November 28, 2005
A1c (Glycohemoglobin, HgbA1c), Diagnosis and Symptoms
Question from Louisville, Kentucky, USA:
I have had two A1c labs drawn, six months apart. The first reading was 5.7. The second was 5.9. I am 41 years old. Both of my parents and grandparents are type 2 diabetics. I have checked my blood sugars at home on a meter, both fasting and two hours postprandial. They have all been within 70 to 120 mg/dl [3.9 to 6.7 mmol/L]. After my last A1c was 5.9, my doctor diagnosed me as having type 2 diabetes. However, all the research I can find says the A1c is not abnormal until it reaches 6.0. Is a “rising” A1c an indication enough to diagnose diabetes? And, wouldn’t my blood sugar levels be higher?
Answer:
By policy, the diagnosis of diabetes is not made with the hemoglobin A1c. It is not sensitive enough to discriminate abnormal fasting blood sugars. Previous publications have shown this to be true. It is true that the hemoglobin A1c has been tied to outcomes from diabetes. However, outcomes and threshold for diabetes are two very different questions. I would accept that you have diabetes, but be happy the A1c is not over 6.0%. Meanwhile, continue to work on lifestyle to keep your sugars down and improve your future health.
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