How A1C Test Helps Detect, Manage Diabetes

Diabetes Alert Day falls on March 27 this year. The annual observance by the American Diabetes Association (ADA) sounds a warning alarm on the prevalence of type 2 diabetes. Many Americans are unaware they are at risk for this serious and potentially lifelong disease.

On the fourth Tuesday of every March, the ADA encourages everyone to take less than five minutes and answer seven questions. At the end, you are given a number from 1 to 10 to determine your risk level for diabetes, 10 being the highest

Since diabetes often has no symptoms in the early stages, it is important to talk to your healthcare provider about your risks and getting tested for the disease.

Facts About the A1C Test
The A1C test is a common blood test used to diagnose prediabetes and diabetes. If prediabetes is detected, you can partner with your healthcare provider to take steps to prevent or delay the onset of type 2 diabetes, says Juliet Vento, M.D., a primary care physician with Baptist Health Primary Care. If diabetes is diagnosed, treatment to prevent complications must begin promptly.

The A1C test reflects your average blood glucose (also known as blood sugar) levels over a period of three months. Specifically, the test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar. A higher percentage indicates higher blood glucose levels and a higher risk of diabetes complications.

A normal A1C level is below 5.7 percent. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. An A1C level of 6.5 percent or above on two separate occasions confirms the diagnosis of diabetes.

Determining Your A1C Goal
If you are diagnosed with prediabetes or diabetes, the A1C test also is used to gauge how well you are managing your condition. Your doctor typically will check your A1C every three months and tailor the treatment accordingly, Dr. Vento says.

For most people diagnosed with type 2 diabetes, an A1C level of 7 percent or less is a common treatment target, say most experts. However, the American College of Physicians recently announced guidelines calling for less stringent blood sugar targets of up to 8 percent.

“A diabetes treatment plan should be customized,” Dr. Vento said. “A higher target, even above 7 percent, may be appropriate for some people, such as the elderly. Their target level may be less aggressive in order to avoid hypoglycemic episodes (a condition where the blood sugar decreases to dangerously low levels) and cause falls, syncope and stroke-like symptoms.”

When determining your A1C goal, your doctor will consider your age, general health, risk of hypoglycemia along with other conditions and your ability to implement healthy lifestyle changes. If your A1C level is above your target, your doctor may recommend a change in your treatment plan to decrease your risk of other health problems.

Preventing Diabetes Complications
People with chronically high glucose levels, or uncontrolled diabetes, are at risk for macrovascular complications, including heart disease and stroke, and microvascular complications, which include diabetic retinopathy, nephropathy and neuropathy, warns Dr. Vento. Retinopathy is damage to the retina in the back of the eyes, which can lead to blindness. Nephropathy is damage to the kidney, which can lead to kidney failure. And neuropathy is nerve damage, which often occurs in the legs and feet and leads to nerve dysfunction.

Prediabetes and type 2 diabetes most often are treated with lifestyle changes and medications. The following healthy lifestyle choices can help you bring your blood sugar level back to your target level, or at least keep it from rising:

• Eat a healthy diet
• Lose weight
• Exercise regularly
• Quit smoking
• Manage stress
• Take your medications as prescribed
• Get regular checkups

Dr. Vento advises her patients to get help managing their diabetes. Baptist Health’s comprehensive diabetes support program offers education classes and cooking classes that emphasize healthy habits. In addition, certified diabetes nurse educators and/or care managers closely follow patients and offer one-on-one counseling on lifestyle, nutrition and medication.

“Managing diabetes requires a day-to-day self-care regimen, and your health depends on your vigilance and compliance,” Dr. Vento said.

Tags: diabetes, diabetes control