Hemoglobin A1c Levels Effective Screening Test for Diabetes

Measuring patients’ glycosylated hemoglobin levels (A1C) could be used to screen for diabetes, according to California-based researchers. It was shown to be more effective then using fasting blood sugars.

A1C is a test that measures the percentage of glucose (sugar) that is attached to hemoglobin, a molecule in red blood cells. It reflects the average glucose levels over the previous 3 to 4 months. Untreated (or uncontrolled) diabetics have A1C levels that are 7.0 percent or higher. Diabetes is also detected by fasting plasma glucose levels of 126 milligrams per deciliter (mg/dL) or greater.

Dr. Mayer B. Davidson stated, "Currently, fasting plasma glucoses are recommended to screen for — and possibly diagnose – diabetes."  "Few physicians are doing this, because most patients are seen during the day, after they have eaten. A1C measurements do not require fasting and can be measured at a routine office visit."

To determine what A1C levels should lead to further testing for diabetes, Davidson of the Charles R. Drew University, Los Angeles and colleagues studied data from 4,935 participants in the 1999-2004 National Health and Nutrition Examination Survey.

Based on fasting plasma glucose levels, 3,280 subjects were normal, 1,485 had pre-diabetic levels (100 to 125 mg/dL) and 170 had previously undiagnosed diabetes (126 mg/dL or higher), the researchers report in the journal Diabetes Care.
Patients with A1C levels of less than 5.8 percent, said Davidson, "will be unlikely to have diabetes and those with 5.8 percent or above will be much more likely. Thus, only a minority of patients will have to return fasting for either a glucose measurement or a full oral glucose tolerance test."

"This should increase the early diagnosis of diabetes so that appropriate treatment can be instituted to prevent the complications of the disease," he concluded.
Diabetes Care, September 2007.

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DID YOU KNOW:
With 15,000 CDE’s and 21 million people with diabetes, that means that, every educator would have to see at least 1,400 people four times a year: this works out to more than 22 people every single weekday and that is just for today’s numbers, what happens when the number increases to 45million in the next 12-15 years.

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