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HbA1c Level


Blood sugar (glucose) tends to bind to different proteins, including hemoglobin and albumin. HbA1c or glycated hemoglobin represents the fraction of the hemoglobin that reacted with the glucose. Given that blood hemoglobin is continuously renewed, the percentage of HbA1c represents the average glycemia (blood glucose level) during the 4- to 6-week period prior to collection. HbA1c is therefore very useful in diagnosing and monitoring diabetes. HbA1c levels are not affected by food intake.

An HbA1c level equal to or greater than 0.065 (6.5%) is consistent with a diabetes diagnosis. An HbA1c level between 0.060 and 0.065 (6.0 and 6.5%) is consistent with “pre-diabetes” and indicates an increased risk of cardiovascular disease. An abnormally low level most often indicates an abnormal hemoglobin fraction that is interfering with the measurement.

Measuring HbA1c levels is recommended every three to six months in patients being treated for diabetes. Treatment targets are to bring HbA1c levels back down as close to normal as possible (below 0.065), but they are adjusted according to different variables, such as the patient’s age, treatment type and risk of hypoglycemia.

Term of the Week

Creatine Kinase MM (CK-MM)

CK (creatine kinase) is an enzyme (protein) found in several tissues, including muscles and the heart. Depending on the tissue, different forms of CK are present: CK-MM is primarily present in skeletal muscles, CK-MB represents 30% of CK from the heart, while CK-BB comes from the brain and smooth muscle, such as the intestinal walls. Atypical forms of CK (macro CK1 and macro CK2) can also be present. CK electrophoresis is most useful when muscular or cardiac disease does not seem to be responsible for the increased level of total CK.