The American Diabetes Association adopts the hemoglobin A1c value of ≥7% as an indicator that warrants intervention in a patient's therapy and establishes a goal of <7% for glycemic control. While hemoglobin A1c levels are not used for diagnostic purposes and do not reveal details about daily glycemic fluctuations, they can be useful in verifying reported SMBG values, as well as providing essential information on patients who do not obtain SMBG values. Hence, the hemoglobin A1c value gives us an estimation of what a person's average blood glucose has been for the past 2 to 3 months. The normal life span of a red blood cell is approximately 120 days therefore, the hemoglobin A1c level will change as new red blood cells are made. The glucose in the blood binds irreversibly to hemoglobin to form a glycated hemoglobin complex. Glycosylated hemoglobin is formed in a nonenzymatic pathway by the normal exposure of hemoglobin to high plasma levels of glucose. 2, 3 A vital element in attaining adequate glycemic control on the part of health care providers is regular monitoring of patient's glycemic control through regular follow-up.Īlthough periodic fasting laboratory testing and assessment of self-monitored blood glucose (SMBG) values are essential in the therapeutic management of diabetic patients, obtaining glycosylated hemoglobin A1c values are equally important for long-term evaluation. 1 As demonstrated in the Diabetes Control and Complications Trial and in the United Kingdom Prospective Diabetes Study, achieving adequate glycemic control in those with diabetes reduces both micro- and macrovascular complications. Approximately 21 million children and adults in the United States have diabetes.
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