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Why You Really Hurt
It All Starts in the foot
by Dr. Burton S. Shuler
 The glycated hemoglobin test
(often called the glycosylated
hemoglobin test) or hemoglobin
(A1C) is a measurement of the
overall control of the diabetic for
the previous two to three months.
Most diabetic specialists feel
it is now the single most important
blood test for known diabetics.
The American Diabetes
Association recommends that if
you are a diabetic, this test
be taken every 3 months.
For patients who are not
yet diagnosed with diabetes,
it is becoming more popular
for making the initial
diagnosis of Diabetes.
The fasting blood sugar
(FBS) test, which is still the
mostly commonly performed
test for Diabetes, does not
reflect the true picture of
diabetic control over a
long period of time. The FBS
only measures the level of
sugar in the blood at the
moment it is taken from
your finger or arm. Patients
have been known to "fake"
the results of their FBS by
staying on their diet and
medication (when they
normally won't) for several
days leading up to the FBS,
in order to have a more
normal result, when in fact
their glucose (sugar) levels
were out of control. You
can not fake the results with
a glycated hemoglobin test
because it is based on
90 days, not an instant
like the FBS.
HOW IT WORKSThe glycated hemoglobin test
measures how much glucose is
attached to hemoglobin cells,
the part of the blood that
carries oxygen. As the hemoglobin
floats around in the blood, it
picks up glucose in about the
same proportion as the glucose
that exists in the bloodstream.
If your blood glucose is generally
running high, the hemoglobin will
have more "glucose coating"
(glycosylization). If your glucose
generally runs low, it will
have less. Since the red blood cells
have about a two to three month
life span in the body before
they are recycled, we can measure
the "glucose coating" of a sample
of hemoglobin. This gives you an
approximate average of glucose
control over the last two to
three month period.
What is the goal of the glycated hemoglobin test?Every person, whether or
not he or she has diabetes,
has a certain amount of
glycosylization present.
Because of more sugar in their
blood, people with diabetes
have a greater amount of
glycosylization present.
A low result on the
glycated hemoglobin test
is a good result. If your
test is in the good control
category, you can be satisfied
that your diabetes management
plan is working well. If
results are in the marginal
category, some fine tuning
of your treatment plan may be
needed. A poor result can
be improved. This test gives you
valuable feedback on how well
you are controlling your diabetes.
It can also let you know when
to work on improving your
diabetes management.
It's important for you to
remember that normal values
for the glycated hemoglobin
test may vary from laboratory
to laboratory, because different
laboratories use different
procedures to perform the
measurement. Be sure to
ask for the "normal"
range for that particular lab. But a goal of 7 or less is what you want.
It's best to have the tests
done by the same laboratory
so you can compare the results
from one test to the next to
note the progress you are
making. Your physician will
help you determine your goal
range for glycated hemoglobin.
If you are Type I or Type II
diabetic, you should be having
this test every 90 days; there
is no reason that you should not.
If your physician is not running
the glycated hemoglobin test on
you every 90 days ask
him why.
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© 1982-2010, Dr. Burton S. Schuler, all rights reserved