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There are several ways to measure glycated hemoglobin, of which HbA1c (or simply A1c) is a standard single test. [5] HbA1c is measured primarily to determine the three-month average blood sugar level and is used as a standard diagnostic test for evaluating the risk of complications of diabetes and as an assessment of glycemic control.
On average, each change of 3.3 mmol (60 mg/dL) in average blood sugar levels will give rise to changes of 2% HbA1c and 75 μmol fructosamine values. [6] However, this overemphasizes the upper limit of many laboratories' reference ranges of 285 μmol/L as equivalent to HbA1c 7.5% rather than 6.5%.
Glucose homeostasis, when operating normally, restores the blood sugar level to a narrow range of about 4.4 to 6.1 mmol/L (79 to 110 mg/dL) (as measured by a fasting blood glucose test). [10] The global mean fasting plasma blood glucose level in humans is about 5.5 mmol/L (100 mg/dL); [11] [12] however, this level fluctuates throughout the day ...
In general, the normal range for most people (fasting adults) is about 4 to 6 mmol/L or 80 to 110 mg/dL. (where 4 mmol/L or 80 mg/dL is "optimal".) A subject with a consistent range above 7 mmol/L or 126 mg/dL is generally held to have hyperglycemia, whereas a consistent range below 4 mmol/L or 70 mg/dL is considered hypoglycemic.
Diabetes is typically diagnosed by a blood test showing unusually high blood sugar. The World Health Organization defines diabetes as blood sugar levels at or above 7.0 mmol/L (126 mg/dL) after fasting for at least eight hours, or a glucose level at or above 11.1 mmol/L (200 mg/dL) two hours after an oral glucose tolerance test. [45]
They are suggested in clinical practice guidelines released by various national and international diabetes organizations. [12] [13] The targets are: Hb A1c of less than 6% or 7.0% if they are achievable without significant hypoglycemia [14] [15] Preprandial (before eating) BG: 3.9 to 7.2 mmol/L (70 to 130 mg/dL) [14]
glucose tolerance test with two hours after the oral dose a plasma glucose ≥ 11.1 mmol/L (200 mg/dL) A random blood sugar of greater than 11.1 mmol/L (200 mg/dL) in association with typical symptoms [24] or a glycated hemoglobin (HbA 1c) of ≥ 48 mmol/mol (≥ 6.5 DCCT %) is another method of diagnosing diabetes. [10]
Furthermore, a recent study showed that patients described as being "Uncontrolled Diabetics" (defined in this study by HbA1C levels >8%) showed a statistically significant decrease in the HbA1C levels after a 90-day period of seven-point self-monitoring of blood glucose (SMBG) with a relative risk reduction (RRR) of 0.18% (95% CI, 0.86–2.64% ...