Many new diabetics don’t understand the relationship between hemoglobin levels and diabetes. They will need to be educated on it by their health care team and on their own. Understanding the meaning of hemoglobin levels and diabetes is a way to tell if your diabetes is being managed properly over a period of time.
Hemoglobin is the pigment that carries oxygen and is also what gives blood its red color. It is also the main protein in the red blood cells. Around 90% of hemoglobin is adult type, or hemoglobin A. One chemical component makes up 92% of hemoglobin A, with the remaining 8% made up of minor components that are slightly different chemically. Of interest to diabetics is hemoglobin A1c (HbA1c), referred to as glucosylated or glucosylated hemoglobin. It is this component of hemoglobin that glucose binds with. Measurements of this A1c hemoglobin levels and diabetes management are an important tool for patients and their doctor to monitor how well glucose levels have been controlled on average over the most recent months.
How is HbA1c Measured?
HbA1c molecules contain an electrical charge that is different than the charges on other hemoglobin components. The HbA1c molecules are also different in size. This allows them to be separated from other hemoglobin A components using a procedure called high pressure liquid chromatography or HPLC. Because the HbA1c molecules aren’t affected by the last meal eaten or other short time-frame fluctuations, blood samples can be taken to teat for these hemoglobin levels and diabetes patients don’t have to worry about when or what they ate prior to testing. So no fasting or other pre-test rituals need to be followed.
What does The HbA1c Levels Tell the Diabetic?
The HbA1c hemoglobin levels and diabetes glucose management (or mismanagement) will show up quickly in the HbA1c level test. The higher the blood’s glucose concentration is, the higher the HbA1c level will be. Since the levels aren’t affected by the normal daily fluctuations in blood glucose levels, they reflect better the average glucose levels over the last six to eight weeks. This gives both the patient and the doctor a better picture of overall glucose management, and can be useful in monitoring the effects of a new diet or exercise regimen, or a new drug therapy, for example.
In a healthy, non-diabetic patient the HbA1c level will be less than 7 percent of the total hemoglobin. Research has shown that many diabetes complications can be prevented, or at least delayed, if the HbA1c level can be maintained around the 7% level. Generally speaking, values need to be kept below 8% to consider attempts at controlling glucose levels successful.
Are There Any Limitations to Monitoring Hemoglobin Levels and Diabetes Management?
It cannot be used to monitor the daily blood glucose levels, because it’s not affected by short-term fluctuations, and cannot be used as a basis to adjust insulin doses. Also, some diseases can cause false readings. Kidney failure, excessive drinking or alcoholism, sickle cell disease and gestational diabetes can all cause false readings of hemoglobin levels and diabetes patients may be given a false sense of security, or alarmed for no reason. This is why other testing is important, and testing for HbA1c can never take the place of the daily testing that must be done.
