By Annette R. Karnash, R.N., M.N.
A glycosolated hemoglobin is a protein molecule in red blood cells that has sugar attached to it, analogous to a glazed donut. It provides an index of the average blood sugar of the previous 3-4 months. The hemoglobin molecule carries oxygen through the blood stream and delivers oxygen to all the cells in the body. IF high levels of sugar are present in the bloodstream, the sugar sticks to the hemoglobin for the duration of the RBC’s life (approximately 90 – 120 days) the molecule’s structure or function may change when it contains a large amount of sugar. Glycosolation provides a warning as to how much glucose has been attached to the hemoglobin molecule during the time the RBC’s have been circulating. This A1C test provides as average view of diabetic control. To maintain tight control, it is recommended that this test be done every 3-4 months, although it can be done as frequently as every month or one a year depending upon the doctor. The results can determine whether changes are needed in the management program. The normal AIC level initially was 7% but is now preferred at 6.5%.
The glycosolated hemoglobin reinforces the person who performs glucose monitoring. Blood glucose monitoring gives the glucose level at the time of testing and can demonstrate the body’s reaction to a specific food, event, medication or activity, whereas A1C provides glucose levels over the past several months. Both tests are included in the proper management of diabetes and if the level is maintained below 7%, the risk for the development is greatly reduced. Each 1% change in A1C represents a change of about 35 mg/dl in blood glucose.
Just as the Pap test helped in detecting uterine cancer in women and the cholesterol test helped to identify those with high fat levels at risk for cardio-vascular disease, the A1C will serve the same purpose – to indicate those at risk for developing the complications of diabetes.
