Diabetic Home Care and Monitoring (cont.)

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Hemoglobin A1C testing

The hemoglobin A1c test (HbA1c) is crucial to monitor blood glucose control in patients with diabetes. In brief, hemoglobin A1c refers to 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 the prior three months blood sugar levels. 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 established patients with diabetes. The HbA1c can be tested when a new case of adult diabetes is suspected, although its use to diagnose borderline pediatric diabetes is still debatable.

To measure HbA1c, blood obtained in the usual way (from a vein) and 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. A few conditions can affect HbA1c measurements, most related to problems with 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 (as with conditions like thalassemias, sickle cell disease, or spherocytosis). The HbA1c is a valuable tool to individualize patient care plans so that glycemic goals can be achieved.

REFERENCE: MedscapeReference. Type 2 Diabetes Mellitus.


Medically Reviewed by a Doctor on 5/30/2012

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