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Focus on Health

Another View: Diabetes and Hemoglobin A1c

By: Michael K. Laidlaw, MD
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When dealing with diabetes, the terminology can seem overwhelming. Many have heard of the term hemoglobin A1c (abbreviated HBA1c), but what exactly does it mean? Where does it come from?

You may have heard of the term "hemoglobin.” This is a chemical found within red blood cells. Its function is to carry oxygen to all of the other cells of the body, such as muscle and brain. Some clever scientists found that not only oxygen, but also glucose, sticks onto hemoglobin. Recall that diabetes is a state of high blood glucose levels. In diabetes, even more glucose will stick onto the hemoglobin. Because the red blood cell lives within the bloodstream for about three months, the HBA1c gives us an idea of how high the blood glucose has been over a three-month period.

This information is very useful for monitoring blood glucose levels and preventing complications of diabetes. A normal HBA1c is presently considered to be between 4-5.6 percent. A HBA1c of 6.5 percent or higher diagnoses diabetes. 5.7-6.4 percent is generally termed pre-diabetes. Most diabetics will have this level monitored every three to six months. The American Diabetes Association recommends that in general diabetic patients should keep their HBA1c below 7 percent  to prevent complications of diabetes. Some patients who are elderly, prone to low glucose reactions or have other chronic diseases may need to keep their HBA1c higher than this, depending on the situation.

In short, the HBA1c is a very useful tool for monitoring diabetes. Proper diet, exercise and often medications in conjunction with physician monitoring are the keys to controlling diabetes in order to live a healthier, happy life.

Michael K. Laidlaw, MD, is a Rocklin physician specializing in endocrinology, diabetes and metabolism.