GLYCOSLATED HEMOGLOBIN (HbA1C)

Glycation refers to non- enzymatic addition of sugar residue to a amino group of a protein.  Hemoglobin, plasma proteins, membrane proteins etc. may undergo glycosylation.

HbA1C gives the retrospective index of integrated plasma glucose values over a six to eight week period and is not subjected to wide fluctuations in plasma glucose levels.  HbA1C serves as a reliable indicator of diabetes control during the past 90 days, effectiveness of treatment and risk of development of acute or long term complications.  Hence HbA1C should be performed routinely in all patients with Diabetes, to access the degree of glycaemic control at initial visit and then, as a part of continuing visit every three months to access metabolic control.

CONTROLLED AND UNCONTROLLED DIABETS


NORMAL HBA1C VALUE  

Normal non diabetic range: 4.5 – 5.6%

Serious risk of hypoglycemia: Less than 4.5

Diabetic Range >5.6%

 

  1. TARGETS FOR BLOOD GLUCOSE

 

Most diabetes organizations have published blood glucose targets for people with diabetes. However, targets should be set individually for each person using these as a guide. There may be circumstances where a person would set targets higher (for older person or a very young child) or would set targets lower (for a woman planning a pregnancy).

It is important to know the individual and together set targets that will best meet their needs (see the table below)

Target Blood Glucose Levels.

HbA1c Pre-meal 2 hours post-meal
IDF Global Guideline for type 2 diabetes <6.5% <110mg/dl <145 mg/dl
Target for most people with diabetes <7% 90-130 mg/dl <180 mg/dl