The A1c level refers to the glucose-modified hemoglobin which is also called HbA1c. It is important to note that hemoglobin is the protein present in red blood cells that transports oxygen to the cells in the body.
The glucose molecules in the blood react with hemoglobin and permanently modify the protein. The level of glucose-modified hemoglobin is proportionate to the amount of glucose in the bloodstream and can be utilized clinically to assess the levels of glucose over a given period of time. In addition, the A1c test is used to diagnose diabetes and monitor the blood glucose level among those who have diabetes.
Life cycle of the red blood cell
The red blood cells usually live between 100-120 days. These are produced in the bone marrow and released into the bloodstream. At the end of the life cycle of a red blood cell, it is engulfed by the macrophages and hemoglobin is broken down and eventually recycled.
The amount of glucose-modified hemoglobin in the red blood cells can be utilized as a measurement of the average amount of glucose in the blood for 100-120 days.
How to interpret the laboratory results
The A1c levels are reported as percentage in the laboratory results. The average levels among non-diabetic individuals is between 4-5.9%. It is important to note that diabetes is diagnosed if the level is equal to or higher than 6.5%.
It is recommended that individuals who are diagnosed with type 2 diabetes have an A1c level below 7% and must be tested at least 2 times in a year. The test often includes an estimated average glucose. Take note that this calculation is based on the A1c levels and expressed as mg/dL or mmol/L.
Possible risks linked with a high A1C level
In case the levels are continuously high, there is a risk for diabetes complications. These complications include skin infections, cardiovascular disease as well as nerve, kidney and eye damage. Based on clinical trials, it revealed that reducing the A1c levels will not minimize the risk for nerve, kidney and eye damage.
It is important to note that the A1c test will not provide details on any acute increase or decrease in the blood glucose level. Due to this, the A1c test does not replace the standard blood glucose monitoring.
Contraindications
The A1c test result is usually based on a normal red blood cell life cycle and must not be carried out among individuals who are pregnant, have red blood cell disorder such as hemolytic anemia or has donated blood recently.