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Before Anything Else – Review of the hemoglobin A1C


This week we need to review a very important concept/piece of information. During our recent visit as part of the Patsy Douglas Foundation’s Diabetes Mission, we found that many people are still grappling with the concept of what a Hemoglobin A1C means. Given how important this number is for people with Diabetes, we definitely need a review and possibly every six months just to make sure we catch the newly diagnosed diabetics as well!{{more}}

Right out the gate, what it means: the hemoglobin A1C gives a measurement of the average level of blood sugar you have had in your system over the past three months. It is often mistaken for the finger stick you get in clinic. They are VERY different!!! When you go to the clinic and the nurse checks your finger (or you check it at home with your own glucose machine), that number you get is telling you what your blood sugar is RIGHT NOW-not yesterday or last week, only right now.

The hemoglobin A1C is most often a blood draw, so you would have to go to the lab to check it. We can do it by finger stick on our mission trip because we bring along special equipment that lets us do that, and some doctors’ offices have a portable hemoglobin A1C machine that can do it by fingerstick. But, right now in St Vincent and the Grenadines, the only way to get a hemoglobin A1C checked is by blood draw. Here is one critically important reason to GO TO THE LAB when your doctor or nurse recommends you do.

Why do you even need to check a hemoglobin A1C (also known as A1C or HbA1C) if we can check a finger stick sugar? For those of you checking your finger sticks at home, you may wonder about this, especially since you can see your numbers several times during the day. The answer lies in the duration of time (3 months) that the hemoglobin A1C measures, and that provides an average of EVERY blood sugar you would have had during that time. So think about it: if over 3 months you checked your blood sugars every minute of every day of every week, every month for three months, then added them up and divided them by the thousands of checks you did, how useful would that information be? It would be incredibly useful in giving us a good idea of what your sugars look like over a long period of time. THAT is what your hemoglobin A1C does. That one little number can fill in gaps, can raise important questions, and can reassure. No one finger stick, or even a series of finger sticks, can do the same thing.

What is a good hemoglobin A1C? Your target number is 7%—think lucky number 7! You should be as close to 7% as possible, without having too many low blood sugars. Why 7%? Research shows us that when people have hemoglobin A1C numbers at or close to 7%, their chances of having problems related to diabetes, such as eye and nerve problems, heart disease, strokes, kidney failure etc., are MUCH LESS, compared to if your hemoglobin A1C is higher. The higher that number, the higher your chances overall of having those problems come up, and no one wants any of those!

So, if you turned up to our clinic days we would have likely checked a hemoglobin A1C on you. If you did not and have not been to the lab in a while, you need to go!!! Recommendations are to have your hemoglobin A1C checked every 3-6 months, so if it has been a while, you need to get moving on that. The information to you and your medical team is invaluable.

Until next week, stay safe and healthy VIncies!

Anita Ramsetty, MD
Director, Roper StFrancis Diabetes Center,
Charleston, SC
[email protected]