HbA1c – What is it and why it is so important in the management of Diabetes

Diabetes is one of the most diagnosed chronic conditions in the world, and Australia is no different. Here are some facts about Diabetes in Australia (Sourced from Diabetes Australia):

• More than 300 Australians develop diabetes every day. That’s one person every five minutes
• Almost 1.9 million Australians have diabetes. This includes all types of diagnosed diabetes (almost 1.5 million known and registered) as well as silent, undiagnosed type 2 diabetes (up to 500,000 estimated)
• Almost 120,000 Australians have developed diabetes in the past year
• For every person diagnosed with diabetes there is usually a family member or carer who also ‘lives with diabetes’ every day in a support role. This means that an estimated 2.4 million Australians are affected by diabetes every day
• Total annual cost impact of diabetes in Australia estimated at $17.6 billion (inflation adjusted)
• Diabetes is the seventh most common cause of death by disease in Australia
• Aboriginal and Torres Strait Islander Australians are three times more likely to develop type 2 diabetes than non-Indigenous Australians, 4.3 times more likely to be hospitalised with type 2 diabetes, and four times as likely to die from it
• Around 1.2 million people are hospitalised with diabetes-related conditions every year

A crucial part of managing an individual’s Diabetes is the HbA1c, which is known as glycated haemoglobin or haemoglobin A1c. After working as a Podiatrist in Sydney for almost 4 years now, I have found that many patients with Diabetes have little to no idea what HbA1c is and what their most recent reading is. Keep reading to find out what you need to know about HbA1c and why it is so important.

What is HbA1c?

This is a vital blood test that is used to measure an individual’s blood sugar levels (BGLs) over the course of a 2-3 month period. As managing diabetes centres around controlling the individual’s blood glucose control, this test provides valuable information on whether changes need to be made to someone’s diet, medication and other aspects of management of their Diabetes.

How does the HbA1c test work?

Haemoglobin is a protein that is present in red blood cells. When glucose in the bloodstream attaches itself to haemoglobin, it forms HbA1c. The more glucose in the blood, the higher the HbA1c. The average life span of a red blood cell is 120 days. Therefore, the HbA1c test reflects the overall blood sugar levels in an individual during the last 2-3 months.

HbA1c is usually expressed as a percentage of the total haemoglobin in the body. For those without Diabetes, between 4.5 – 6% is considered normal. For individuals with Diabetes, the general goal is to keep this figure below 7%. Having said that, this depends on individual circumstances as each individual’s Diabetes management is individualised. Specifically in Podiatry, keeping the HbA1c below 7% is known to reduce the risk of Diabetes related complications in the foot and lower leg.

Why it the HbA1c test so important?

Regular blood tests only give a snapshot of current glucose levels and they can be altered whether someone has been fasting or not, or depending on what they have consumed prior to getting tested.

Health practitioners used the results of the HbA1c test to assess the effectiveness of the Diabetes treatment plans. If the HbA1c is elevated for prolonged periods of time, this indicates the treatment plans may need adjusting to control the blood glucose levels more effectively. The sooner the blood glucose levels can be controlled, the less likely individuals are at risk of developing Diabetes related conditions such as kidney disease, nerve damage, eye disease and damage to the blood vessels in the lower legs and feet.

As reliable as the HbA1c test is, there are certain circumstances where it may not be accurate. For example, in anaemia or blood disorders, the lifespan of red blood cells is altered. In addition to this, health practitioners do not solely rely on the HbA1c in diagnosis and management of Diabetes. Tests like the fasting glucose and oral glucose tolerance tests are also used in diagnosis and management of Diabetes.

If you have concerns or questions

At Sole-Lution Podiatry we treat individuals with Diabetes on a regular basis and are more than happy to talk to you about any questions or concerns you might have regarding Diabetes and the HbA1c test. Have a great day and see you soon!