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Could Your Hemoglobin A1C Test Be Wrong?

The prefer room to screen for diabetes is with an A1C test. It ’ s easily done with a fingerstick in your doctor ’ south position and doesn ’ metric ton command you to fast ( not eat ) anterior to the screen. In ideal situations, if your results from two back-to-back tests are both 6.5 % or higher, then your sophisticate can confirm that you have diabetes. But circumstances are often less than ideal. We ’ ll speak about times when your A1C test could be inaccurate below .Lab technician holding a blood sample with a red cap, the sample is in focus and the person is in the background out of focus.AegeanBlue/iStock via Getty Images ad ad

What is hemoglobin A1C?

Hemoglobin is a protein that sits inside crimson blood cells and is responsible for carrying oxygen throughout your body. Interestingly, hemoglobin can besides attach to glucose ( or carbohydrate ) traveling in your blood, and that hemoglobin-glucose combination is known as glycosylated hemoglobin, hemoglobin A1C, or HbA1C. The higher your blood carbohydrate levels are, the higher your hemoglobin A1C levels will be .

What does an A1C test measure? 

An A1C test measures the share of hemoglobin in your blood that carries glucose. The higher the total of glucose in the blood, the higher the A1C percentage. A normal A1C measurement is less than 5.7 %, while an A1C of 5.7 % to 6.4 % could suggest prediabetes, and an A1C of 6.5 % or higher normally means diabetes. The great thing about an A1C test is that it represents your average blood sugar levels over 2 to 3 months. In other words, it isn ’ t affected by the pizza you had the night before, and you don ’ t have to fast for the trial to be accurate. That ’ south because glucose stays attached to hemoglobin for adenine long as the red blood cell that holds them remains in your bloodstream ( which is about 2 to 3 months ). Certain health conditions that affect your blood and hemoglobin can cause your HbA1C test to be inaccurate .

When your A1C test says you have diabetes, but you really don’t

The comply conditions can falsely raise your A1C screen results, making you think you have lots of glucose in your bloodstream when you don ’ metric ton .

  • Certain types of untreated anemias: Anemia caused by a miss of iron, vitamin B12, or vitamin bc ( vitamin B9 ) can falsely raise your A1C test results. Your body needs these vitamins and minerals to create newly, goodly, red blood cells and replace older, dying ones. If your body international relations and security network ’ thymine making new lineage cells, that means you ’ ll have more of the older cells floating about, including ones that have already picked up glucose .
  • Kidney failure or chronic kidney disease: Abnormal kidney operation is a problem that can happen in people with diabetes. Chronic kidney disease can lead to low vitamin and mineral levels and anemia, which, as you saw above, can cause your A1C quiz results to be falsely high .
  • Extremely high triglycerides: Triglycerides are a type of fat found in your lineage. When you have besides a lot of this adipose tissue ( where your triglyceride rake quiz is over 1,750 mg/dL ), it can make your A1C levels seem higher on your test than they actually are .
  • After a splenectomy: One function of your irascibility is to remove old and damaged crimson blood cells from your bloodstream as you make new crimson blood cells. But if you had share or all of your irascibility removed in a splenectomy, those previous blood cells — including the ones with hemoglobin A1C — will sit around for longer .

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When your A1C test says you don’t have diabetes, but you really do

The play along conditions can falsely lower your A1C test results, making you think you don ’ t have excess glucose in your bloodstream when you do .

  • During treatment of certain anemias: We talked about some anemias above. If you ’ re taking iron or vitamin B12 supplements to treat those anemias, you ’ re encouraging your body to make new red blood cells. This can cause your A1C test to be falsely humble. ( Again, if you have an iron insufficiency anemia and you ’ re NOT treating it, your A1C test will be falsely high. )
  • After donating blood: Your A1C test results will be inaccurately abject after a lineage contribution ( or in other situations of major blood loss ). When your consistency is in a low-blood state, it will start to make red blood cells more quickly, and you ’ ll have newer red blood cells overall. That means the share of hemoglobin A1C in your bloodstream will be lower, besides.
  • During pregnancy: A1C can be falsely low during pregnancy because the body is in overdrive making more ( younger ) red lineage cells to deliver oxygen to the growing baby. even so, A1C is still used to monitor fraught women with diabetes. The prey A1C in pregnancy is below 6 % .
  • Hemolysis: Hemolysis is when your crimson lineage cells are destroyed, cutting short-circuit their life. It can happen as a consequence of autoimmune diseases, taking certain medications ( like ribavirin or interferon alpha ), or genetic blood disorders like familial spherocytosis .
  • During erythropoietin treatment: Erythropoietin, the active ingredient in Epogen and Procrit, is used to increase red blood cell production after chemotherapy or if you have profound anemia caused by highly depleted cast-iron levels. The inflow of raw crimson blood cells can cause a falsely gloomy A1C test .
  • Hemodialysis: Both hemodialysis and peritoneal dialysis may falsely lower A1C levels. If you have kidney failure on dialysis, A1C levels may not be the best way to monitor your diabetes .

Blood donations can make your A1C test inaccurate either way

If you ’ ve good received donate blood in a blood transfusion, your A1C test results will be unreliable. A transfusion can affect your measurement in many ways, as it dilutes your crimson blood cells with person else ’ s red blood cells .

Race and ethnicity can affect A1C

The A1C quiz works best on hemoglobin A, the most coarse type of hemoglobin that people have. But depending on where in the worldly concern you ( or your ancestors ) come from, your rake might have a different type of hemoglobin. These are called hemoglobin variants, and they are more coarse if you or your family come from Africa, South and Southeast Asia, or the Mediterranean. Having a hemoglobin discrepancy such as hemoglobin S, C, D, or E, can affect the accuracy of an A1C result. Luckily, many labs now run A1C tests that are not affected by hemoglobin variants. There is a entire list here. If you have a hemoglobin variant, you and your supplier can work together to find a lab that will give you accurate A1C results. ad ad

Is there an alternative to the A1C test?

If you can ’ t trust on an A1C test, the next best test to measure blood sugar control is the fructosamine lineage quiz. Diabetes specialists will check the concentration of a protein called fructosamine in your lineage to get a relatively long-run calculate of your lineage sugar levels. – – – Dr O .image

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source : https://nutritionline.net
Category : Healthy