Diabetic Home Care and Monitoring (cont.)

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Hemoglobin A1C (HbA1c) testing

The hemoglobin A1c test (HbA1c) is crucial to monitor blood glucose control in patients with diabetes. In brief, hemoglobin A1c is the final product of several chemical reactions that occur in the bloodstream as red blood cells are exposed to glucose. A red blood cell typically lives for about three months, so the HbA1c reading provides a report card averaging blood sugar levels over the prior three months. Many different methods are available to determine the HbA1c level. Regardless, HbA1c level has been shown to predict the risk for developing complications of diabetes, much in the same way that cholesterol levels are predictive of heart disease. The HbA1c test should be performed routinely at three-month intervals in patients with established diabetes. HbA1c can be tested when a new case of adult diabetes is suspected, although its use to diagnose borderline pediatric diabetes is still controversial.

To measure HbA1c, blood obtained in the usual way (from a vein) can be sent to a laboratory. Alternatively, many clinics specialized in diabetes care now have desktop HbA1c machines, which will read a simpler fingerstick blood sample within minutes. Several conditions can affect HbA1c measurements, and most relate to disorders of the red blood cells. For example, results may be falsely low if too few red cells are present (anemia). Falsely low readings can occur when red blood cells lose their proper shape (due to conditions like thalassemias, sickle cell disease, or spherocytosis). HbA1c is invaluable as a tool to individualize patient care plans so that glycemic goals can be achieved.

REFERENCE: Medscape. Type 2 Diabetes Mellitus.

Medically Reviewed by a Doctor on 12/4/2014

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