HB1Ac Test

ketoacidosis diabetes

What is the HbA1c test?


HbA1c is a common term that most diabetic patients are familiar with when it comes to diabetes management. The term Hb1Ac refers to glycated hemoglobin. This development takes place when glucose joins hemoglobin (a vital part of your blood cell that transports oxygen from the lungs to various parts of the body) making blood ”glycated’.

This test not only helps in identifying the above but also looks at blood glucose levels over the last two to three months. Hence the amount of Hb1Ac found is directly proportionate to your blood glucose levels. This test provides a better reading so that diabetic patients can better understand their sugar levels.

What is Diabetes? 

Diabetes is a chronic disease that has impacted many people worldwide. The cause reason for this is because the body is unable to produce sufficient amount of insulin or is unable to effectively use the insulin produced. People are often diagnosed with two types of diabetes.

Type 1 Diabetes: When the body is said to produces insufficient levels of insulin, they are said to have Type 1 Diabetes. This is attributed to genetic reasons.

Type 2 Diabetes: When the body is unable to use insulin effectively or has grown resistant to insulin, that person is said to have Type 2 Diabetes. This could be due to a lack of physical exercise and excess body weight.
 
It is important to regularly check blood sugar levels. Common methods of testing are the Fasting Plasma Glucose Test and Oral Glucose Tolerance Test. Another method of testing that is recommended for better sugar management is HbA1c. While the first two methods of testing are commonly used, HbA1c is another form of testing that provides a better understanding of glucose levels. It also helps in planning and managing diabetes in the long run.

What is the impact of Diabetes in India?

According to reports from the World Health Organisation of India, diabetes impacts around 8.7% of the youth and adult population that lie between the age of 20-70 years. Their research also suggests that minimum of 30 million people within India has been impacted by diabetes. Some major factors that attribute to this are urbanization, unhealthy food habits, sedentary lifestyle, etc. Obesity is another major contributing factor. 

Why should you consider testing for Hb1Ac?

If you are at a higher risk of getting diabetes then this test is recommended. Some common risk factors include:

– Physical inactivity
Obesity
– High blood pressure
– History of heart disease

If you’re a patient of diabetes and experience the following symptoms:

– Increase in urination
– Fatigue
– Blurry vision
– Increase in the feeling of thirst

Then undergoing the Hb1Ac test is recommended for you . According to studies, red blood cell circulates in the body for three to four months. The HbA1c takes this into account. The test measures blood sugar levels of a blood cell.  It measures the accumulation and concentration of glucose to the blood cell, thereby giving a better understanding of blood sugar levels over the past few months. This, in turn, will help patients understand their sugar levels and how to maintain it.

This test not only helps patients of diabetes but also helps prediabetic individuals keep a check on their blood glucose levels too. Prediabetic individuals are people whose sugar levels show the risk of manifesting into diabetes; hence it is important for them to better understand their blood sugar level so that they can manage it better. It helps in the diagnosis of Type 1 and Type 2 diabetes.

What’s the difference between HbA1c and blood glucose levels?


HbA1c focuses on providing a more accurate reading of sugar levels over the past few months. This test provides a comprehensive reading that acts as a base to keep a track of sugar levels and formulate plans to maintain sugar levels.

For a diabetic patient, the blood glucose level helps understand the concentration of sugar in their blood at that point of time. Almost all diabetic patients use a meter to keep track of their sugar levels. The measurement of a blood glucose test is done in the form of a fasting plasma glucose test.

Whereas HbA1c provides a more comprehensive approach. This testing method also provides a little more accuracy. When sugar is processed it enters the bloodstream and attaches itself to the haemoglobin, hence the amount of glucose in your system is proportionate to the sugar that is in your system at that particular time.

As blood cells remain in the body for a few months, the test reflects an average of your blood glucose level of those few months. For example, if your blood sugar has been low for a week then you Hb1Ac would reflect that in its result.

The HbA1c test results are normally measured in percentage (DCCT unit) or as a value in mmol/mol (IFCC unit).

What range should HbA1c results fall under?

The following table shows the percentage of estimated blood sugar based on the A1c test.

A1c test levelsEstimated blood sugar levels (mg/dL)Estimated blood sugar levels (mmol/L)
5% (31 mmol/mol) 97 (mg/dL) 5.4 (mmol/L)
6 % (42 mmol/mol) 126 (mg/dL) 7 (mmol/L)
7% (53 mmol/mol) 152 (mg/dL) 8.4 (mmol/L)

8% (64 mmol/mol)  
183 (mg/dL) 10.2 (mmol/L)
9% (75 mmol/mol) 212 (mg/dL) 11.8 (mmol/L)
10% (86 mmol/mol) 240 (mg/dL) 13.3 (mmol/L)
11% (97 mmol/mol) 269 (mg/dL) 14.9 (mmol/L)
12% (108 mmol/mol) 298 (mg/dL) 16.6 (mmol/L)
13% (119 mmol/mol) 326 (mg/dL) 18.1 (mmol/L)
14% (130 mmol/mol) 355 (mg/dL) 19.7 (mmol/L)


The following table looks at the ideal ranges for individuals:

Patient condition Required mmol/mol level   Percentage
Normal 42 mmol/mol or below Below 6%
Pre-diabetic individuals42 to 47 mmol/molBetween 6% to 6.4%
Diabetic individuals 48 mmol/mol or more 6.5% or More


For individuals without diabetes, it is recommended that their HbA1c levels lie between 4% and 5.6%. Hence it is fair to say that your blood sugar levels should be below 5.7%
 
If the test results feature a range between 5.7% and 6.4% then the individual is considered prediabetic (the condition is also known as impaired fasting glucose) and has a higher of becoming diabetic in the future.
 
If test results feature a score that is 6.5% and above on separate occasions, the individual the test belongs to can be diagnosed with diabetes.  
 
It is suggested that for most individuals 7% or less is a common target, but this again varies from person to person. It is always best to consult a physician when it comes to interpreting the test results. 

Can change in red blood cells or haemoglobin affect HbA1c results?

Certain medical conditions like experiencing blood loss, sickle cell disease, undergoing a transfusion, haemodialysis, undergoing erythropoietin treatment and anaemia can affect the accuracy of the HbA1c testing. Some other conditions that can affect the A1c results are kidney failure, liver disease and, iron deficiency.

What is the procedure for this test?

The test is an extremely simple procedure. The process is a blood test where a health care professional will draw out a blood sample from your vein. Here you might feel a small prick momentarily. The blood sample would be collected into a vile or a test tube and then it’s all ready to undergo the testing process. 

What would you need to prepare for this test? 

While some tests require the person to undergo the test on a empty stomach, the HbA1c is a simple process and hence no fasting would be required before going through the same. There no special preparations recommended for this test. 

When can you expect back the HbA1c test results?

Since the procedure for this test is simple, the results for this test should come within 24 to 72 hours.

What is the average price range to for HbA1c test in India?

The average price range for this test throughout India ranges from Rs 353 to Rs. 565.

Is A1C testing recommended for pregnant women? 

Pregnant women are extremely susceptible during their gestational period to high blood sugar . They need to maintain their health during this period as their health will affect their baby’s health as well. During this period, it is important for them to keep track of their sugar levels.

This holds true for women who have been diagnosed with diabetes and women who are prone to developing diabetes during pregnancy.
Health care professionals might recommend this form of testing for couples who are planning their pregnancy to avoid complications during the pregnancy period.

Since the test itself provides a comprehensive reading on the past few months, it would give the expecting mother a better idea with regards to her sugar levels before pregnancy and allow her to plan her pregnancy. 
 
If a diabetic or a prediabetic individual is expecting a baby, one of the ways doctors and nurses would monitor blood levels is through A1c. According to the NICE guidelines, the recommended blood sugar level for women should aim for during pregnancy is 43 mmol/mol (6.1%) or lower.
 
Another form of testing glucose levels during pregnancy is the Glucose Challenge Test or the oral Glucose Tolerance Test (OGTT). If a woman did have gestational diabetes, then it is recommended for her to test for diabetes 12 weeks after the baby is born. 
 

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