HbA1c: the gold standard of diabetes testing

Diabetes

When people talk about diabetes being an epidemic they are not exaggerating; recent data from Public Health England suggests that last year 3.8 million people in England aged over 16 had diabetes - that's around 9% of the adult population.


Helen Marsden

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When people talk about diabetes being an epidemic they are not exaggerating; recent data from Public Health England suggests that last year 3.8 million people in England aged over 16 had diabetes - that's around 9% of the adult population. This figure is steadily rising as a result of our increasing weight (68.8% of adults are now classed as overweight or obese) and our unhealthy diets. Worryingly, 1 in 4 people with diabetes, around 940,000, don't even know they have it.

Until recently, most diabetes tests just checked for fasting blood sugar. The limitation with this method of testing is that it only measures blood glucose at one point in time despite the fact that blood sugar levels can can change throughout the day and even over time. This means it doesn't provide a good measure of average blood sugar over a particular time period. An HbA1c test, on the other hand, gives a more accurate diabetes diagnosis.

The term HbA1c refers to glycated haemoglobin. It occurs when haemoglobin, a protein in red blood cells that carries oxygen throughout your body, joins with glucose in the blood, becoming 'glycated'. By measuring glycated haemoglobin, we are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months - in effect the lifespan of the red blood cell. If blood sugar levels have been high in recent weeks, HbA1c will also be higher. Not only is this test a better indicator of sugar control, it is also more convenient than a blood glucose test as it does not require a fasting sample.

An HbA1c result of anything under 42 mmol/mol is normal, 42-47  is prediabetic and 48 or over is diabetic. So what do you do if you get an elevated result? Well the good news is that prediabetes can be reversed through weight loss, exercise and a healthy diet which cuts back on sugar and refined carbohydrates. Some people have even been able to reverse diabetes through adopting a very low calorie diet (always under the supervision of a doctor). If you don’t think you have the will-power for that then you will need to control your blood sugar through lifestyle measures and medication aimed at lowering your blood sugar. For you, HbA1c will become a regular test your doctor performs to ensure good blood sugar control for the rest of your life.

What are the risks of uncontrolled blood sugar? Too much glucose in the blood causes damage to blood vessels, nerves and organs causing cardiovascular disease, kidney disease, blindness and even cancer; in fact, most of the diseases of ageing are accelerated through elevated blood sugar. A high HbA1c result can also explain premature wrinkles, as a build up of ‘advanced glycation age products’ (AGEs), the proteins or lipids that become glycated as a result of exposure to sugars, are a factor in ageing – even ageing skin.

If you are worried your lifestyle may be affecting your health, or are experiencing symptoms, an HbA1c blood test is the most effective way to test for diabetes.


See our Diabetes test for further details. Only £39

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