My Hemo...What?
Key Facts About HbA1c
Medicine | 5 min. read | by Gloria M Rivera
Recently, I interpreted for the first appointment between a very sweet (no pun intended) Spanish-speaking patient with diabetes and his primary care provider. Everything was going smoothly until the doctor asked about the patient’s most recent hemoglobin A1C numbers. The patient replied with a very confused and unexpected, “¿Mi hemo… qué? ¿Qué es eso?” (My hemo… what? What is that?)
After I interpreted his reply, the doctor looked just as surprised and confused. This is a test the patient should have been familiar with, especially after living with diabetes for over 20 years. Thankfully, the doctor took the time to explain what the A1C test is and why it is so important for patients with diabetes, using simple language, and answered all of the patient’s questions.
As I interpreted the conversation, I couldn’t help but think“This would make a great topic for my first blog post!” And here we are.
What is this Hemoglobin A1c?
If you’ve ever interpreted for a patient with diabetes, chances are you’ve come across the hemoglobin A1c test. This blood test, also known as A1c, HbA1c, glycohemoglobin, glycated hemoglobin, or glycosylated hemoglobin, measures a person’s average blood glucose (blood sugar) levels over the past two to three months.
It’s a vital tool for healthcare providers, not only for diagnosing diabetes but also for monitoring how well the condition is being managed. By providing a long-term view of blood sugar control, the A1c test helps determine whether a patient is following their treatment plan, whether the treatment is effective, and whether any medication adjustments are needed.
How the A1c Test Works
The formation of hemoglobin A1c begins in the bloodstream when there isn’t enough insulin to move glucose into the body’s cells. As a result, excess glucose, think of it as “sprinkles”, remains in the blood and starts attaching to hemoglobin inside red blood cells (the “donuts”).
Since red blood cells live for about 120 days, the A1c test is like taking a snapshot of those sprinkled donuts to see how much glucose (or “sprinkles”) have attached to the red blood cells (the “donuts”) over the past 3 to 4 months. Say glucoooooose for the picture! *click*
That’s why this test is such a valuable tool for the long-term monitoring of diabetes. If a patient is taking their medication, eating well, and exercising, their “donuts” should have just a “few sprinkles”. But if they’re not following their treatment plan—or if their medication needs to be adjusted—their blood sugar will remain high, and their “donuts” will be covered in “sprinkles.”
Understanding A1c Numbers
The A1C test measures the percentage of red blood cells (the “donuts”) that have sugar-coated hemoglobin (the “sprinkles”).
A target A1c level varies by each person’s age, overall health and other factors. The goal value for a person without diabetes is an A1c below 5.7% and the goal for most adults with diabetes is an A1C that is less than 7%.
Research shows that keeping A1C levels under 7% can significantly delay, or even prevent, serious long-term complications of diabetes, such as kidney disease, nerve damage, and vision loss.
How Often Do You Need an A1c Test?
How often the A1C test is done depends on the type of diabetes, how well it’s managed, and a healthcare provider’s recommendations. The American Diabetes Association (ADA) recommends A1C testing at least twice a year for people who are meeting their treatment goals and have stable blood sugar levels. For those who are newly diagnosed or not yet well controlled, testing may be needed every three months.
In short…
The A1C test is both a practical tool for diagnosing diabetes and a valuable resource for managing it. If a patient’s A1C is above the normal range, it may signal to the provider that the patient is not following their treatment plan or that their medication needs to be adjusted. On the other hand, keeping A1C levels within the recommended range can help prevent or delay long-term complications.
I hope this post gave you a clearer understanding of the A1C test and helps you the next time you’re interpreting for a patient and their provider. If you’d like to learn more about this topic, you can find the resources I used listed below.
And remember, sharing is caring! Feel free to pass this along to fellow interpreters who might find it helpful.
xo,
Gloria
Resources
- Testing.com: A1c
- American Diabetes Association (ADA): Understanding A1c Test
- WebMD: Hemoglobin A1c for diabetes
- Centers for Disease Control (CDC): All About your A1c
- Mayo Clinic: A1c Test
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