Hemoglobin A1c and Glucose

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Glucose

A blood glucose test measures the amount of a sugar called glucose in a sample of your blood. Glucose is a major source of energy for most cells of the body, including those in the brain. The hormones insulin and glucagon help control blood glucose levels.

Also known as: A1c, Glycated Hemoglobin, Glycohemoglobin, Glycosylated Hemoglobin, HA1c, HbA1c, Hemoglobin A1c, Hemoglobin A1c HgbA1C, Hgb A1c

Hemoglobin A1c

The A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months. It does this by measuring the concentration of glycated (also often called glycosylated) hemoglobin A1c. Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs). There are several types of normal hemoglobin, but the predominant form – about 95-98% – is hemoglobin A. As glucose circulates in the blood, some of it spontaneously binds to hemoglobin A. The hemoglobin molecules with attached glucose are called glycated hemoglobin. The higher the concentration of glucose in the blood, the more glycated hemoglobin is formed. Once the glucose binds to the hemoglobin, it remains there for the life of the red blood cell – normally about 120 days. The predominant form of glycated hemoglobin is referred to as HbA1c or A1c. A1c is produced on a daily basis and slowly cleared from the blood as older RBCs die and younger RBCs (with non-glycated hemoglobin) take their place. This test is used to monitor treatment in someone who has been diagnosed with diabetes. It helps to evaluate how well their glucose levels have been controlled by treatment over time. This test may be used to screen for and diagnose diabetes or risk of developing diabetes. In 2010, clinical practice guidelines from the American Diabetes Association (ADA) stated that A1c may be added to fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) as an option for diabetes screening and diagnosis. For monitoring purposes, an A1c of less than 7% indicates good glucose control and a lower risk of diabetic complications for the majority of diabetics. However, in 2012, the ADA and the European Association for the Study of Diabetes (EASD) issued a position statement recommending that the management of glucose control in type 2 diabetes be more "patient-centered." Data from recent studies have shown that low blood sugar (hypoglycemia) can cause complications and that people with risk of severe hypoglycemia, underlying health conditions, complications, and a limited life expectancy do not necessarily benefit from having a stringent goal of less than 7% for their A1c. The statement recommends that people work closely with their doctor to select a goal that reflects each person's individual health status and that balances risks and benefits.
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The Hemoglobin A1c and Glucose panel contains 2 tests with 2 biomarkers.

Brief Description: The Hemoglobin A1c and Glucose panel is a combination of two essential blood tests that provide valuable information about an individual's blood sugar levels over both short and extended periods. This panel helps healthcare professionals assess how well a person's blood sugar is being managed and can indicate the risk or presence of diabetes.

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Fasting is required

When and Why the Hemoglobin A1c and Glucose Panel May Be Ordered

The Hemoglobin A1c and Glucose panel is commonly ordered:

  1. Diagnosis of Diabetes: For individuals who present symptoms of diabetes or are at risk due to factors like obesity, family history, or other related conditions.

  2. Monitoring of Diabetes Management: For those diagnosed with diabetes to monitor how well their blood sugar levels are being controlled over time. It's typically ordered at regular intervals for this purpose.

  3. Risk Assessment: In individuals considered at high risk for developing diabetes, such as those with polycystic ovary syndrome (PCOS), a history of gestational diabetes, or metabolic syndrome.

  4. Evaluation of Treatment Plans: To evaluate the efficacy of medications or lifestyle changes aimed at regulating blood sugar.

What the Hemoglobin A1c and Glucose Panel Checks For

  • Hemoglobin A1c: This test measures the average blood sugar level over the past 2-3 months. It provides an indication of long-term glucose control by assessing the percentage of hemoglobin (a protein in red blood cells) that has sugar attached to it. A higher percentage of hemoglobin A1c suggests poor blood sugar control.

  • Glucose: Often referred to as a blood sugar test, this measures the amount of glucose present in the blood at the time of the test, providing a snapshot of the current blood sugar level. It's sensitive to recent meals, stress, exercise, and other short-term factors.

Other Lab Tests Often Ordered Alongside a Hemoglobin A1c and Glucose panel

When a Hemoglobin A1c (HbA1c) and Glucose panel is ordered, it typically indicates an assessment for diabetes or prediabetes. These tests help in evaluating long-term glucose control and current blood sugar levels. To provide a comprehensive overview of diabetes management and its complications, other tests are often included. Here are some tests commonly ordered alongside this panel:

  1. Fasting Lipid Profile:

    • Purpose: To measure cholesterol levels, including total cholesterol, LDL (low-density lipoprotein), HDL (high-density lipoprotein), and triglycerides.
    • Why Is It Ordered: Diabetes is a risk factor for cardiovascular disease, and lipid levels are important in assessing overall cardiovascular health.

  2. Complete Blood Count (CBC):

    • Purpose: To evaluate overall blood health, including red and white blood cells, and platelets.
    • Why Is It Ordered: To detect conditions like anemia, which can be more common in people with diabetes.

  3. Urine Albumin (Microalbumin) and Creatinine Ratio:

    • Purpose: To check for the presence of small amounts of albumin in the urine.
    • Why Is It Ordered: To assess for early signs of kidney damage, a complication of diabetes.

  4. Serum Creatinine and Estimated Glomerular Filtration Rate (eGFR):

    • Purpose: To assess kidney function.
    • Why Is It Ordered: Diabetes can lead to kidney damage over time, and monitoring kidney function is an important part of diabetes care.

  5. Liver Function Tests:

    • Purpose: To evaluate liver enzyme levels and liver function.
    • Why Is It Ordered: Diabetes increases the risk of fatty liver disease and other liver conditions.

  6. Thyroid Function Tests (TSH, Free T4):

    • Purpose: To assess thyroid gland function.
    • Why Is It Ordered: Thyroid disorders are more common in people with diabetes, especially type 1 diabetes.

  7. C-Peptide Test:

    • Purpose: To measure the level of C-peptide, a byproduct of insulin production.
    • Why Is It Ordered: To help distinguish between type 1 and type 2 diabetes and assess insulin production in people with diabetes.

  8. Insulin Levels (fasting and/or postprandial):

    • Purpose: To measure the amount of insulin in the blood.
    • Why Is It Ordered: To evaluate insulin production and resistance, especially in type 2 diabetes or in the evaluation of hypoglycemia.

  9. Fructosamine:

    • Purpose: To provide an indication of average blood glucose levels over the past 2-3 weeks.
    • Why Is It Ordered: To complement HbA1c for patients needing shorter-term monitoring or those with conditions affecting HbA1c reliability.

These tests, when ordered alongside a Hemoglobin A1c and Glucose panel, provide a comprehensive assessment of diabetes management, risk factors for diabetes-related complications, and overall health status. They are crucial for diagnosing diabetes, monitoring treatment effectiveness, and managing long-term health in individuals with diabetes. The specific combination of tests will depend on the individual's medical history, current health status, and diabetes management plan.

Conditions or Diseases the Hemoglobin A1c and Glucose Panel Can Check For

  • Diabetes Mellitus: Persistently elevated levels of glucose and hemoglobin A1c can indicate the presence of diabetes mellitus, a chronic condition that affects how the body processes blood sugar.

  • Prediabetes: If the results are higher than normal but not in the diabetic range, it may indicate a state of prediabetes, where blood sugar levels are higher than they should be but not high enough yet to be diagnosed as diabetes.

  • Reactive Hypoglycemia: Low glucose levels may indicate this condition, which is a drop in blood sugar that occurs a few hours after eating a meal.

In conclusion, the Hemoglobin A1c and Glucose panel is a crucial diagnostic tool in the realm of metabolic and endocrine health. By assessing both short-term and long-term blood sugar levels, this panel provides comprehensive insights into an individual's glycemic status, aiding in early diagnosis, management, and treatment optimization for conditions related to blood sugar imbalances.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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