An understanding of the A1C levels can help a diabetic to control his or her blood sugar level. Why should someone with diabetes try to maintain a pre-determined blood sugar level? First of all the presence in the blood stream of a “normal” blood sugar level helps anyone, including a diabetic, to feel better.
Second, a person with a “normal” blood sugar level in his or her bloodstream does not put added strain on his or her heart. A person with a proper blood sugar level does not put a strain on his or her kidneys. An excess amount of sugar in the blood can slow the flow of blood in the capillaries. That can damage the tissues fed by the same capillary beds.
The combination of potentially harmful changes that result from a too high blood glucose level underline the importance of the A1C level. Since those changes take place during times when the blood contains too much glucose, control of the glucose level in the blood can help to avoid unwanted damage to the body’s cells. Awareness of his or her A1C level gives a diabetic the ability to work towards such control.
A diabetic can obtain the tools needed for testing his or her blood sugar level at home. The results of such a test give a “one-time” glimpse of the blood sugar level in the test subject. Diabetics are encouraged to keep a journal, and to put the results of any at-home blood test in that journal. Yet not all diabetics choose to maintain a journal. Moreover, a diabetic might find it necessary to forgo the placement of one or more journal entries.
There have also been cases when a child with diabetes was learning to keep his or her own journal. At such times, the child might also be learning how to test his or her blood without help from parents or other adults. If the child performs the test improperly, then he or she will not have correct figures in his or her journal.
The above considerations indicate why a physician can not rely on journal entries to evaluate the amount of control that a diabetic patient has over his or her blood sugar level. The physician has thus come to depend on the A1C level. A diabetic needs to appreciate just how the A1C level can reveal to the physician whether or not a diabetes treatment plan is working.
The A1C test measures the level of what is called “glycated hemoglobin.” The hemoglobin is the protein in the red blood cells that allows those cells to carry oxygen. The molecular structure of hemoglobin allows the red blood cell to pick-up oxygen in the lung and to release it in an oxygen-deprived body cell.
Of course, the hemoglobin in the red blood cells does not link to only oxygen. Hemoglobin molecules in the blood also link to other chemicals in the blood stream. If a diabetic has a high level of blood sugar in his or her bloodstream, that excess sugar enters the red blood cells. The hemoglobin in the blood cells links to the entering sugar.
Biochemists have given a name to the process that creates a linkage between hemoglobin and sugar. Biochemists call that process “glycation.” Once hemoglobin links to a sugar molecule, it becomes glycated hemoglobin. The level of glycated hemoglobin in the blood indicates the level of sugar in the blood.
Now once the body produces a molecule of hemoglobin, that hemoglobin remains in the bloodstream for two to three months. If it becomes glycated hemoglobin, it continues to stay in a red blood cell for the normal “life” of a hemoglobin molecule (2-3 months). The A1C level gives the physician an overview of a patient’s blood sugar level for a two to three month interval. Exactly what level does the physician want to see?
A trained physician should know that a patient without diabetes usually has an A1C level of 5%. The A1C level in a diabetic can be expected to rise above 5%. What sort of rise should alarm the physician? What sort of rise should let the physician know that his or her patient needs an improved diabetes treatment plan?
A diabetic who has an A1C level of 8% does not need to make major changes in his or her treatment plan. Such a diabetic has an A1C level that shows only a mild rise above the normal A1C level. Such a diabetic has come close to achieving control of his or her blood sugar level.
A diabetic who has an A1C level of 25% would hear pleas from his or her physician to make immediate changes in the existing diabetes treatment schedule. An A1C level of 25% would show that the treatment schedule currently in use had failed to offer a means for control of the diabetic’s blood sugar level.
Of course a physician would not call for great changes in a diabetes treatment plan after looking at only a single A1C level. The physician would want to know if that level had remained stable for twenty-four to forty-eight hours. Only when an A1C l level has shown such stability does a trained physician feel ready to base a treatment schedule on that A1C level.
The A1C level reveals what a single test of the blood sugar level can never hope to reveal. The A1C level discloses the degree to which a diabetic has managed to maintain an acceptable blood sugar level. By examining a patient’s A1C level, a physician can watch for indications that a patient might have subjected his or her body tissues to an abnormally large amount of glucose.
A high A1C level indicates passage of a 2 to 3 month period during which the red blood cells have managed to link up with excess sugar molecules. During that same period, the patient’s circulatory system and nervous system has been under stress. Armed with that information, a wise physician should take appropriate action.