The American Diabetes Association and other leading diabetes organizations in the U.S. will come out within the next six months with guidelines on the use of the A1C test as a diagnostic tool for patients with type 2 diabetes.
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With the diagnosis of diabetes increasing 90 percent over the past ten years, it is important that we have an easy way to diagnosis the disease. Prior to this announcement we had to use the fasting blood glucose, where you had to fast for the test and it still was not 100% accurate. You could have a normal fasting blood sugar and still have diabetes. We also have the Oral Glucose Tolerance Test (OGTT), where you have to drink 75 grams of glucose and then have someone check your blood sugars every 20-30 minutes until your blood sugar peaks. The OGTT was more expensive because it took time in the doctor’s office.
After the ADA announces the guidelines, we will have a test that you will not have to fast for and can be done anytime of the day.
The A1C is an indicator of the average blood glucose level over the past two or three months measured by the concentration of hemoglobin molecules in the red blood cells with glucose attached to the cells. It is also a good predictor of future complications like nerve, eye and kidney damage.
According to a CDC report in October, diagnosed diabetes cases went up by more than 90 percent among U.S. adults over the past 10 years. From 4.8 cases per 1,000 population during 1995-97, the number climbed up to 9.1 per 1,000 people in 2005-07 in 33 states.
In the Epic-Norfolk study they found that those people that had a A1c of 6% compared to those people with a 5%, regardless of whether they had diabetes or not, had a 28% increase in cardiovascular death. So we might also be able to use the A1c test to let patients know if they are at risk for cardiovascular disease even if they do not have diabetes.
The results of the A1c test will also tell people if they have prediabetes or at risk for prediabetes, rather than waiting until their fasting blood sugars goes higher then 126mg/dL.
The A1c test should be done for every person at every physical whenever blood is drawn for other tests such as cholesterol.
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