Loading ...Diabetes is diagnosed through various lab tests, the chief one remaining a Fasting Blood Sugar. Fasting Blood Glucose is a simple blood test, after not having anything by mouth for 12 hours prior to test (that includes coffee, but does not include water). Usually, if you have a fasting blood sugar over 126, you may have diabetes. Many things can affect your blood sugar, besides diabetes, so a doctor should always be involved in this determination. For instance, chronic infections and medications may both elevate your blood sugar.
Hemoglobin A1c look at the control of your blood sugar over a period of time, or approximately 3-4 months. Results based on the American Endocrinology Association guidelines are listed before. The American Diabetic Association uses HbA1c’s, but has a slightly different interpretation. As one can see, depending on which association or guidelines you use, may determine how the results are interpreted. This can be problematic when not seeing the same physician over time.
Hemoglobin A1c
- Normal: Less than 6.5
- Excellent: 6.5-7.5
- Good: 7.5-8.5
- Fair: 8.5-9.5
- Poor: Greater than 9.5
Interpreting results of the HbA1c can be tricky, as already stated. However, even other obstacles stand in the way of standardization of results and interpretation of ranges. Utilizing different lab regents may give you different ranges of normal. Additionally, given two individuals, both with an HbA1c of the same level, does not equate with the blood glucose level which actually exists. Therefore, variations between individuals exist; although variations between HbA1c for just one person, are very important. Finally, HbA1c’s are tied in with the life cycle of one’s red blood cells. Certain diseases, such as B12 deficiency, may make the life cycle either longer or shorter, which means HbA1c results can either be excessively high or low, but not meaningful for diabetic diagnosis. This is why; HbA1c’s have not traditionally been used for diagnosis.
However, we live in the real world, and when a patient presents who has signs and symptoms of diabetes, many doctors may suspect that a patient may not return the next day for a Fasting Blood Glucose. Therefore, their only option is an HbA1c. As this practice is prevalent, researchers have recently looked at how best to standardize the results of HbA1c tests. After looking at thousands of participants, they finally derived the following scale:
Patients with values less than 5.8% are unlikely to have diabetes and those with 5.8% or above need to have further testing. As the HbA1c does not have to be a fasting test, results are immediately available to the physician. One can only hope that the patient will be more motivated to return the following day, if they know this is based on a lab value which is abnormal.
