Glycated hemoglobin A1c - what is it? In another way, it is called glycogemoglobin (short designation: hemoglobin A1c, HbA1c) - this is an indicator of blood biochemistry. It reflects sugar levels over a period of 3-4 months. This period is associated with the life expectancy of the red blood cells themselves. A standard blood sugar test reflects the glucose level at the time of the study.
Glycated hemoglobin - what is this analysis and why is it needed? It is necessary to detect diabetes mellitus (DM) even at the stage when there are no clinical symptoms, as well as to monitor the effectiveness of the treatment if it is already diagnosed. But few people know what this indicator is.
With incoming products, sugar passes through the cell membrane, and its gradual connection with amino acids occurs. The result of this reaction becomes glycated hemoglobin. It reflects the percentage of blood hemoglobin in combination with glucose molecules. Hyperglycemia in diabetes significantly accelerates the response of the compound (Maillard reaction), respectively, the level of glycogemoglobin rises. Since the red blood cell lives about 120 days, the study shows blood sugar during this period.
The higher its level, the higher glycemia has been in the last 3 months. With latent diabetes, this suggests the need for treatment and examination by standard methods. With diagnosed diabetes, this indicates possible complications and also requires action.
If glycated hemoglobin is elevated, what does this tell the doctor with existing diabetes? A high level of A1c requires treatment correction for this diagnosis. When diagnosed by determining blood sugar, a number of contradictions are noted, and no technique can boast of its accuracy. They are related to the fact that this indicator depends on many external factors, primarily on the correctness of preparation for the examination.
When they talk about the analysis for glycated hemoglobin, this means that the doctor suspected the development of prediabetes or diabetes. The result will confirm or refute all doubts by 100%. Inside the red blood cell, hemoglobin is always stable, so the analysis data is accurate. What is blood for glycated hemoglobin? This is from 2011, according to WHO recommendations, the necessary data for the diagnosis of diabetes.
Analysis designation
Glycated hemoglobin is presented in several forms:
In analyzes, it is the latter form that matters. Why and what is it? The analysis for glycated hemoglobin is indicated by these letters because in an adult it is represented by several fractions, and most of it is fraction A (from the English. Adult - adult).
HbA1 or alpha-1 is the most common type of hemoglobin, because it accounts for 96-98% of the total mass of this protein in the body.
Any red blood cell always contains almost 270 million hemoglobin molecules. The reaction of its connection with glucose proceeds slowly, without the participation of enzymes. This process has a direct proportion to glycemia and is irreversible.
Patients always have individual differences - the spread of HbA1c values ​​even in two people with the same glycemia level reaches 1%. There are no exactly the same people.
Researchers believe that nevertheless the most reliable indicator will be its value in the last month before taking the analysis. Its indices determine the whole obtained picture of HbA1c by half. The value of glycated hemoglobin is measured as a percentage of the total volume of the whole protein, which is also very convenient.
Glycated and glycated hemoglobin - is there a difference? No, these are synonyms. And one more remark: glycated does not participate in the delivery of oxygen to the cells of the body and does not remove carbon dioxide. Therefore, the higher it is, the greater the oxygen starvation of the body.
Glycated hemoglobin - what is it and how does it manifest itself? It changes during exercise and nutrition, shows the average daily glucose level, regardless of nutrition, exercise, taking drugs, etc.
What happens to glycogemoglobin after 4 months
The red blood cell lives about 4 months, neatly performing all its functions - participation in the gas exchange in the blood, etc. Then the red blood cells undergo destruction in the pulp of the spleen. Glycohemoglobin and its free form also break down. The final decay product is bilirubin, which enters the blood and liver.
Glucose is no longer associated with bilirubin. With the creation of new red blood cells, when the blood is renewed, the values ​​will already reflect these young red blood cells and show the blood glucose - glycemia over the next 90 days.
What does it mean - glycated hemoglobin, and is it possible to study it in the laboratory? The determination of glycogemoglobin in the laboratory is necessary for:
- diagnosis of diabetes;
- compensation estimates;
- predicting complications;
- when planning pregnancy for women with diabetes;
- if gestational diabetes is detected, then to address the issue of its treatment.
In addition, it is used as a marker that identifies a risk group. Standard tests against it lose.
What else is the value of such an analysis? It will help suspicious patients get rid of doubts and conjectures, when the sugar content is on the verge of normal. Some diabetics neglect their diet and reduce sweets in their diet in only 1-2 weeks, hoping that the doctor will not understand this. But glycogemoglobin will also reveal such a sin of a diabetic.
The only drawback of such a technique is the high price and the inability to pass an analysis in many diagnostic centers. The high cost of the service, by the way, is redeemed by the diagnostic value of the indicator.
Norms of glycogemoglobin in the blood
What does it mean - glycated hemoglobin, and does it have any norms? The norm, of course, is, because healthy people also have it. Interestingly, it does not depend on age and gender, i.e. the same for both adults and children, both for women and for men.
The rate of glycated hemoglobin - what is it? Its normal level is up to 5.5%. This value will indicate that there is nothing to worry about, and diabetes will not threaten you over the next 3 years. By the way, the lack of risk varies somewhat by age - in the elderly it will be up to 7.5%.
Further, the decryption will be as follows: A1C is 5.6-6.0%. Glycated hemoglobin 6% - what does it mean? There is a risk of diabetes, and you should analyze your diet, lifestyle - reduce weight, increase physical activity. With hemoglobin A1C from 6.1 to 6.4%, the risk of diabetes is very high. Your doctor may prescribe medications that decrease insulin resistance.
When A1C exceeds 6.5%, this is diabetes. And in diabetics, this indicator will be determined by the degree of compensation of the disease. By the way, there are cases when A1c was less than 4% - this is also not health and requires urgent treatment. Such a cause may be, for example, a pancreatic tumor.
Norm for women
In a woman, the value of glycogemoglobin can change with:
- different types of diabetes;
- anemia when there is a deficiency of iron;
- Chronic renal failure;
- after surgery (for example, removal of the spleen);
- weak vessels.
In such cases, the level of glycogemoglobin also depends on age:
- up to 30 years old - 4-5;
- up to 50 years old - 5-7;
- older than 50 years - from 7 and above.
Men have the same numbers.
Norms for diabetes
In diabetic patients, the Hba1C figures may vary depending on:
- type of diabetes and the age of the patient;
- the presence of complications and concomitant diseases;
- life expectancy.
In young women with type 1 diabetes and the absence of complications, the norm will be equal to a healthy norm (5.5%) and they can bear and give birth to a child. If this is not, the risk of miscarriage and various abnormalities and malformations in the fetus is high.
In elderly people with complications of diabetes, concomitant pathologies, and a life expectancy of less than average is assumed, an indicator of 7.5-8.0% will be quite satisfactory.
Treatment for type 2 diabetes
Depending on the level of glycogemoglobin in the detection of T2DM, treatment will be prescribed taking into account the following. For example, glycated hemoglobin 6.6 is what? HbA1C 6.5–7.5% - the treatment will be prescribed as a mono-tablet preparation; HbA1C 7.6-9.0% - a combination of two drugs.
And what does this mean - glycated hemoglobin is increased by more than 9.0%? In this case, treatment is required urgent and serious, and it is better to start it with insulin therapy ± tablets, in some cases it is possible to start with a combination of 2-3 drugs. Diabetics need to keep in mind that when HbA1C is reduced by only 1%, the risk of developing microvascular complications decreases immediately by 30%.
What is the frequency of the test for diabetes?
At the onset of the disease, until compensation for diabetes is achieved, the study is carried out quarterly. Next comes the type of SD:
- with T1DM - control is also quarterly;
- with T2DM - once every six months.
For prevention with full health, the test is taken every 3 years. Every 4 months it is necessary to donate blood to those who had diabetics in their family. Glycated hemoglobin 7 - what does it mean? In the standards for diabetics, the number 7 is often found and is, as it were, the starting one, depending on age.
The norm for diabetes is about 8%. In middle age, hemoglobin A1C is less than 7%, with no risk of complications. At a young age, the same level - the presence of severe complications. In addition, the level of 7% indicates the possibility of developing hypoglycemia in a child.
If hemoglobin A1c is 10% or higher, urgent hospitalization is required. This will also indicate irreversible changes. It should be noted that although lowering the level of hyperglycemia is the main goal of diabetes treatment, it is dangerous to reduce it sharply. This immediately disrupts the microcirculation of blood in small vessels and contributes to the development of retinopathy and neuropathy in the kidneys.
Competent and safe reduction - 1-1.5% per year. The International Diabetes Federation recommends keeping HbA1c levels permanently below 6.5%.
Factors contributing to an increase in hemoglobin A1c
Glycohemoglobin rises not only with the risk of diabetes. Other factors can also provoke its increase:
- iron deficiency in the body;
- physical inactivity;
- age after 45 - somatic background often becomes dysfunctional;
- splenectomy;
- oncology;
- polycystic ovary;
- the birth of a large fetus;
- intestinal obstruction;
- thick blood;
- excess vitamins gr. B;
- pulmonary failure;
- heart disease.
Factors Contributing to Lower A1c
To reduce the percentage of hemoglobin can:
- blood loss;
- blood transfusion, as a result of which the concentration of HbA1C became diluted;
- blood diseases, when the life span of red blood cells becomes reduced;
- hypoglycemia;
- hereditary causes;
- adrenal insufficiency;
- the presence of defective forms of hemoglobin, distorting the results of the tests;
- pancreatic insulinoma;
- long-term low-carb diet;
- intense physical activity.
Glycated hemoglobin in pregnant women
During pregnancy, the body of the expectant mother undergoes many changes. This can not but affect the level of glucose in women. Therefore, the norm of hemoglobin A1C during gestation differs from the norm in non-pregnant women.
- At a young age, it is 6.5%.
- The average age corresponds to a rate of 7%.
- In pregnant women, the level should not fall below 7.5%. Tests for glycated hemoglobin in a pregnant woman are performed every 1.5 months. He will not only indicate the sugar content, but also show how the future baby develops and feels.
Deviations from the norm are detrimental not only to the “curious dog” itself, but also to his mother. If glycohemoglobin is below normal, it will indicate a low iron content in the body. and fetal development may be inhibited. Then the doctor will recommend strengthening the mother’s nutrition.
A high level will indicate increased overfeeding of the fetus, as a result of which a large fetus will be expected (from 4 kg or more), and this means a difficult and protracted birth for the mother.
How to take an analysis
Blood test for glycated hemoglobin - what is it and how is it carried out? For such an analysis, special rigorous training is not required, because the indicator is stable for 3 months. No need to starve, take sugar or wait for recovery from a cold, recover from stress, you can even inject insulin.
Glycated hemoglobin analysis - what does this suggest in terms of preparation? The patient can come to the laboratory at any day and time of the day. Eating food and fluids in this case do not play absolutely. But still, for reinsurance, doctors tend to focus on the traditional rules for taking an analysis and prescribe a blood test in the morning on an empty stomach. They believe that then mistakes will not be made for sure. 30-90 minutes before the analysis, it is better not to smoke and not to strain physically.
The day before, it was not recommended to take certain diuretics: Indapamide, Propranolol, etc. Blood in different laboratories can be taken not only from a vein, but also from a finger. 3 veins of blood are taken from a vein.
The analysis is done within a few hours. The distortion of the results can be when:
- bleeding
- anemia;
- poisoning by alcohol or lead;
- with chronic renal failure;
- thyroid disease;
- taking vitamins C and E.
How to lower glycated hemoglobin?
Reducing the level of glycogemoglobin is the main goal in the treatment of diabetes mellitus in general and the prevention of its development. In diabetics, this can only be achieved by treating and eliminating hyperglycemia.
The recommendations are pretty standard:
- adherence to diet, balanced nutrition, with the restriction of animal fats and simple carbohydrates;
- increase in physical activity - classes 3 times a week for 45 minutes;
- normalization of weight, if there are problems with this;
- in the presence of diabetes - the implementation of all the instructions of the attending physician;
- stress avoidance.
Diet
Completely excluded are products from premium flour, soda, simple sugars, pasta and potatoes. Other vegetables are welcome, also on the table should be meat, vegetable oils, sour milk.
With an increased level of glycogemoglobin, it is important and you need to eat especially more meat to increase hemoglobin. Complex carbohydrates and vegetable proteins such as legumes, greens, nuts, whole-grain or whole grain bread are recommended in order to increase the fiber content in the diet, fruits. Fasting with the goal of losing weight is completely excluded.
Physical exercise
With hyperglycemia, moderate physical activity during the day will help to spend more glucose and keep the body in good shape. It will also improve heart function and reduce weight. It is very useful swimming, elementary walking, walks in the fresh air, cycling. Extreme sports are not your path.
And with low hemoglobin A1c, any sport is not shown, since this is an excessive load for the body.
Stress has always been the culprit of hyperglycemia. Other negative emotions are no exception. They always increase blood sugar. Taking care of the nervous system will also be that you do breathing exercises.
Often stress can be triggered by bad habits. It is possible to get rid of them yourself, if you understand that life will be the price. And, of course, the timely and scrupulous implementation of all the doctor’s recommendations has not been canceled.