Internal MedicineEndocrinology
Glycated hemoglobin
Glycated hemoglobin
The glycated hemoglobin test (also known as HbA1c or A1c test) measures the amount of glucose bound to hemoglobin in red blood cells. The results can reflect blood glucose levels over the past 2 to 3 months.
The following groups of people need to undergo glycated hemoglobin testing:
Glycated hemoglobin can be used to assess the severity of diabetes and help guide treatment adjustments. Patients diagnosed with diabetes need regular glycated hemoglobin tests.
If elevated blood glucose is found for the first time, glycated hemoglobin should also be checked during the visit. If glycated hemoglobin exceeds the normal range, it indicates that blood glucose has been elevated for at least 2 to 3 months. If glycated hemoglobin is still within the normal range, it indicates that the blood glucose elevation is short-term. This can help differentiate acute blood glucose elevation conditions, such as fulminant type 1 diabetes and stress-induced hyperglycemia.
What should be the target glycated hemoglobin level for diabetic patients?
The target glycated hemoglobin level varies for different types of diabetic patients.
For most non-pregnant adult patients with type 2 diabetes, glycated hemoglobin should be controlled to < 7.0%.
For type 2 diabetic patients with a short disease course, who are young, without complications, and without coexisting cardiovascular disease, blood glucose can be controlled to near normal levels, with glycated hemoglobin controlled to < 6.5%, provided that this does not lead to hypoglycemia.
For patients with a history of severe hypoglycemia, elderly individuals, those with significant diabetic complications, or those with other severe coexisting diseases, or a very long duration of diabetes, who find it difficult to achieve conventional treatment goals despite diabetes self-management education, appropriate blood glucose monitoring, and effective doses of multiple hypoglycemic medications including insulin therapy, the glycated hemoglobin target can be relaxed to < 8.0%.
For patients with type 1 diabetes, glycated hemoglobin should be controlled to < 7.5% during childhood and adolescence, and < 7.0% in adulthood, with avoiding hypoglycemia being an important prerequisite.
For pregnant women diagnosed with gestational diabetes during pregnancy, glycated hemoglobin should be controlled to below 5.5% during pregnancy.
For pregnant women diagnosed with diabetes before pregnancy, glycated hemoglobin should be controlled to below 6.0% during pregnancy.
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