The diabetes A1c test is a means of testing concentrations of glycated hemoglobin in your blood. The test is now regularly administered to diabetics as part of their treatment regimen. Glycated hemoglobin is also referred to as glycosylated hemoglobin, or ‘A1c’. A1c is the the term most often used by physicians, and the one you are likely to hear when your doctor first tells you his or her plan to treat your diabetes. The test can be administered right in the office before you meet with your physician. Very little blood is drawn for the test. The blood is then submitted to an A1c testing system and the measurement of A1c is displayed on the system’s LED screen and recorded by the technician on your medical record. The technology for doing an diabetes A1c test has advanced to the point that now diabetics can do their own test at home with a home A1c testing system, which is readily available at most pharmacies.
A1c, or glycated hemoglobin, is formed in the blood when red blood cells interact with blood plasma glucose in the absence of enzymes. The red blood cell becomes glycated over its 120 day life span. The blood has normal amounts of glycated hemoglobin when plasma glucose is at normal levels. As the average amount of plasma glucose increases, glycated hemoglobin also increases. At any time, plasma glucose may increase or decrease. Measuring the amount of glucose in plasma at any single given time will not tell you what the average amount of glucose has been in the blood over 120 days, but obtaining the amount of A1c in the blood will tell you.
A1c amounts tell us the average glucose concentration in blood over a period of months. The higher the concentration of A1c, the higher the amounts of glucose have been persistently in the blood. Glucose concentration varies, sometimes widely, throughout the day. The body’s homeostatic mechanism will normally quickly restore the proper balance, unless there is a problem with the glucose controlling mechanism, or chemistry. When glucose is persistently at higher than normal levels, the condition exhibits symptoms, and causes damage to the body. This persistent higher-than-normal levels of glucose is called hyperglycemia. Persistently lower than normal levels also exhibits symptoms and can cause body damage. This condition is called hypoglycemia. Diabetes is one or the other. The key word in this description is “persistence”. The A1c test tells us the average glucose concentration over time. It tells us if the level has been higher than normal persistently, over a period of months. For this reason the American Diabetes Association division for Standards of Medical Care in Diabetes added the A1c test to its means for diagnosing diabetes in 2010.
By taking regular diabetes A1c tests, your physician can determine what course of action to take in best treating your diabetes. This may be an increase or decrease in medication(s) dosage, or the changing of medications. Until recently, only laboratory or point-of-care tests, such as the high-performance liquid chromatography (HPLC), the immunoassay, or the boronate affinity chromatography tests were available for measuring glycated hemoglobin, but now you can get a home diabetes A1c test device and do your own testing at home. These are especially useful if your doctor visits for diabetes management are 6 months or a year apart. If the readings are higher than you expect, you can move up your visits to an earlier date.
The diabetes A1c test broaches on the miraculous. To think the body is doing its own glucose averaging is astounding. What is not so comforting is the significance of buildups of that glycated hemoglobin. High concentrations warn of possible heart problems, kidney, vision, and nerve damage. This is why we take a diabetes A1c test, to prevent such progressive diabetes damage. If these tests do help prevent such consequences of diabetes, they’re truly miraculous in their own right.