According to the latest version of the prevention and treatment guidelines for type II diabetes in 2020, the HbA1C index was formally included in the diagnostic criteria for diabetes, with HbA1c ≥ 6.5% as the cut-off point to assist in the diagnosis of diabetes. In the treatment of diabetes, the level of glycosylated hemoglobin has important clinical significance in evaluating the overall control of blood sugar, finding problems in the treatment and guiding the treatment plan.
If the glycosylated hemoglobin is more than 9%, it means that the patient continues to have hyperglycemia, which will lead to complications such as diabetes nephropathy, arteriosclerosis, cataract, and is also a high-risk factor for death from myocardial infarction and stroke. The detection of glycosylated hemoglobin can be used to guide the adjustment of treatment plan. HbA1c has certain significance in judging the different stages of diabetes. Polystyrene latex agglutination reaction is the most commonly used method to detect glycosylated hemoglobin.
This immune reaction is formed by the combination of the total Hb and HbA1c of the tested blood sample variety with the HbA1c antibody in the reagent to form agglutination. The amount of agglutination varies with the concentration of HbA1c protein. The concentration of HbA1c antigen is measured by turbidimetry with a biological analyzer. With endpoint method, the biochemical analyzer can directly reflect the amount of agglutination by measuring the absorbance value of the reaction solution and the percentage of HbA1c in Hb can be calculated.
Glycosylated hemoglobin A1c，often abbreviated HbA1c, is the product of the combination of hemoglobin in red blood cells and carbohydrate (mainly glucose) in serum through non enzymatic reaction. Glycosylated hemoglobin formed by non enzymatic reaction is characterized by persistence, slowness and irreversibility. Therefore, the concentration of glycosylated hemoglobin is determined by the past rather than the immediate blood glucose concentration, and has nothing to do with factors such as empty stomach before testing, insulin injection, or taking hypoglycemic drugs. It is generally believed that the glycosylated hemoglobin concentration can effectively reflect the average blood glucose level in the past 8-12 weeks. Glycosylated hemoglobin is composed of HbA1a, HbA1b and HbA1c, of which HbA1c accounts for about 70%, and its structure is relatively stable. The concentration of HbA1c is commonly used as a monitoring indicator for diabetes control in clinical practice and the concentration is expressed as a percentage of adult hemoglobin.
HbA1c is the gold standard to measure blood glucose control, and also an important method to diagnose and manage diabetes. In the treatment of diabetes mellitus, the level of glycosylated hemoglobin has important clinical significance in evaluating the overall control of blood glucose, finding problems in the treatment and guiding the treatment plan. If the concentation of HbA1c is more than 9%, it means that the patient continues to have hyperglycemia, which will lead to diabetic nephropathy, arteriosclerosis, cataract and other complications. It is also a high-risk factor for death from myocardial infarction and stroke. The detection of glycosylated hemoglobin can be used to guide the adjustment of treatment plan. HbA1c has certain significance in judging different stages of diabetes.
In healthy people, the HbA1c test level is less than 6.5% of total hemoglobin. A level of 6.5% signals that diabetes is present. Studies have demonstrated that the complications of diabetes can be delayed or prevented if the HbA1c test level can be kept below 7%. It is recommended that treatment of diabetes be directed at keeping an individual’s HbA1c level as close to normal as possible (<6%) without episodes of hypoglycemia (low blood glucose levels).
As mentioned previously, normal levels of HbA1c are less than 6%, so a measurement over 6% is considered high. For many people with type 1 and type 2 diabetes, the goal is to keep the HbA1c levels under 7%, since keeping levels below 7% has been shown to delay the complications of diabetes.