![]() However, with rapid cell turnover, there are a larger number of young red cells that are not bound to glucose, resulting in a falsely low A1C value. Vitamin B12 or folate deficient anemia can cause low red cell turnover. If red blood cell turnover is low, there may be a disproportionate number of older red cells, causing a falsely high A1C value. For patients with diabetes, the typical goal is to maintain the A1C level below 7%, as levels consistently higher than 8% may lead to long term complications.Ĭonditions that affect A1C values (Selvin, 2020)Īny condition that impacts the life cycle of the red blood cell will affect A1C results. A level greater than 6.5% is considered diabetes. An A1C level between 5.7% and 6.4% is considered prediabetes, indicating the patient is at a high risk of developing diabetes in the future. ![]() For people without diabetes, the normal range for A1C level is between 4% and 5%. It is a reliable, rapid test that does not require the patient to fast and can help differentiate a stress-induced hyperglycemia from a chronic or sustained hyperglycemia found in diabetes (Dugger & Clark, 2011). Red blood cells live for approximately three months so A1C can reflect the average plasma glucose over the previous 90 days. When we eat, glucose enters the bloodstream and as it builds up, it binds to hemoglobin in the red blood cells creating glycated (or glycosylated) hemoglobin. The American Association of Clinical Endocrinologists and the American College of Endocrinology recommend that the A1C should be used in conjunction with other criteria such as fasting plasma glucose (FPG) and/or oral glucose tolerance tests (OGTTs) when diagnosing diabetes (Hill & Appel, 2010). While the test has been around for decades, it was finally recognized in 2010 by the ADA as a tool to diagnose diabetes and prediabetes (Dugger & Clark, 2011) and has become the most routinely used test to monitor chronic glycemic control (Selvin, 2020). Glycated hemoglobin (A1C, hemoglobin A1C, HbA1c) is a clinical blood test that estimates mean blood glucose over a two-to-three-month timeframe. It is a snapshot of a patient’s glucose level at a specific point in time. In this blog, we will focus on hemoglobin A1C, what it is, and why it’s important.įingerstick blood glucose and continuous glucose monitoring are common methods that provide instant results allowing clinicians and patients with diabetes to make decisions on glucose management and insulin dose selection before meals and throughout the day (Selvin, 2020). Nurses must possess a clear understanding of the variety of ways that blood glucose can be measured as we play an integral role in educating our patients about their diabetes and how to monitor it. For patients with diabetes, controlling glucose levels is critical in preventing long term complications. ![]()
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