Summary

HbA1c is a type of hemoglobin protein found in red blood cells, responsible for transporting oxygen throughout the bloodstream. In laboratory practice, it is used to detect and monitor prediabetes and diabetes.

‍

Overview

HbA1c, also known as glycated hemoglobin, is a crucial biomarker that comes into play when glucose, or sugar, in your blood, combines with hemoglobin. This attachment forms HbA1c. Interestingly, the amount of HbA1c in your blood is directly proportional to your blood sugar levels – the higher they are, the more HbA1c you'll find in your bloodstream.

What makes HbA1c particularly significant is its ability to reflect your average blood sugar levels over an extended period, typically the past two to three months. This characteristic makes it a valuable tool for the diagnosis and monitoring of diabetes, a condition characterized by the body's inability to either properly utilize or produce insulin - the hormone essential for transporting glucose into your cells.^[1,2]

‍

What should you know about this biomarker?

Tracking your HbA1c over time can help you and your doctor assess how well you are managing your diabetes and determine whether you need to adjust your treatment plan. 

HbA1c can be expressed as the percentage of red blood cells that have glucose-coated hemoglobin. The normal range of HbA1c for most people without diabetes is 20 - 42 mmol/mol. If your HbA1c is between 42 - 47.5 mmol/mol, you may have prediabetes, which means you have a higher risk of developing diabetes in the future. If your HbA1c is 47.5 mmol/mol or higher, you may have diabetes.^[3]

There are more possible states of your blood test result:

• If your HbA1C level is lower, it isn't typically a problem unless you're experiencing symptoms such as fatigue or dizziness. Consult your healthcare provider if you have concerns.
• If your HbA1c result is within the optimal range it shows that the blood sugar control is working properly. 

• If your HbA1c result is higher than the reference range, it indicates higher blood sugar levels. High levels may indicate prediabetes or diabetes, so it is important to consult your healthcare provider. Furthermore, for people diagnosed with diabetes, higher levels of HbA1c indicate a greater risk of developing complications. 

‍

Genetics

Genetics can also influence HbA1c levels. Studies have managed to point out multiple genetic loci that are associated with HbA1c, and this includes not only genes that are intimately tied to glucose metabolism but also those that pertain to the hemoglobin molecule itself.

A Genome-Wide Association Study (GWAS) discovered that a specific variant in the G6PD gene is associated with reduced HbA1c levels, particularly among African Americans. This is an important discovery, as it implies that the diagnosis of Type 2 Diabetes (T2D) in this population could potentially be less effective due to the naturally lower levels of HbA1c resulting from this genetic variation.^[4]

‍

Recommendations

If your HbA1c is outside the normal range, consider making some changes to your lifestyle.^[5] 

• Maintain a healthy diet that is low in added sugar, refined carbohydrates, and saturated fat, and high in fiber, lean protein, and healthy fats. Choose foods that have a low glycemic index, indicating they do not raise your blood sugar level too quickly or too much.
• Increase your physical activity to at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. Exercise can help lower your blood sugar level, improve insulin sensitivity, and reduce risk of cardiovascular disease.
• Take medication if prescribed by your doctor. Follow your doctor's instructions on how and when to take your medication, and check your blood sugar level regularly.
• Manage your stress levels, as stress can affect your well-being. Try to find healthy ways to cope with stress, such as meditation, yoga, breathing exercises, or talking to someone you trust.
• Quit smoking if you are a smoker, as smoking can worsen your blood sugar control and increase the risk of heart disease, stroke, and other problems.

‍

The information and tests provided on our website are for educational purposes only and are not a substitute for professional medical advice. Always consult with your healthcare provider before making health decisions. Our tests do not diagnose or treat diseases. Individual results may vary and should be discussed with a healthcare provider.