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The problem of using HbA1C as the only indicator of diabetes control



Hemoglobin A1c is a widely accepted tool for monitoring glycemic control. It is clinically comfortable and not sensitive to acute variability in glucose fluctuations. The DCCT study of the 1970s showed its importance in predicting diabetic outcomes and the risk of complications in people with diabetes. Clearly, HbA1c can be a very good control indicator. I do not think anyone can discuss this. The problem is when it is used as the sole indicator of control. How many of your clinicians rely solely on your HbA1c?

HbA1c is not the "big picture". Put simply, HbA1c is an indicator of how much glucose has been associated with hemoglobin or red blood cells in life (three months). He can not tell us anything about glucose fluctuations, quality of life or time in the range (I think the new gold standard).

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can also be significant. "HbA1c may be falsely elevated at any time when there is a condition that prolongs the life of red blood cells." Some examples include iron deficiency anemia, B12 anemia, follicular deficiency anemia and asplenia (lack of (high triglycerides> 1,750 mg / dL) and significant hyperbilirubinaemia (high bilirubin> 20 mg / dL) may increase HbA1c (high triglycerides> 1,750 mg / dL) and the ingestion of some drugs as excessive alcohol, alcohol, opiate and salicylates can also be significant.HBA1c may occur under conditions that shorten the life of red blood cells, such as during pregnancy or spleenomegaly (spleen enlargement) Chronic blood loss, vitamin E uptake and ingestion of vitamin C may also cause the same

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I want to encourage you to ask questions. And you and your diabetes & nbsp; are more than just A1c. Please make sure you treat this way! "Therefore, it is important to look at the overall picture in the assessment of diabetes and in particular why the time in the range (time spent between 70-180 mg / dl) has become a good assessment tool of diabetes in combination with HbA1c I know these things are complicated … but I suppose if there is one thing you leave this post I want to encourage you to ask questions You and your diabetes are more than one A1c

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