suspected the development of prediabetes or diabetes. The result will confirm or disprove all doubts by 100%. Inside the red blood cell, hemoglobin is always stable, so the analysis data is accurate. What is blood for glycated hemoglobin? This is from 2011, according to WHO recommendations, the necessary data for diagnosing diabetes.
Assay designation
Glycated hemoglobin comes in several forms:
- HbA1a.
- HbA1b.
- HbA1c.
In analyzesit is the last form that matters. Why and what is it? The analysis for glycated hemoglobin is indicated by these letters because in an adult it is represented by several fractions, and most of it is fraction A (from English adult - adult).
HbA1 or alpha-1 is the most common type of hemoglobin because it accounts for 96-98% of the total mass of this protein in the body.
Any erythrocyte always contains almost 270 million hemoglobin molecules. The reaction of its connection with glucose proceeds slowly, without the participation of enzymes. This process has a direct proportion with glycemia and is irreversible.
Individual differences in patients always exist - the spread of HbA1c values even in two people with the same level of glycemia reaches 1%. No two people are exactly alike.
Researchers believe that the most reliable indicator will be its value in the last month before taking the analysis. Its indicators half determine the entire resulting picture of HbA1c. The value of glycosylated hemoglobin is measured as a percentage of the total volume of the total protein, which is also very convenient.
Glycated and glycosylated hemoglobin - is there a difference? No, they are synonyms. And one more note: glycated is not involved in the delivery of oxygen to the cells of the body and does not remove carbon dioxide. Therefore, the higher it is, the greater the oxygen starvation of the body.
Glycated hemoglobin - what is it and how does it manifest itself? It changes with physical activity and nutrition of the body, shows the average daily glucose level,regardless of diet, exercise, medication, etc.
What happens to glycohemoglobin after 4 months
Erythrocyte lives for about 4 months, carefully performing all its functions - participation in gas exchange in the blood, etc. Then the red blood cells are destroyed in the spleen pulp. Glycohemoglobin and its free form also breaks down. The end product of the breakdown is bilirubin, which enters the bloodstream and liver.
Glucose no longer binds to bilirubin. With the creation of new red blood cells, when the blood is renewed, the values will already reflect these young red blood cells and will show the blood glucose - glycemia for the next 90 days.
What does it mean - glycated hemoglobin, and is it possible to study it in the laboratory? Determination of glycohemoglobin in the laboratory is necessary for:
- diagnosing diabetes;
- compensation estimates;
- predicting complications;
- when planning pregnancy in women with diabetes;
- if gestational diabetes is detected, then to address the issue of its treatment.
In addition, it is used as a marker that determines the risk group. Standard analyzes against his background lose.
What else is the value of such an analysis? It will help suspicious patients get rid of doubts and guesses, when the sugar content is on the verge of normal. Some diabetics neglect their diet and cut down on sweets in their diet for only 1-2 weeks, hoping that the doctor will not understand this. But glycohemoglobin will also reveal such a diabetic sin.
The only disadvantage of this technique is the high price and the impossibility of passing the analysis in many diagnostic centers. The high cost of the service, by the way, is redeemed by the diagnostic value of the indicator.
Norms of glycohemoglobin in the blood
What does it mean - glycated hemoglobin, and does it have any norms? Of course, there is a norm, since he althy people also have it. Interestingly, it does not depend on age and gender, i.e. the same for adults and children, for both women and men.
The norm of glycated hemoglobin - what is it? Its level is normally up to 5.5%. Such a value will indicate to you that there is nothing to worry about, and diabetes does not threaten you within the next 3 years. By the way, the absence of risk varies somewhat by age - in the elderly it will be up to 7.5%.
Further, the decoding will be as follows: A1C is 5, 6-6, 0%. Glycated hemoglobin 6% - what does it mean? There is a risk of diabetes, and you should analyze your diet, lifestyle - reduce weight, increase physical activity. With hemoglobin A1C from 6.1 to 6.4%, the risk of diabetes is very high. Your doctor may prescribe medications to reduce insulin resistance.
When A1C exceeds 6.5%, it is already diabetes. And in diabetics, this indicator will be determined by the degree of compensation for the disease. By the way, there are cases when A1c was even less than 4% - this is also not he althy and requires urgent treatment. Such a cause may be, for example, a tumor of the pancreas.
The norm for women
In a woman, the value of glycohemoglobin can change when:
- different types of diabetes;
- anemia when there is iron deficiency;
- CKD;
- after operations (eg removal of the spleen);
- weak vessels.
In such cases, the level of glycohemoglobin also depends on age:
- under 30 - 4-5;
- under 50 - 5-7;
- over 50 - 7 and up.
Men have the same numbers.
Norms for diabetes
In diabetic patients, Hba1C numbers may vary depending on:
- type of diabetes and age of the patient;
- presence of complications and concomitant diseases;
- life expectancy.
In young women with type 1 diabetes and no complications, the norm will be equal to the he althy norm (5.5%) and they can bear and give birth to a child. If this is not the case, the risk of miscarriage and various anomalies and malformations in the fetus is high.
In older people who have complications of diabetes, comorbidities, and life expectancy is expected to be less than average, an indicator of 7.5–8.0% would be quite satisfactory.
Treatment for type 2 diabetes
Depending on the level of glycohemoglobin, when DM2 is detected, treatment will be prescribed taking into account the following. For example, glycated hemoglobin 6, 6 - what is it? HbA1C 6, 5-7, 5% - treatment will be prescribed in the form of a mono-tablet drug; HbA1C 7, 6-9, 0% - a combination of twodrugs.
What does it mean - glycated hemoglobin is increased by more than 9.0%? Treatment in this case requires urgent and serious, and it is better to start it with insulin therapy ± tablets, in some cases it is possible to start with a combination of 2-3 drugs. Diabetics need to keep in mind that with a decrease in HbA1C by only 1%, the risk of developing microvascular complications immediately decreases by 30%.
What is the frequency of the test for diabetes?
At the onset of the disease, until diabetes compensation is achieved, the study is carried out quarterly. Next, the type of SD comes into effect:
- with DM1 - control is also quarterly;
- for type 2 diabetes - once every six months.
For prevention in full he alth, the test is taken every 3 years. Every 4 months it is necessary to donate blood to those who had diabetics in their family. Glycated hemoglobin 7 - what does it mean? In the standards for diabetics, the number 7 is often found and is, as it were, a starting point, depending on age.
The norm for diabetes is about 8%. In middle age, hemoglobin A1C is less than 7%, while there is no risk of complications. At a young age, the same level - the presence of severe complications. In addition, a level of 7% indicates the possibility of developing hypoglycemia in a child.
If hemoglobin A1c is 10% or more, urgent hospitalization is required. It will also indicate irreversible changes. It should be noted that, although reducing the level of hyperglycemia is the main goal of diabetes therapy, it is dangerous to sharply reduce it. This immediately disrupts blood microcirculation in small vessels andcontributes to the development of retinopathy and neuropathy in the kidneys.
Competent and safe reduction - 1-1.5% per year. The International Diabetes Federation recommends keeping HbA1c below 6.5% at all times.
Factors that increase hemoglobin A1c
Glycohemoglobin rises not only at risk of diabetes. Other factors can also provoke its increase:
- iron deficiency in the body;
- hypodynamia;
- age after 45 – somatic background often becomes unfavorable;
- removal of the spleen;
- oncology;
- polycystic ovaries;
- birth of a large fetus;
- intestinal obstruction;
- thick blood;
- excess of vitamins gr. B;
- lung failure;
- heart disease.
Factors contributing to the decrease in A1c
Reduce the percentage of hemoglobin can:
- blood loss;
- blood transfusion that diluted HbA1C;
- blood diseases, when the lifespan of red blood cells becomes reduced;
- hypoglycemia;
- hereditary causes;
- adrenal insufficiency;
- the presence of defective forms of hemoglobin, distorting the results of tests;
- pancreatic insulinoma;
- long-term low-carbohydrate diet;
- intense exercise.
Glycated hemoglobin in pregnant women
During pregnancy, the body of the expectant mother undergoes many changes. This can not but be reflected in the level of glucose in a woman. Therefore, the norm of hemoglobin A1C during gestation differs from the norm in non-pregnant women.
- At a young age it is 6.5%.
- Mean age corresponds to 7%.
- In older pregnant women, the level should not fall below 7.5%. Tests for glycated hemoglobin in a pregnant woman are carried out every 1.5 months. It will not only indicate the sugar content, but also show how the unborn baby develops and feels.
Deviations from the norm are detrimental not only to the "bubbler" himself, but also to his mother. If glycohemoglobin is below normal, it will indicate a low iron content in the body. and fetal development may be retarded. Then the doctor will recommend strengthening the mother's nutrition.
A high level will indicate increased overfeeding of the fetus, as a result of which the birth of a large fetus (from 4 kg or more) will be expected, which means a difficult and protracted birth for the mother.
How to get tested
A blood test for glycated hemoglobin - what is it and how is it done? To conduct such an analysis, special strict preparation is not required, because the indicator is stable for 3 months. No need to starve, take sugar or wait to recover from a cold, recover from stress, you can even inject insulin.
Analysis for glycated hemoglobin - what does it involve in terms of preparation? The patient can come to the laboratory any dayand time of day. Eating and drinking do not play a role in this at all. But still, for reinsurance, doctors tend to focus on the traditional rules for taking the test and prescribing blood donation in the morning on an empty stomach. They believe that mistakes will then not be made for sure. For 30-90 minutes before the analysis, it is better not to smoke or exert yourself physically.
The day before, some diuretics are not recommended: Indapamide, Propranolol, etc. Blood in different laboratories can be taken not only from a vein, but also from a finger. 3 blood cubes are drawn from a vein.
The analysis is done within a few hours. Distortion of results can be at:
- bleeding;
- anemia;
- alcohol or lead poisoning;
- with chronic renal failure;
- thyroid disease;
- taking vitamins C and E.
How to lower the level of glycated hemoglobin?
Reducing the level of glycohemoglobin is the main goal in the treatment of diabetes in general and the prevention of its development. This can be achieved in diabetics only by treating and eliminating hyperglycemia.
Recommendations are pretty standard:
- following a diet, eating a balanced diet, limiting animal fats and simple carbohydrates;
- increased physical activity - 3 times a week for 45 minutes;
- normalization of weight, if there are problems with this;
- in the presence of diabetes - the fulfillment of all prescriptions of the attending physician;
- avoiding stress.
Diet
Completely excluded products from premium flour, soda, simple sugars,pasta and potatoes. Other vegetables are welcome, there should also be meat, vegetable oils, sour milk on the table.
With an increased level of glycohemoglobin, it is important and necessary to eat especially more meat to increase hemoglobin. Recommended complex carbohydrates and vegetable proteins such as legumes, greens, nuts, only wholemeal or whole grain bread in order to increase the fiber content in the diet, fruits. Starvation for the purpose of losing weight is completely excluded.
Physical activity
For hyperglycemia, moderate exercise throughout the day will help you use more glucose and keep your body toned. It will also improve heart function and reduce weight. Swimming, elementary walking, outdoor walks, cycling are very useful. Extreme sports are not your thing.
And with low levels of hemoglobin A1c, any sport is not indicated, since this is an unbearable burden for the body.
Stress has always and everywhere been the culprit of hyperglycemia. Other negative emotions are no exception. They always raise blood sugar. Taking care of the nervous system will also be the fact that you will do breathing exercises.
Often, stress can be provoked by bad habits. It is feasible to get rid of them yourself, if you understand that life will be the price. And, of course, the timely and scrupulous implementation of all the doctor's recommendations has not been canceled by anyone.
