HbA1c is probably one of the most important blood tests that is central to overall health.
Most people have never heard of it, and unless you are diabetic, it is very unlikely your
doctor will request it.
So, what is HbA1c and why is it important?
HbA1c is a term commonly used in relation to diabetes.
In addition to being useful in the diagnosis of diabetes and useful in monitoring the response
of treatment in diabetic patients, HbA1c is also a helpful blood test for those without
diabetes as it can give important information about one’s health generally, particularly
one’s risk of heart disease, cancer and Alzheimer’s disease.
So, let’s start with an explanation of what HbA1c is.
The term HbA1c refers to glycated haemoglobin.
Red blood cells contain haemoglobin that carries oxygen around the body.
At any one time, a small proportion of the glucose in our blood permanently binds to
the haemoglobin and the haemoglobin that permanently carries a glucose molecule is said to be glycated.
The level or percentage of glycated haemoglobin is proportional the level or concentration
of glucose in the blood.
So, the higher the blood glucose level, the higher the level of glycated haemoglobin.
Red blood cells are continually renewed and recycled.
Because red blood cells last about 10-12 weeks, the level of glycated haemoglobin (HbA1c)
in a blood sample is a measure of blood glucose levels during the 10-12 weeks before the blood
test.
This is often referred to as the estimated average glucose (eAG).
HbA1c can identify people with prediabetes and diabetes.
So, an HbA1c below 42mmol/mol (or 6.0%) is regarded as normal.
People with prediabetes have a level of between 42 and 47 mmol/mol (6.0 to 6.4%) and people
with diabetes have an HbA1c over 48 or 6.5%
For people with diabetes this is important as the higher the HbA1c, the greater the risk
of developing diabetes-related complications such as blindness and cataracts, kidney failure,
heart disease, nerve problems and amputations.
So, diabetics should have regular HbA1c blood tests.
For people without diabetes, even with an HbA1c below 48 or 6.5%, a higher level of
HbA1c is associated with a higher risk of coronary artery disease (that is heart attack),
stroke, many forms of cancer and dementia including Alzheimer’s disease.
So, knowing our HbA1c is very important.
Now here is the good news.
There are simple and effective ways to lower our HbA1c that does not involve drugs or major
life style changes.
We don’t have to go on special liquid diets and we don’t have to go to the gym 5 times
a week.
By eating less processed and refined food and by eating healthier nutritious real food,
together with a moderate increase in activity such as walking, we can reduce our HbA1c.
Many people with diabetes and prediabetes can achieve a normal HbA1c in this way and
similarly those who do not have diabetes can lower their HbA1c and in so doing they reduce
their risk of heart attack, stroke, cancer and Alzheimer’s disease.