The HbA1c test , also known as Glycated Haemoglobin or Glycosylated Haemoglobin is a blood test that assesses an individual’s blood sugar or glucose control. Measurement of blood glucose levels is an integral aspect of diabetes management. In addition to the blood glucose test, the HbA1c test is also included in the long-term monitoring of diabetes health. The test helps measure the average blood sugar level over the past 90 days.

Routine assessment of blood sugar at home or through a laboratory test is a temporary instance. Since the blood sugar levels are subjected to constant fluctuations, it is essential to know the average blood glucose levels being maintained by your body in the blood. The HbA1c test measures the average blood sugar levels by determining the amount of glucose that is coated on haemoglobin in the red blood cells (RBCs).

The HbA1c test is a valuable aspect of the diabetes management toolkit of an individual. HbA1c levels are elevated in individuals with high blood glucose in diabetes. High HbA1c levels are also a sign of kidney disease, heart disease and nerve damage. So if you are someone with diabetes willing to assess your blood sugar control, it is recommended to get an HbA1c test.

• Prerequisites

The HbA1c blood test does not require any special preparations. The test does not require any fasting.

• Best time to get tested.

The test can be taken at any time during the day. During the test, a professional will take a blood sample from the vein in your arm by inserting a needle. The collected blood sample will be sent to the laboratory for testing. According to the American Diabetes Association, the HbA1c test can be conducted twice a year for patients with well-controlled diabetes and every 3 months in patients with poorly controlled diabetes.

• Eligibility for HbA1c test

All individuals who wish to track their diabetes control are eligible to take the HbA1c test. Individuals who manifest symptoms of diabetes are eligible for getting an HbA1c test.

• Cautions before taking the HbA1c test

It is important to note that individuals with conditions like anaemia, sickle cell anaemia, thalassemia, kidney failure, or liver disease, as well as those receiving blood transfusions, may experience altered HbA1c results. Additionally, if you have different types (variants) of haemoglobin, it can affect your HbA1c results. In that case, you may need advanced testing. The HbA1c test alone cannot be performed for diagnosis of type 1 diabetes or gestational diabetes. Other tests are required to get a complete picture of your condition.

The HbA1c test is crucial for both managing diabetes and diagnosing the condition. The following are the reasons for which the HbA1c test can be ordered:

• For individuals aged 45 and above, routine testing helps monitor blood sugar levels, with a frequency of every 3 years if results are within normal range.

• For those without a diabetes diagnosis, an A1C test may be ordered if symptoms suggestive of diabetes are present, such as intense thirst, increased urination, blurry vision, or persistent fatigue.

• If diagnosed with prediabetes, testing is done every 1 to 2 years to assess progression. Those diagnosed with diabetes should undergo HbA1c testing at least twice a year to evaluate the effectiveness of their treatment plan.

• Additionally, individuals at risk for type 2 diabetes may undergo screening with an HbA1C test, particularly if they have a family history of the condition, a personal history of gestational diabetes, obesity, a sedentary lifestyle, or are over the age of 35.

• Taking an HbA1c test at home to assess blood sugar control helps prevent the risk of developing diabetes complications such as diabetic kidney disease, diabetic retinopathy (eye damage due to diabetes), and neuropathy (nerve damage due to diabetes).

Therefore, the HbA1c test helps identify individuals who may benefit from early intervention and lifestyle modifications to prevent diabetes and its complications effectively.

The findings of the HbA1c test help determine the percentage of haemoglobin being coated with glucose. However, these percentage ranges tend to fluctuate based on individual factors such as age and health status. For diagnosing diabetes or prediabetes, commonly utilized percentage thresholds are:

Additionally, here are the therapeutic glycaemic targets:

Please note that individualized targets may be determined based on various factors as mentioned in the provided notes.

It is noteworthy that the findings of the HbA1c test should not be correlated or compared with fasting, random, or postprandial blood sugar levels as they measure blood glucose levels only at the time of testing. In contrast, the HbA1c test reflects the average blood glucose concentration over the past 12 weeks.