Currently, the government is intensively conducting HbA1c examinations at almost all health facilities in Indonesia. This attracts attention because there are still some people who do not know about the importance of HbA1c for monitoring diabetes. Although the sampling is not influenced by certain conditions such as fasting, there are still some conditions that can cause the measurement results to be false increase or false decrease
Glycohemoglobin or HbA1c is a test performed to monitor blood glucose levels in diabetic patients. This test is carried out to be an indicator of treatment or carrying out a healthy lifestyle, especially those that have been lived by someone with diabetes. This means that in addition to testing the level of glucose in the blood, a person with diabetes needs an HbA1c test to determine whether drugs, diet, exercise, and therapy affect blood sugar. Because the Glycohemoglobin test is different from the blood sugar test that can be done every day when is the right time for an HbA1c test?
For those of you who have diabetes, it is necessary to do an HbA1c test. This is useful for reviewing and evaluating how much of a positive influence lifestyle and medications taken every day have.
This hemoglobin A1C examination shows the average level of glucose in the blood for the last 2 to 3 months. Blood sugar levels in red blood cells in normal people range below 5.7 percent. For someone with prediabetes between 5.7 – 6.4 percent and diabetes above 6.5 percent.
The HbA1c test can be done every 3-6 months, if the glucose level in red blood cells is good, the risk of complications is minimal. This test is indeed more accurate than fasting blood sugar tests, random or after eating, which can be done at any time.
Unlike the 2-hour glucose tolerance test, the HbA1c test can be performed at any time and without fasting. The test is also less affected by drugs that affect glucose metabolism. There are two conditions in the result of HbA1c Testing:
- False increase
Conditions that prolong the lifespan of red blood cells such as iron deficiency anemia, B12, and folic acid deficiency anemia due to reduced erythrocyte proliferation or functional asplenia due to decreased destruction of blood cells could falsely increase HbA1c levels.16 Severe hypertriglyceridemia (>1750 mg/dL), severe hyperbilirubinemia (>20 mg/dL), and uremia (due to carbaminohaemoglobin) also constitute commonly reported conditions associated with falsely elevated HbA1c. Alcohol intake due to the creation of a complex with acetaldehyde may cause a false increase in HbA1c levels. Furthermore, several drugs and substances have been reported to interfere with HbA1c levels such as salicylates, opioids, and lead poisoning.
- False decrease
On the other hand, there are conditions that cause falsely decreased levels of HbA1c such as anemia due to blood loss, hemolytic anemia by shortening the lifespan of erythrocytes, and splenomegaly which leads to increased red cell turnover.
Pregnancy also results in a false decrease of HbA1c levels because of the decreased life span of the red blood cells. Moreover, the use of vitamin E, ribavirin, interferon A, cephalosporins, levofloxacin, penicillins, anti-inflammatory drugs, and quinine (which may cause hemolytic anemia) has been associated with falsely decreased HbA1c levels.
Patients with end-stage renal disease present falsely decreased HbA1c values due to reduced proliferation rate and differentiation of erythrocyte precursor cells and ineffective response to endogenous erythropoietin (anemia of chronic disease). Additional factors such as the use of erythropoietin injections and uremia could also modify HbA1c levels. In these patients, glycaemic control should be monitored with other methods except HbA1c, such as the measurement of fructosamine and glycosylated albumin (these methods estimate the glycemia of the last 3 weeks because the half-life of albumin is 14–20 days).
The way to reduce HbA1c levels is to be disciplined in living a healthy lifestyle according to their respective conditions. Because everyone has a different body condition, diligent control and consultation with experts are recommended to measure how successful you are in controlling diabetes. The most important thing to keep sugar levels in red blood cells below 6.5% is to live a healthy lifestyle, maintain a healthy diet, exercise regularly, and manage stress. Also, don’t forget to always control the HbA1c levels and it can be done in hospitals or other health facilities.
One of them they are using Eclipse A1c Hemoglobin A1c POC Analyzer. Eclipse A1c offers a fast and easy way to measure HbA1c in a clinic or long-term care facility that prioritizes speed and convenience. HbA1c can be measured in just 3 simple steps and the results are certified by the National Glycohemoglobin Standardization Protocol (NGSP) to ensure accuracy. PT Isotekindo Intertama is a distributor for Eclipse A1c Hemoglobin A1c POC Analyzer products which are official and registered at the Ministry of Health of the Republic of Indonesia.
There are features and benefits of Eclipse A1c Hemoglobin A1c POC Analyzer:
- Eclipse A1c Hemoglobin A1c POC Analyzer dimensions 248 x 162 x 95 mm. It is a compact & lightweight instrument even for small labs with limited space
- Samples from capillaries and veins (stored in EDTA tubes for a maximum of 1 week at a temperature of 4°C). Using Eclipse A1c Hemoglobin A1c POC Analyzer easier for sampling, especially when it is not going to be used immediately
- Eclipse A1c Hemoglobin A1c POC Analyzer blood sample required is small (1 µL), it comfortable for use
- Fast measurement time (5 seconds), Eclipse A1c Hemoglobin A1c POC Analyzer only takes 5 seconds to test the HbA1c
Let's live a healthy life with routine HbA1c control.
References:
- American Diabetes Association. (2019) Classification and diagnosis of diabetes: standards of medical care in diabetes
- BMJ Journals. (2020). Is HbA1c an ideal biomarker of well-controlled diabetes?
- Insert Pack Eclipse A1c POC Analyze
- VOI (2022). HbA1c Check Should You Fast Or Not? Know The Complete Information.
