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Hemoglobin A1C Blood Test Varies More Than Expected (July 20, 2012)

Most people with diabetes are told relatively early on that they must control their Hemoglobin A1C levels. Hemoglobin A1C is the measure of blood glucose that doctors use to determine how well diabetes treatment is working over a long period. If numbers remain high, the treatment is traditionally considered to be inadequate. This old truism may be changing, however. While very high Hemoglobin A1C levels are still dangerous, the American Diabetes Association is changing its diabetes testing guidelines for some patients.

Guidelines for Hemoglobin A1C

The old guidelines from the American Diabetes Association (ADA) said that all patients suffering from diabetes should work to keep blood A1C at 7 or below. The new guidelines offer a wider range of interpretations and tell patients to work closely with their doctors to determine the correct target for each individual situation. Younger people with a relatively recent diabetes diagnosis may need to keep their Hemoglobin A1C levels as low as 6. Many patients will use the old target of 7, but some cases may require more leniency. For instance, older diabetes sufferers who have another serious condition, such as heart disease, may be able to allow Hemoglobin A1C levels to rise as high as 8. Both the ADA and the European Association for the Study of Diabetes agreed on this new position, jointly published in Diabetes Care. According to the president of the ADA, it’s unreasonable to expect that all patients should use the same target numbers or medications. The ADA feels that a patient’s target level should be adjusted according to that person’s other health factors. While the ADA may be changing its recommendations, many doctors have been tailoring treatment goals to the patient for years. They often feel pressure to use a specific target, however. The changes in the ADA’s recommendations allow both patients and doctors to reduce the feeling of outside pressure and focus on getting the right option for the individual situation. The old idea that a single number made it easier for both diabetes sufferers and medical professionals is now being discarded in favor of a friendlier system that adapts to the patient.

Diabetes Management

Despite apparently coherent guidelines, medical professionals have been arguing about the best way to handle diabetes treatment for many years. Some researchers believe that the best treatment guidelines are those based on scientific formulas. The argument for this method holds that consistent treatment for all patients provides the best standard of care. Other medical professionals note that this technique results in a mechanical approach to medicine that doesn’t allow for individual variation. At the moment, doctors use a wide range of options to treat chronic high blood sugar and insulin resistance. There are many different drugs available, each with its own data set and effectiveness level. Doctors also encourage patients to modify their diets and increase activity levels, which can decrease or eliminate the need for medications. These many different approaches mean that it’s hard to have a single effective treatment regimen.

Hemoglobin A1C Blood Testing

It’s important for patients not to confuse the Hemoglobin A1C test with the at home testing using a glucose monitor. Most home tests are immediate blood glucose tests and provide different data. The Hemoglobin A1C test is usually done in a lab, with home tests available only through specialty suppliers or through a medical professional. Glucose monitors provide a picture of a person’s blood sugar levels at that moment, while the Hemoglobin A1C test offers data over a longer period. Both tests are important in diagnosing and treating diabetes.
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