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Glucose, a type of sugar in your blood, typically comes from the food you eat. While your body uses glucose as energy for many critical bodily functions, excess glucose : that is blood sugar gets attached to Haemoglobin. HbA1c tests this value of glucose attached to Hb for an average of 3 months. Haemoglobin is a component of red blood cells (RBCs) that carries oxygen from the lungs to the whole body. In type 2 diabetes the blood glucose gets high because your body does not produce enough insulin (a type of hormone) to move blood sugar from your bloodstream into your cells, or because your cells stop responding to insulin. The lifespan of RBCs is 3 months and hence it makes practical sense to test HbA1c every 3 months.
The haemoglobin A1c test may have several purposes:
To diagnose and monitor diabetes. With type 2 diabetes your blood glucose gets too high because your body doesn't make enough insulin to move blood sugar from your bloodstream into your cells, or because your cells stop responding to insulin.
Prediabetes means that your blood glucose levels are higher than normal, but not high enough to be diagnosed as diabetic. Lifestyle changes, such as healthy eating and exercise, may help delay or prevent a prediabetic from becoming type 2 diabetic.
For people who have diabetes, the test is used to indicate how well diabetes has been controlled over the last few months.
Who else is advised to get tested every 3 to 6 months? Experts suggest those over 45 should monitor their levels. Also, those who are under 45 but are either obese or have a family history/predisposition to diabetes should also keep a check. Those who have been detected prediabetic are also to check HbA1c regularly.
People who have been diagnosed as diabetic should get tested every 3 to 6 months or more frequently if it is not getting under control.
Important to note that HBA1c test is not used to diagnose gestational diabetes, a form of the disease that can develop during pregnancy.
A1c, glycohemoglobin, glycated haemoglobin
If you have diabetes, you should opt for an HBA1c test two to four times a year to see how you are managing it. Your healthcare team will order exactly how often you should get tested.
If you haven’t been diagnosed with diabetes, a healthcare provider may order an HBA1c test if you have any symptoms of the condition. These symptoms include:
Fatigue, or feeling tired all the time.
increased urination (peeing).
You may also get an HBA1c test if you are at risk for diabetes. Risk factors include:
Extra weight or obesity.
family history of diabetes.
lack of activity or exercise.
history of heart disease.
Hypertension (high blood pressure).
Normal: HbA1c below 5.7%,
Prediabetes: HbA1c between 5.7% and 6.4%
Diabetes: HbA1c of 6.5% or higher
A healthcare provider known as a phlebotomist usually performs the blood draw, including those for an HBa1c test, but any healthcare provider trained in drawing blood can perform this task. Your healthcare provider then sends the blood samples to a lab where a medical laboratory scientist prepares the samples and performs the tests on machines known as analysers.
The A1C test is a simple blood test. You don't need to be in fasting for the A1C test, so you can eat and drink normally before the test.
The person drawing your blood will:
Ask you to pull up your sleeves on the upper arm (for example, by rolling up your sleeve).
Tie a band called a tourniquet around your upper arm.
Clean the area on the inner arm with disinfectants, where it bends.
And then insert a thin needle into a vein.
And collect blood into a tube attached to the needle.
Remove the needle from the vein, then put a spot band-aid on the tiny hole.
You usually return to normal activities after a haemoglobin A1c test. If you receive a blood draw, the phlebotomist will put a small spot band-aid over the pricked site to make sure that the bleeding stops. If you want to leave the bandage on for an hour or more. You may have noticed some bruising where the needle was inserted.
Fingersticks do not typically cause lasting pain or discomfort. If needed, you can apply a bandage to your fingertip to stop the bleeding.
These blood tests are very common and don’t carry any significant risks. You may have a slight pain like an ant bite when the needle gets inserted, and a small bruise may develop there.
An A1c test result gets reported as a percentage. The number represents the portion of haemoglobin proteins that are glycated, or hold glucose. The higher the percentage, the higher your blood sugar levels have been over the last few months.
Less than 5.7% means you don’t have diabetes.
5.7% to 6.4% signals pre-diabetes.
6.5% or higher means a diabetes diagnosis.
7% or lower is the goal for someone trying to manage their diabetes.
People with diabetes need to manage their blood sugar levels to prevent them from becoming too high.
Managing blood sugar levels can reduce the risk of complications affecting the small blood vessels, especially those of the eyes and kidneys, and the coronary arteries. This can help to prevent many of the problems that can occur with diabetes, including
Reaching and maintaining an A1C of 7% or lower can significantly reduce these risks.
However, everyone is different. An individual can work with a healthcare professional to determine their blood sugar and A1C targets.
These reports are available via email or WhatsApp within 6 hours of the collection of the blood sample.
If you have anaemia or another type of blood disorder, an HbA1c test may be less accurate for diagnosing diabetes. If you have one of these disorders and are at risk for diabetes, your health care provider may recommend different tests.
A normal HbA1c level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a value of 6.5% or above indicates diabetes.
It does not require fasting. The test may be done at any time as part of an overall blood screening and it is recommended in health packages.
Reference values for HbA1c in age groups are: For individuals aged 20 - 39 years, the upper limit is 6.0%, increasing to 6.1% for individuals aged 40 - 59 years, while for people aged above 60 years, the upper limit is 6.50% - 7.0%.
HbA1c at home testing kit is required. The test requires a drop of blood and allows you to get a good value of your HbA1c level in a few minutes. This kit allows you to get an up-to-date HbA1c reading between the official HbA1c tests from your healthcare team.
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