Glycated hemoglobin (HbA1c) is the best indicator for monitoring diabetes and the effectiveness of antidiabetic treatments. How is it dosed? What does a high or low rate mean?
Glycated hemoglobin (or HbA1c) allows to’assess blood sugar balance over the past 3 months. This dosage also reflects the risk of long-term complications. We can consider glycated hemoglobin as the glycemic control memory, unlike blood sugar which provides information at a given time. The higher the blood sugar level has been in the last three months, the higher the value of glycated hemoglobin will be. “It is the best marker of glycemic balance ; it is widely used in current medical practice in the monitoring of diabetes”explains Dr. Yves Fouré, general practitioner.
Be careful not to confuse glycated hemoglobin with hemoglobin, the main constituent of red blood cellswhich has the function of transporting oxygen to the cells.
The dosage of glycated hemoglobin is done through a blood test. “We consider that diabetes is balanced if the level of glycated hemoglobin is between 6 and 7%, according to age.” Beyond that, diabetes is considered unbalanced and the risk of long-term complications increases.
An increase in the HbA1c level is linked to a excess blood glucose. This happens when the amount of insulin in the blood is insufficient. We are then in a situation hyperglycemiawith the following potential symptoms: fatigue, heavy urination, intense thirst and hunger, dizziness, etc.
► The increase in the level of glycated hemoglobin may be linked to a diet excessively high in carbohydrateshas a insufficient dosage of drugs anti-diabetics or even a insufficient insulin intake. “stress and infections can also increase blood sugar levels, which will therefore cause an increase in glycated hemoglobin. However, this phenomenon is ephemeral.adds Dr. Fouré.
An abnormally low level of glycated hemoglobin also suggests an imbalance of diabetes. “This may be due to a medication overdose anti-diabetics. It is then necessary to readjust the treatment.” The symptoms are then those of hypoglycemia (palpitations, hot flushes, nausea, etc.).
When the attending physician or diabetologist notices an abnormal rise (or fall) in glycated hemoglobinit is necessary that rehabilitate diabetes treatment (metformin, glitazones, sulfonylureas, glinides, dipeptidylpeptidase-4 inhibitors, GLP-1 analogues). “We are reviewing the doses in order to rebalance the diabetes and avoid the long-term consequences.”
Thanks to Dr Yves Fouré, general practitioner in La Rochelle.
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