
July 26, 2006
A1c (Glycohemoglobin, HgbA1c)
Question from San Diego, California, USA:
I have been tested with an A1c of 7.3 and was told this is high. First of all, what is this a test of? What is the “normal” range for this? Should my low dose of glyburide be “taking care of” this problem, if indeed it is a problem?
Answer:
A hemoglobin A1c test is a test that is not integrated into the care of patients with diabetes around the globe. It is the gold standard for determining the level of chronic glucose control. The assay specifically measures the amount of the hemoglobin protein in the blood that has been attached to glucose. The amount of glucose that attaches to the protein is dependant on the amount of glucose in the blood from one day to the next. The test is a good indicator of your average daily blood sugar over the previous three months. All the chronic long-term outcomes studies dealing with diabetes, both type 1 and type 2 diabetes, have been studied in relation to the hemoglobin A1c test. The normal range varies from laboratory to laboratory and depends on the methodology used by each laboratory. Most assays have a normal range up to 6.0%. The American Diabetes Association recommends that patients maintain their hemoglobin A1c levels at a level that is 1% of the normal range. However, it is preferable to have a normal level, provided that hypoglycemia does not limit this from occurring. In your particular situation, you have to go back to your physician and ask whether your medication needs to be adjusted to tighten your level of control.
JTL