Can The A1c Test Result In A Different Diagnosis Than The Blood Glucose Tests
Yes. In some people, a blood glucose test may show diabetes when an A1C test does not. The reverse can also occuran A1C test may indicate diabetes even though a blood glucose test does not. Because of these differences in test results, health care professionals repeat tests before making a diagnosis.
People with differing test results may be in an early stage of the disease, when blood glucose levels have not risen high enough to show up on every test. In this case, health care professionals may choose to follow the person closely and repeat the test in several months.
Interestingly Your Ethnicity Can Also Affect Your A1c Result
Everyone has a different type of hemoglobin, depending on their ethnicity. A1C test works best with type A hemoglobin. Hemoglobin variants such, C, D or E, can affect the precision of A1C as well .
It is crucial to note that the A1C test is not always accurate. Repeated checks can give higher or lower measurements for the same blood samples. Doctors rely on other tests as well called fructosamine blood tests. This test gives an extended-term assessment of your sugar level.
To view the list of factors that may cause a high A1C result, please click here.
Do you need more information on the Haemoglobin A1C blood test, please click here
What Does A1c Stand For
Hemoglobin A1C , commonly called A1C, stands for glycosylated hemoglobin. An A1C test provides information on how well-controlled a persons diabetes is. It does this by measuring the percentage of red blood cell hemoglobin protein that has sugar stuck to it and provides a three-month average of your blood glucose levels, explains , MD, a board-certified endocrinologist at the Center for Endocrinology at Mercy Medical in Baltimore. The higher blood sugar levels are, the more glucose attaches to hemoglobin. The results provide patients and their healthcare providers with information on how well their treatment, diet, and medication is working and whether adjustments are necessary.
There are a few reasons a doctor might suggest an A1C test:
- To make a diagnosis of Type 2 diabetes
- To test for prediabetes
- To monitor blood sugar levels
- To determine if treatment adjustments are needed
The A1C blood test is not for diagnosing Type 1 diabetes, gestational diabetes, or cystic fibrosis-related diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases .
Recommended Reading: Number Of Grams Of Sugar Per Day For Diabetic
What Do You Do If Blood Sugar Is Too High
The best thing to do when your blood sugar levels are too high is to eat low carb and high protein meals and drink a high amount of water. Did you forget to take your insulin? You can do a correction bolus or take your medication before you eat. If the high blood sugar continues, contact your doctor and ask them to review your current dosages of insulin or if they need to prescribe another type of medicine for diabetes that will help keep blood glucose levels within the normal range.
Keep testing your blood sugar levels at regular intervals to make sure your high blood sugar is dropping, and if so, not dropping too fast and too much.
What Is An A1c Blood Test
The A1C test is a common blood test that measures the amount of glucose in the blood. The A1C blood test goes by many other names, including A1C, HbA1C, glycated hemoglobin, glycosylated hemoglobin or hemoglobin A1C. Hemoglobin is a protein found in the red blood cells that carries oxygen to the cells. Glucose attaches to hemoglobin in your blood cells, and the A1C test measures the amount of hemoglobin with attached glucose.
The test results reflect your average blood sugar over the past 2-3 months. As your red blood cells have a lifespan of around 3 months, this is why the test gives us an average of what has been going on in your blood for the past few months.
The higher your A1C level, the greater your risk of developing diabetes, and the poorer your blood sugar control if you already have diabetes.
Also Check: Is Insulin Used To Treat Type 2 Diabetes
Using The Same Biomarker For Diagnosing And Monitoring Diabetes Might Be An Advantage
A1C is used to monitor diabetes and to establish the degree of metabolic control. Deviation from individualized A1C targets prompts physicians to modify treatment strategies with lifestyle intervention and/or drug titration or changes. The use of A1C for diagnosing diabetes has the advantage that, in subjects with A1C 6.5% , baseline A1C is already measured and deviation from target is immediately available . In subjects with A1C of 6.006.49% , an effective prevention strategy can be immediately undertaken with the awareness that a single A1C is definitely more reliable than a single FPG to stratify the risk of the disease. Yet, in subjects with A1C of 5.505.99% plus other diabetes risk factors , counseling can be immediately offered because diabetes risk is substantial, and single A1C assessment is definitely more reliable than single FPG to capture chronically high-normal glucose levels.
Pertinent to this issue is the firm belief that the implementation of the standardization of A1C assay would proceed more rapidly worldwide if A1C were to also be used for diagnosing diabetes. A1C assessment is crucial for diabetes monitoring, and establishing the individual A1C target definitely requires that the parameter is International Federation of Clinical Chemistry standardized and DCCT aligned. In fact, the A1C target and the deviation from it in the single patient remain totally uncertain when the laboratory provides A1C data that are not aligned to standard.
What Is A Hemoglobin A1c Test
A hemoglobin A1c test measures the amount of blood sugar attached to hemoglobin. Hemoglobin is the part of your red blood cells that carries oxygen from your lungs to the rest of your body. An HbA1c test shows what the average amount of glucose attached to hemoglobin has been over the past three months. It’s a three-month average because that’s typically how long a red blood cell lives.
If your HbA1c levels are high, it may be a sign of diabetes, a chronic condition that can cause serious health problems, including heart disease, kidney disease, and nerve damage.
Other names: HbA1c, A1c, glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin
Read Also: Diabetes And Heat Exhaustion Symptoms
Whats The Difference Between A1c And Blood Glucose Levels
February 27, 2018 by Diabetes Care
Checking your A1C as well as your blood glucose levels are things youll do when you have diabetes. Thats because they are both key markers in determining whether your blood sugar levels are within the ideal target range to keep you healthy. So whats the difference between your A1C and blood glucose level? Heres a closer look at what each one means in relation to managing your diabetes.
Large Trial Compared Usual Tools For Assessing For Diabetes In Adults
The researchers looked at data from 9,000 adults, ages 20 years and older, from the 2005-2014 National Health and Nutrition Examination Survey . The information collected by the research team included body weight and blood test results.
Based on the fasting blood glucose test and the OGTT, 765 patients were diagnosed as having type 2 diabetes . However, only about 27% of these individuals were classified as having diabetes based on their A1c levels, which is how Dr. Villacreses and her team determined that nearly three-quarters of those at risk for diabetes were not aware that they had this chronic disease, and therefore were not receiving treatment.1
“Most worrisome, 73 % of patients would have missed out on early intervention and treatment,” she tells EndocrineWeb. While the A1c test is convenient, ”we recommend that we do not rely solely on this number,” Dr. Villacreses says.
The guidelines for diagnosis and treatment of type 2 diabetes from the American Diabetes Association already advise against relying solely on A1c,3 she says. While the American Diabetes Association guidelines specify that diabetes can be diagnosed based on fasting plasma glucose , the OGTT, or the A1c, our findings confirm that reliance on A1c remains the least reliable method for assessing diabetes risk.
Don’t Miss: Cheapest Insulin In The World
Setting Goals For A1c Levels
The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. Someone who has had untreated diabetes for a long time might have a level above 8%.
If you have diabetes and your level is above your target, your doctor may change your treatment plan to get your level down.
A combination of diet, exercise, and medication can bring your levels down.
People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year.
People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can affect the results of the hemoglobin A1c include supplements such as vitamins C and E and high cholesterol levels. Kidney disease and liver disease may also affect the test.
Cost Of The Assay: Savings Or No Savings
One of the major concerns raised by critics of the use of A1C for diagnosing diabetes is the higher cost of the assay when compared with FPG. There is no doubt that from an analytical point of view , FPG is cheaper than A1C. However, other considerations about cost should be made. FPG assessment requires overnight fasting, whereas A1C can be assessed any time. This means that a person could go or could be driven by a relative/friend to the laboratory, even during lunch or in the late afternoon, avoiding loss of work hours. It is also possible to collect blood for A1C assessment in the evening and hand it to the laboratory in the following days. Yet, in subjects with FPG 7 mmol/L , A1C assessment would be needed the next few days as a second step in a newly diagnosed diabetes workup. On the contrary, when A1C assessment yields a value 6.5%, the second step required to initiate diabetes monitoring after diagnosis would be completed, with a substantial savings of both analytical and nonanalytical costs. On the other hand, when using FPG to screen for diabetes and finding a value in the range of 5.66.9 mmol/L , an OGTT is frequently prescribed to establish glucose tolerance. This test requires hours in the laboratory, with additional analytical and nonanalytical costs. In such cases, which represent a sizable portion of the general population, A1C rather than FPG would provide an immediate diabetes diagnosis or a valuable risk stratification without supplementary testing.
Don’t Miss: Long Acting Insulin Side Effects
Hba1c Is Your Average Blood Glucose Levels For The Last Two To Three Months If You Have Diabetes An Ideal Hba1c Level Is 48mmol/mol Or Below
If you’re at risk of developing type 2 diabetes, your target HbA1c level should be below 42mmol/mol .
On this page well go through what HbA1c means, and why aiming for your target level is so important. Well also explain the HbA1c test in more detail, and show you what you can do to lower your HbA1c levels if theyre too high. Plus, you can use our HbA1c converter tool if youre looking to find out your level in % or mmol/mol.
How Often Is A1c Tested
To keep A1C levels in check, patients should have the test repeated regularly. If the A1C is less than 5.7, indicating you dont have diabetes, you should have it checked every three years, according to Robert Williams, MD, a family doctor and geriatrician in Lakewood, Colorado, and a medical advisor for eMediHealth. If it is between 5.7 and 6.4, indicating you are at risk of developing diabetes, you should have it rechecked every one to two years. If you have a confirmed diabetes diagnosis, and your blood sugar is well-controlled, you should have an A1C test every six months. If you already have diabetes and your medications change, or your blood sugar is not well-controlled, you should have an A1C test every three months.
Recommended Reading: How Much Is Insulin Out Of Pocket
Some Medications Such As Opioids Can Cause High A1c Levels
Several different medications can interfere with A1C test results. Some can even cause errors in readings or bring up inaccurate results. Some opiates and even over-the-counter drugs can increase your A1C levels. According to a study by the NIH, common drugs like aspirin also cause high or low A1C levels.
Of course, taking the occasional aspirin wonât affect your levels too much. It usually only starts to skew the results of an A1C test if you are taking these medications at regular, larger doses over a long period. This isnât a one size fits all rule, though. For example, among those with type 2 diabetes, aspirin didnât show any elevated levels at all.
Signs Symptoms And Diagnosis Of Diabetes
The signs and symptoms of Type 1 diabetes usually develop quickly, especially in children, over a period of weeks. In babies and young children, the first indication of Type 1 diabetes may be a yeast infection that causes a severe diaper rash that’s far worse than the common red, puffy and tender skin rash. In young children and infants, lethargy, dehydration and abdominal pain also may indicate Type 1 diabetes.
Once the symptoms appear, a blood test generally will reveal very high blood glucose.
Type 2 diabetes can be detected easily during a routine screening exam and blood test. However, it frequently can go undiagnosed for years unless a physician draws a blood sample to check the blood glucose.
In the early stages of Type 2 diabetes, you experience few to no noticeable signs of the disease. As time goes by and the untreated blood glucose continues to rise, symptoms begin.
If you’re over 40 or have parents or siblings with diabetes, be sure to have your blood glucose checked routinely.
The most common symptoms of undiagnosed Type 1 and Type 2 diabetes are:
Also Check: Is Type 2 Diabetes Serious
High Hba1c May Increase Mortality
Higher HbA1c levels were associated with increased mortality from all causes among nondiabetics, in a meta-analysis of 11 studies with over 113k people .
A study of over 2.1k people who had a stroke reported that the risk for all-cause mortality was significantly increased when HbA1c level was > 5.5% compared to HbA1c < 5.5%, and it further dramatically increased 2 3 times in the highest HbA1c group 7.2% .
The American Diabetes Association estimated that the risk of diabetes-related mortality increased by 25% for each 1% increase in HbA1c. It has also been estimated that each percentage point increase in HbA1c corresponds to a 35% increase in the risk of heart disease and an 18% increase in the risk of heart attack .
Why does elevated HbA1c relate to mortality? Ample evidence shows that elevated glucose can increase oxidative stress. Oxidative stress then damages blood vessels, contributing to heart disease. Oxidative stress can also damage DNA, potentially resulting in gene mutation and cancer development .
What Does It Mean When Your A1c Levels Are Elevated
Typically, The definition of a high A1c level is A1c more than 6.5% which diagnose diabetes mellitus according to American diabetes association.Dont miss: Full A1c ChartFor instance Hgb A1c% 7.0 and fasting sugar result is 130 mg/dl, the interpretation for these levels indicate mildly uncontrolled type 2 DM.While in an example like this:Hemoglobin A1c level of 8.0% but fasting blood glucose level comes 100 mg/dl , the A1c is elevated while the fasting test tells that theres no diabetes.Remember that: A1c is a calculated value of an average of B.G. levels for a time of about 90 120 days.So that the patient asks us
Recommended Reading: How Many People In The Us Have Type 1 Diabetes
Maintain A Healthy Weight
Eating a balanced diet and exercising can help you lose or maintain weight. Ask your doctor what a healthy weight is for you.
Work with them to determine how many calories you should be eating. If you need to lose weight, ask them how much weight you should be losing per week to stay healthy.
Crash diets and extreme workout plans may make for entertaining television, but they arent realistic for long-term maintenance. Theyre often unhealthy as well.
A1c Results And What The Numbers Mean
| Diagnosis* | |
|---|---|
| Diabetes | 6.5 percent or above |
When using the A1C test for diagnosis, your doctor will send your blood sample taken from a vein to a lab that uses an NGSP-certified method. The NGSP, formerly called the National Glycohemoglobin Standardization Program, certifies that makers of A1C tests provide results that are consistent and comparable with those used in the Diabetes Control and Complications Trial.
Blood samples analyzed in a doctors office or clinic, known as point-of-care tests, should not be used for diagnosis.
The A1C test should not be used to diagnose type 1 diabetes, gestational diabetes, or cystic fibrosis-related diabetes. The A1C test may give false results in people with certain conditions.
Having prediabetes is a risk factor for developing type 2 diabetes. Within the prediabetes A1C range of 5.7 to 6.4 percent, the higher the A1C, the greater the risk of diabetes.
Don’t Miss: Can You Get Rid Of Diabetes Type 1