Glycated hemoglobin is one of the indicators of a biochemical blood test. Allows you to determine the average blood sugar level over the past three months. In tests it may be referred to as HbA1C or A1C.
Knowing its significance is important in order to promptly identify diabetes mellitus, monitor the course of the disease and the effectiveness of the therapy used.
Indications for analysis of glycosylated hemoglobin
Analysis for glycated hemoglobin is performed for the following purposes:
- Diagnosis of carbohydrate metabolism disorders (with a glycated hemoglobin level of 6.5%, the diagnosis of diabetes mellitus is confirmed);
- Monitoring diabetes mellitus (glycated hemoglobin allows you to assess the level of disease compensation over 3 months);
- Assessment of patient adherence to treatment - the degree of compliance between the patient's behavior and the recommendations he received from the doctor.
A blood test for glycated hemoglobin is prescribed to patients who complain of extreme thirst, frequent excessive urination, fatigue, blurred vision, and increased susceptibility to infections. Glycated hemoglobin is a criterion for retrospective assessment of glycemic levels.
Depending on the type of diabetes and how well the disease responds to treatment, glycated hemoglobin analysis is carried out 2 to 4 times a year. On average, patients with diabetes are recommended to donate blood for testing twice a year. If a patient is diagnosed with diabetes for the first time or the control measurement is unsuccessful, doctors prescribe a glycated hemoglobin test again.
Why is analysis needed?
Hemoglobin is an iron-containing protein that has the ability to bind with oxygen, which ensures its transport through tissues. Hemoglobin is concentrated in red blood cells - erythrocytes. As a result of a slow non-enzymatic reaction, an irreversible connection of hemoglobin with sugar occurs. The consequence of glycation is the formation of glycosylated hemoglobin. The speed of this reaction increases depending on the amount of sugar in the blood. The degree of glycation is assessed over 3–4 months. This is exactly the amount of time the life cycle of a red blood cell takes. That is, the analysis of glycated hemoglobin allows us to identify the average level of glycemia over 90–120 days.
Important! There is no point in conducting analysis more often than after 3-4 months, since the life cycle of a red blood cell takes exactly that amount of time.
Preparation and delivery of glycated hemoglobin analysis
Analysis for glycated hemoglobin does not require special preparation. There is no need to donate blood on an empty stomach. Before blood sampling, the patient does not need to limit himself to drinks or refrain from physical or emotional stress. It will not affect the results of the study and taking medications (except for drugs that reduce blood glucose levels).
The test is more reliable than a blood sugar test or a “load” glucose tolerance test. The analysis will reflect the concentration of glycated hemoglobin accumulated over three months. The form that the patient receives will indicate the results of the study and the norm of glycated hemoglobin. The interpretation of the test results at the Yusupov Hospital is carried out by an experienced endocrinologist.
How is the material collected?
The material for the study is venous blood. There is a standard algorithm for collecting venous blood. The patient sits in a chair, takes a comfortable position, places one arm on a special cushion and slightly bends it at the elbow.
The medical worker bandages the arm above the elbow with a special rubber bandage, after placing a cloth napkin under it (protects it from damage).
The skin is then treated with a disinfectant, a needle is inserted and, after obtaining a sufficient amount of blood, the syringe is removed. The puncture site is additionally treated and a cotton swab is applied to it, which must be removed after the bleeding has stopped.
Some medical centers have different blood collection systems. For this purpose, a special vacuum tube is used, which reduces skin trauma and increases the reliability of the study. The sampling technology is practically no different from the traditional method, but instead of a syringe, a vacuum tube is used. Blood can be stored at a temperature of 2 to 8°C. The stability of the sample is maintained for 7 days.
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Norms of glycated hemoglobin
Normally, the level of glycated hemoglobin varies from 4.8 to 5.9%. The closer the level of glycated hemoglobin in a diabetic patient is to 7%, the easier it is to control the disease. As glycated hemoglobin levels increase, the risk of complications increases.
Endocrinologists interpret the glycated hemoglobin indicator as follows:
- 4-6.2% – the patient does not have diabetes;
- From 5.7 to 6.4% - prediabetes (impaired glucose tolerance, which is associated with an increased risk of diabetes);
- 6.5% or more – the patient has diabetes.
Several factors may affect the indicator. In patients with abnormal forms of hemoglobin (patients with sickle erythrocytes), the level of glycated hemoglobin will be underestimated. If a person suffers from hemolysis (decomposition of red blood cells), anemia (anemia), severe bleeding, then his test results may also be underestimated. Increased levels of glycated hemoglobin occur with a lack of iron in the body and with a recent blood transfusion. Analysis for glycated hemoglobin does not reflect sudden changes in blood glucose levels.
Table of correspondence of glycated hemoglobin to the average daily plasma glucose level for the last three months.
| Glycated hemoglobin (%) | Average daily plasma glucose level (mmol/l) |
| 5,0 | 5,4 |
| 6,0 | 7,0 |
| 7,0 | 8,6 |
| 8,0 | 10,2 |
| 9,0 | 11,8 |
| 10,0 | 13,4 |
| 11,0 | 14,9 |
Features of the study
The level of glycated hemoglobin may increase under the following conditions:
- the risk of developing diabetes mellitus or the presence of this disease;
- lack of vitamin B12, as well as iron - both components are closely related to hemoglobin metabolism;
- active consumption of alcohol or alcoholic beverages, alcoholism;
- a pronounced decrease in the acidity of erythrocytes;
- chronic renal failure, renal dysfunction;
- genetic or biochemically caused disorders in the protein composition of the blood;
- increased life expectancy of red blood cells;
- against the background of active use of opiates.
The glycating hemoglobin level decreases in the following situations:
- against the background of active intake of vitamin preparations, especially vitamin C, B12;
- for chronic liver diseases;
- against the background of increased acidity of red blood cells;
- when using certain medications, such as aspirin or antiviral drugs;
- with reduced life expectancy of red blood cells.
Before prescribing a diagnosis, the patient must tell the attending physician about the medications that the person is taking, because some medications can have a significant impact on the test result.
Assessing the level of glycated hemoglobin is an important diagnostic criterion that helps the doctor suspect the development of diabetes mellitus in a patient, prescribe additional research methods in a timely manner and begin therapy.
The interpretation of diagnostic results should be carried out exclusively by the attending physician - only the doctor fully understands all the factors that could have influenced the study indicator.
Normal hemoglobin level in women
What is glycated hemoglobin in women? This is a specific combination of red blood cell hemoglobin with glucose. For women aged 30 years, the norm is 4.9%, 40 years – 5.8%, 50 years – 6.7%, 60 years – 7.6%. Normally, the content of glycated hemoglobin in seventy-year-old women is 8.6%, and in 80-year-old women it is 9.5%.
For women over 80 years of age, the normal content of glycated hemoglobin is 10.4%. In cases where a patient has been suffering from diabetes mellitus for a long period of time, the endocrinologist can set an individual norm for her, based on the characteristics of the body and the severity of the disease.
When the glycated hemoglobin content is from 5.5% to 7%, women are diagnosed with type 2 diabetes mellitus. An indicator from 7% to 8% indicates well-compensated diabetes mellitus, from 8 to 10% – fairly well compensated, from 10 to 12% – partially compensated. If the level of glycated hemoglobin is over 12%, diabetes is uncompensated.
An increased level of glycated hemoglobin in women may indicate the presence of anemia, impaired body tolerance to glucose, and the consequences of surgical interventions (removal of the spleen). Doctors speak of a reduced level of glycated hemoglobin in women when its content in the blood plasma is less than 4.5%. In pregnant women, the content of glycated hemoglobin may be lower than normal due to an increase in the daily need for iron. For pregnant women, the daily iron requirement is 15 mg-18 mg, from 5 to 15 mg. A decrease in hemoglobin levels in women can occur due to heavy, prolonged uterine bleeding.
Complexes with this research
Monitoring the diet of a nursing mother Assessing metabolic disorders and the risk of iron and calcium deficiency 2,010 ₽ Composition
Women's check-up No. 1 38 studies for an annual preventive examination 13,430 ₽ Composition
Expanded hospital complex Expanded infectious screening for prevention and hospitalization 4,910 ₽ Composition
IN OTHER COMPLEXES
- Risk of severe COVID-19 RUB 740
- Diabetes monitoring RUB 1,900
- Advanced women's anti-aging diagnostics RUB 22,090
- Prediabetes and diabetes 620 ₽
- Biochemistry of blood. 19 indicators 3,930 ₽
Increased and decreased levels of glycated hemoglobin
An increased level of glycated hemoglobin indicates a long-term gradual but steady increase in the concentration of glucose in a person’s blood. These data do not always indicate the development of diabetes mellitus. Carbohydrate metabolism may be impaired as a result of impaired glucose tolerance. The results will be incorrect if the tests are performed incorrectly (after meals, not on an empty stomach).
A glycated hemoglobin content reduced to 4% indicates a low level of glucose in the blood - hypoglycemia in the presence of tumors (pancreatic insulinoma), genetic diseases (hereditary glucose intolerance). The level of glycated hemoglobin decreases with inadequate use of drugs that reduce blood glucose levels, a low-carbohydrate diet, and heavy physical activity leading to exhaustion of the body. If the level of glycated hemoglobin is increased or decreased, consult an endocrinologist at the Yusupov Hospital, who will conduct a comprehensive examination and prescribe additional diagnostic tests.
Why are rates declining?
A decrease in glycosylated hemoglobin in diabetics is called hypoglycemia. The cause of the pathological condition is often a tumor of the pancreas, which provokes the synthesis of large amounts of insulin.
Reasons for low HbA1c hemoglobin levels other than diabetes:
- long-term adherence to a low-carbohydrate diet;
- genetic diseases, fructose intolerance;
- kidney pathologies;
- intense physical activity;
- excess insulin dose.
To diagnose pathologies that cause a decrease in HbA1c hemoglobin levels, a comprehensive examination of the entire body is required.
How to reduce glycated hemoglobin
You can reduce the level of glycated hemoglobin using the following measures:
- Add more vegetables and fruits to your diet that contain a lot of fiber, which helps stabilize blood glucose;
- Consume more skim milk and yogurt, which contain a lot of calcium and vitamin D, which help normalize blood glucose levels;
- Increase your intake of nuts and fish, which contain Omega-3 fatty acids, which help reduce insulin resistance and regulate blood glucose levels.
To reduce glucose resistance, season your dishes with cinnamon, add cinnamon to your foods, add it to tea, sprinkle it on fruits, vegetables and lean meats. Cinnamon helps reduce glucose resistance and glycated hemoglobin levels. Rehabilitation specialists recommend that patients perform a set of physical exercises daily for 30 minutes, which allow them to better control the level of glucose and glycated hemoglobin. During your workout, combine aerobic and anaerobic exercises. Strength training can temporarily lower blood glucose levels, while aerobic exercise (walking, swimming) helps automatically lower blood sugar levels.
In order to do a blood test for the content of glycated hemoglobin and get advice from a qualified endocrinologist, call the contact center of the Yusupov Hospital. The price of the study is lower than in other medical institutions in Moscow, despite the fact that laboratory assistants use the latest automatic glycated hemoglobin analyzers from the world's leading manufacturers.
The importance of the HbA1C test
Diabetes mellitus is a fatal disease that requires careful treatment to reduce the risk of its many complications. If blood glucose levels are effectively controlled from the time of diagnosis, the patient's long-term outcome will be better, even if control worsens in subsequent years. This means that early diagnosis has the dual benefit of allowing better control of blood glucose levels and contributing to improved patient health.
Monitoring blood glucose levels
The convenience of the HbA1C test means that its use to screen for diabetes may increase patient acceptance of testing. The analysis also makes it possible to compare indicators with the previous survey. All this improves treatment results.
On the other hand, using the HbA1C test for routine testing is more expensive than measuring plasma glucose. But in this case, the usefulness of such an analysis is undeniable.
The main value of the HbA1C test is its ability to reflect blood glucose levels over a specific period, rather than a specific point of testing. This period reflects the lifespan of red blood cells containing hemoglobin, namely 120 days. However, the level also shows recent changes in the HbA1C value, since 50% of HbA1C is formed one month before collection of the test sample, 25% in the previous month. The remaining 25% reflects the remaining early four-month period.
Child health problems with gestational diabetes mellitus
Thus, at the birth of children with fetopathy, there is a violation of their adaptation to extrauterine life, which is manifested by the immaturity of the newborn even with a full-term pregnancy and its large size: macrosomia (child weight more than 4000 g), respiratory disorders up to asphyxia (suffocation), organomegaly (enlarged spleen, liver, heart, pancreas), heart pathology (primary damage to the heart muscle), obesity, jaundice, disorders in the blood coagulation system, the content of erythrocytes (red blood cells) in the blood increases, as well as metabolic disorders (low values of glucose, calcium , potassium, magnesium blood).
Children born to mothers with uncompensated gestational diabetes mellitus are more likely to experience neurological diseases (cerebral palsy, epilepsy); during puberty and thereafter, the risk of developing obesity, metabolic disorders (in particular, carbohydrate metabolism), and cardiovascular diseases is increased.
On the part of a pregnant woman with gestational diabetes mellitus, polyhydramnios, early toxicosis, urinary tract infections, and late toxicosis are more common (a pathological condition that is manifested by the appearance of edema, high blood pressure and proteinuria (protein in the urine), develops in the second and third trimester up to preeclampsia - cerebrovascular accident, which can lead to cerebral edema, increased intracranial pressure, functional disorders of the nervous system), premature birth, spontaneous abortion, delivery by cesarean section, labor anomalies, and trauma during childbirth are more common.
Disorders of carbohydrate metabolism can develop in any pregnant woman, taking into account the hormonal and metabolic changes that consistently occur at different stages of pregnancy. But the highest risk of developing gestational diabetes is in women who are overweight/obese and over 25 years of age; presence of diabetes in close relatives; with disorders of carbohydrate metabolism identified before the current pregnancy (impaired glucose tolerance, impaired fasting glycemia, gestational diabetes in previous pregnancies); glucosuria during pregnancy (the appearance of glucose in the urine).
Gestational diabetes mellitus, which first developed during pregnancy, often does not have clinical manifestations associated with hyperglycemia (dry mouth, thirst, increased volume of urine excreted per day, itching, etc.) and requires active detection (screening) during pregnancy !
Top Tips for Lowering A1C
Your A1C is an important part of the diabetes control picture, but it's not the only indicator of your health. For someone who has large fluctuations in blood sugar (which is more common in patients taking insulin), the A1C may remain on target because the two- to three-month average is good. But, daily fluctuations can reduce your quality of life and increase the risk of complications.
Diabetes is always a serious condition. Patients should treat diabetes care like a job . But the time and effort you put into it can lead to good control and a better quality of life.
Making these healthy changes can help you improve your daily blood sugar regulation and lower your A1C levels :
Make an exercise plan and stick to it
Find something you enjoy doing that gets your body moving - walk the dog, exercise with a friend, ride an indoor bike or a regular bike outdoors.
A good goal is 150 minutes of moderate exercise per week . Different types of exercise (strength or resistance training and aerobic exercise) can lower A1C levels, making the body more sensitive to insulin. You should not be inactive for more than two days in a row and should strive for strength training.
However, be sure to consult your doctor before you start exercising. He or she can offer you a customized plan.
If you monitor your blood sugar daily, check it before and after your workout. Exercise can either cause an increase in blood sugar because the liver releases glycogen stores, or it can cause a decrease in blood sugar because it increases insulin sensitivity. If you're not careful, this can cause your blood sugar levels to fluctuate. This is especially important if you are taking insulin or another diabetes medicine that causes insulin secretion, such as a sulfonylurea.
Eat a balanced diet with correct portion sizes
It's best to consult with a certified diabetes care provider or registered dietitian to determine what a balanced diet and appropriate portions .
But, a great rule of thumb is to aim to fill your plate half with vegetables, one-quarter with proteins, and one-quarter with whole grains. If you like fruit, limit your servings to a small cup, eat with some protein to prevent your blood sugar from spiking.
Also, avoid processed foods, sugary sodas and fruit juices, which are rich in carbohydrates and calories and thus can spike your blood sugar and contribute to weight gain.
Stick to a regular schedule
Skipping meals, going too long between meals, or eating too much or too often can cause your blood sugar to drop and rise. This is especially true if you take insulin or certain diabetes medications. Your doctor can help you determine the best eating schedule for your lifestyle.
Follow your diabetes treatment plan
Diabetes treatment is very individual. Ultimately, factors including how long you've lived with the disease, your socioeconomic status, and any other conditions you live with can play a role in choosing the best treatment approach for you.
Your doctor will help you determine the steps you need to take to successfully manage your diabetes. Always consult your doctor before making any changes, such as going on a low-carb diet or starting a new exercise regimen, especially before taking any medications or changing your insulin.
Check your blood sugar levels
Consult your doctor to determine if and how often you should check your blood sugar. You may be tempted to buy an at-home A1C testing kit, but doctors don't recommend it. Daily fluctuations in blood sugar may be masked by an A1C result that is at target.
Instead, if you have a personal continuous glucose monitor, use it to make sure you're at your optimal level. For many people, this is 70 to 180 milligrams per deciliter (mg/dL) (3.9 to 10 mmol/L).
Understanding your A1C level is an important part of overall diabetes management . If you have any questions about your A1C levels or what they mean, don't hesitate to ask your doctor.
