Diabetes and
HbA1c or A1c
What is diabetes?
Diabetes simply means the body has problem metabolizing the
sugar or glucose. The pancreas produces a hormone known as insulin that helps
getting the glucose into cells as fuels. People with diabetes either have
malfunctioned pancreatic cells that does not produce sufficient insulin or the
cells are not reacting to insulin properly. This then results in glucose
accumulating in blood or excreted through urine.
Types of diabetes
The diabetes is generally classified into three types, namely
type 1, type 2 and gestational.
Type 1 is also known as juvenile diabetes as often found in
children or young adults. It is generally thought that the beta cells in the
pancreas do not produce insulin in this group of patients. Hence, most will
need supplemental insulin.
Type 2 is the more commonly seen type. There are many risk
factors associated with this condition including genetics, old age, diet,
inactivity, obesity and ethnicity. Careful monitoring is essential for prevention
of diabetes complications.
Gestational diabetes as the name suggests, usually occurs in
late pregnancy. It pays to know that many who had this may develop type 2 later
on in life.
What is HbA1c?
One commonly used term in diabetes management is HbA1c or the
correct medical term, glycosylated (glycated) hemoglobin. Some even call it A1C
for simplicity sake. It is a measurement of average control of blood sugar
level for the past 2 to 3 months.
The hemoglobin (a type of red blood cell) transform into glycosylated
state when exposed to glucose in blood. And the glycosylated hemoglobin remains
so until its life span of 120days. Therefore, by measuring the amount of
glycosylated hemoglobin in blood will give a picture of how well diabetes has
been managed for the past 3 months.
What is normal HbA1c value?
There maybe some slight variants between institutions’
recommendations. But generally, it is recommended to be below either 7.0% or
6.5%. Sometimes the target for individual patient may differ due to other risk
factors.
How often to do the test?
The American Diabetes Association has recommendation
for at least 2 times a year. Due to the nature of the test, which is measuring
hemoglobin, it is not a surrogate for daily blood sugar level that is needed to
adjust insulin doses. Therefore, it is crucial that people with diabetes check
daily blood sugar level with a glucometer.
Every 3 monthly HbA1c may be needed for some patients.
Does Diabetes Diet help?
There are many information out there that advocates tight sugar
control with diet can help with diabetes. That is a fact. However, there is
still ongoing debate on how to achieve that, either by starting low sugar diet
or low glycemic index diet.
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