Monday 18 February 2013

Hba1c and Diagnosis of Diabetes


HbA1c reflects average plasma glucose over the previous eight to 12 weeks. It can be performed at any time of the day and does not require any special preparation such as fasting. These properties have made it the preferred test for assessing glycaemic control in people with diabetes. More recently, there has been substantial interest in using it as a diagnostic test for diabetes and as a screening test for persons at high risk of diabetes.
An HbA1c of 6.5% is recommended as the cut point for diagnosing diabetes. A value less than 6.5% does not exclude diabetes diagnosed using glucose tests. The expert group concluded that there is currently insufficient evidence to make any formal recommendation on the interpretation of HbA1c levels below 6.5%.
Diabetes is typically featured by high levels of blood glucose. Up to now, diagnosis for diabetes is usually adopted through two measures: first, fasting blood sugar higher than 7 mmol/l; second, oral glucose tolerance test (OGTT) or random blood sugar higher than 11.1mmol/l. Because venous and fingertip blood sugar levels may differ from each other and are easily mixed together, diabetic specailists are presently trying to find new measures to diagnose diabetes.
Blood sugar increase is a gradually developing process, a1c is no expectation. Thereby, 6.5% is adopted as a tangenancy point. Patients with Hba1c higher than this level are at increased risks of developing such diabetic complications as diabetic retinopathy. Patients with hba1c level 6%-6.5% and with family history, old age and obesity belong to high risk group of developing diabetic kidney disease, or diabetic nephropathy.
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