Why should diabetics test glycosylated hemoglobin?

Glycated hemoglobin (HbA1c) is an important indicator in blood testing and is crucial to understanding and managing diabetes.

1. What is Glycated Hemoglobin (HbA1c)

Glycated hemoglobin (HbA1c) is an indicator commonly used in medical examinations to reflect the average blood sugar level in the human body over the past two to three months. To understand the concept of glycated hemoglobin, you first need to understand the basic functions and interactions of hemoglobin and glucose in the human body. Hemoglobin is a protein present in red blood cells, which is mainly responsible for carrying oxygen from the lungs to various tissues and organs throughout the body. Glucose, as the main energy source of the human body, is transported to the whole body through blood circulation for use by cells. In this process, a portion of glucose will irreversibly bind to hemoglobin molecules to form glycated hemoglobin.

The level of glycated hemoglobin is affected by blood glucose concentration and the life span of red blood cells. Since the average life span of red blood cells is about 120 days, glycated hemoglobin can reflect the average blood glucose level over the past three months. This feature makes HbA1c an important indicator for monitoring the blood glucose control status of diabetic patients. Compared with daily blood glucose monitoring, glycated hemoglobin testing is not affected by immediate blood glucose fluctuations, providing people with a more stable and long-term blood glucose level assessment.

The results of HbA1c are expressed as a percentage. In non-diabetic people, normal HbA1c levels are usually below 5.7%. When HbA1c levels are between 5.7% and 6.4%, it is considered a risk state of high blood sugar levels, i.e. prediabetes. HbA1c levels of 6.5% or above can be used as one of the diagnostic criteria for diabetes.

Maintaining HbA1c within a reasonable target range is critical for people with diabetes. Your doctor will set a personalized HbA1c target based on your patient's specific circumstances, such as age, risk of diabetes complications, and your personal preferences.

2. The relationship between glycosylated hemoglobin and diabetes

The relationship between glycated hemoglobin (HbA1c) and diabetes is close and complex, involving multiple levels such as physiology, pathology and clinical treatment. Diabetes is a group of metabolic diseases characterized by hyperglycemia (abnormally high blood sugar levels), mainly including type 1 diabetes, type 2 diabetes and gestational diabetes. In these conditions, due to insufficient insulin secretion or weakened response of the body to insulin, glucose cannot effectively enter cells from the blood and be used, which leads to a continuous increase in blood sugar levels. Long-term high blood sugar can lead to various complications and damage to multiple organs such as the heart, eyes, and kidneys. As an indicator reflecting the average blood sugar level in the past two to three months, glycated hemoglobin plays an important role in the diagnosis and management of diabetes.

The level of glycosylated hemoglobin can be used as a criterion for the diagnosis of diabetes. According to the guidelines of the International Diabetes Federation (IDF) and other health organizations, an individual can be diagnosed with diabetes when his or her HbA1c level reaches 6.5% or above. This standard is based on a large number of studies showing that HbA1c levels are positively correlated with the risk of developing diabetes-related complications in the future. Compared with traditional fasting blood sugar and oral glucose tolerance tests, HbA1c testing has the advantages of being non-invasive, easy to operate, and having stable results, and is particularly suitable for long-term monitoring and large-scale screening.

The level of glycosylated hemoglobin is directly related to the quality of blood sugar control in diabetic patients. Good blood sugar control can significantly reduce the risk of diabetes-related microvascular complications and macrovascular complications. Therefore, HbA1c has become an important indicator for monitoring and adjusting diabetes treatment plans. Usually, doctors will set individualized HbA1c target values ​​based on the patient's specific situation to guide the formulation and adjustment of treatment plans.

How to use glycosylated hemoglobin to manage diabetes

The use of glycated hemoglobin (HbA1c) to manage diabetes is a core component of modern diabetes care, based on a deep understanding of glycated hemoglobin as an indicator of long-term blood sugar control. The HbA1c measurement reflects the average blood sugar level over the past two to three months, providing doctors and patients with a stable and accurate tool for assessing blood sugar control.

Once diagnosed with diabetes, regular monitoring of HbA1c becomes key to tracking treatment effectiveness and adjusting treatment plans. Doctors will set personalized HbA1c goals based on the patient's specific circumstances, including age, risk of complications, duration of disease, and personal treatment goals. For most people with diabetes, maintaining HbA1c below 7% is a generally accepted goal to reduce the risk of diabetes-related complications.

HbA1c monitoring results can help doctors evaluate patients' blood sugar control and adjust treatment strategies accordingly. If the HbA1c level is higher than the target range, it indicates that the treatment plan needs to be adjusted, which may include changing lifestyle, adjusting the type or dose of oral hypoglycemic drugs, or introducing or increasing insulin therapy. On the contrary, if HbA1c is lower than the target level, it may be necessary to reduce the dose of the drug or adjust the treatment plan to avoid the risk of hypoglycemia.

Author: Qiu Wenxi, Department of Laboratory, Yulin First People's Hospital