![]() Ī falsely low HbA1c value can result from several conditions including high altitude, pregnancy, hemorrhage, blood transfusion, erythropoietin administration, iron supplementation, hemolytic anemia, chronic kidney failure, liver cirrhosis, alcoholism, sickle cell anemia, and spherocytosis. HbA1c measurement in these patients must be interpreted with caution and should be confirmed with plasma glucose samples to diagnose diabetes. People diagnosed with sickle cell anemia, thalassemia, anemia, kidney failure, liver disease, or patients receiving blood transfusions can experience altered results due to the longevity of the red blood cell. There are several conditions where the HbA1c test can produce inaccurate results. In addition to the determination of A1c levels predicting progression of microvascular complications, the extension of DCCT into EDIC study showed benefit in the cardiovascular risk and mortality in the longterm for those patients with lower levels of HbA1c. Tighter control shown by levels of HbA1c in the 7% range or lower, were correlated with 35-76% decrease in microvascular complications, like retinopathy, nephropathy and neuropathy, in patients with type 1 diabetes. The DCCT trial reported that a higher mean A1c level was the dominant predictor of diabetic retinopathy progression. ![]() From the completion of the trial, the National Glycohemoglobin Standardization Program (NGSP) was formed to define a standardized assay that was usable across laboratories. The Diabetes Control and Complications Trial (DCCT) was a landmark trial that provided a wealth of data on A1c and its correlation to blood glucose levels, as well as establishing specific treat to target A1c goals. The amount of glucose that is present in the blood will attach to the hemoglobin protein, and increased glucose levels will reflect on the surface of the hemoglobin protein, thereby rendering a higher A1c level. Hemoglobin becomes glycated or coated with glucose from the bloodstream. The main job of hemoglobin is to carry oxygen from the lungs to all the cells of the body. Since red blood cells live about an average of three months, the A1c test will reflect those red blood cells that are present in the bloodstream at the time of the test this is why the A1c serves as an average of blood sugar control. In fact, hemoglobin is what gives blood its bright red coloring. Hemoglobin is a protein only found in red blood cells. The test can also be used to diagnose diabetes. The test shows an average of the blood sugar level over the past 90 days and represents a percentage. ![]() The hemoglobin A1c (glycated hemoglobin, glycosylated hemoglobin, HbA1c, or A1c) test is used to evaluate a person's level of glucose control.
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