Glycated hemoglobin: the norm in the blood test
Glycated hemoglobin is an iron-containing protein that may indicate the latent course of diabetes. It starts to be produced when blood sugar levels rise. Also glycated hemoglobin is called glycated hemoglobin.
Even a short-term rise in blood glucose leaves a mark in the body. It can be detected 30-45 days after the event occurred. Glycated hemoglobin is formed instead of ordinary hemoglobin, which is transformed against the background of a jump in glucose.
Content:
- What does it mean?
- Norm values
- The relationship of glycated hemoglobin and glucose
- Why does the level of glycated hemoglobin rise and fall in the blood?
- How to take?
What does it mean?
When the level of glucose in the blood rises, the body is unable to completely process it. Therefore, its molecules interact with proteins (albumin, hemoglobin, lipoproteins), forming a strong connection. Glycation of hemoglobin is an irreversible process, it is called the Maillard reaction.
The blood cells that carry hemoglobin have a "lifespan" of 3 months, so its compounds with glucose can be detected even long after the jump in blood sugar levels has occurred.
With latent diabetes mellitus, glucose will combine with hemoglobin several times faster. In the future, he is not able to get rid of its molecules, so such hemoglobin can be detected until the time when the erythrocytes that carry it are alive.
Counting these destroyed hemoglobin molecules makes it possible to estimate the degree of glycation. This allows you to reveal the latent course of the disease, even if the sugar level at the time of the study is within normal limits. Glycated hemoglobin is always present in the human body; it is not any pathogenic compound for it. Normally, it should not be more than 6% of the total level of normal hemoglobin.
Thus, the study allows you to establish the blood glucose level of a person a month old or more. The analysis is informative even in the case when the jump in sugar was short-lived. Excess glucose molecules will still react with hemoglobin, which will affect the results of the study.
Norm values
If a person is healthy and does not develop diabetes mellitus, then the level of glycated hemoglobin will be in the range of 4-5.8% of the total amount of hemoglobin in the blood. Exceeding these indicators can be observed only in children during the neonatal period. At this time, the child has fetal hemoglobin in the blood, but by one year, the baby's body must completely remove it.
If a person suffers from diabetes, then the hemoglobin level can rise to 12% or more.
Interpret the received data as follows:
- The level of glycated hemoglobin does not exceed 6% - this is an indicator of the norm.
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The hemoglobin level rises to 6-8%. This indicates that there was a jump in glucose, but the body coped with them on its own. The same indicators can be in people with diabetes, but taking medications. In this case, it is they who cope with glucose.
- The glycated hemoglobin level reaches 9%. These data indicate compensated diabetes mellitus, which requires initiation of treatment or a revision of therapy.
- The level of glycated hemoglobin rises to 9-12%. This situation requires extreme vigilance, as it indicates that the body itself is no longer able to cope with the surges in blood sugar. If diabetes mellitus therapy is carried out, then such a level of glycated hemoglobin indicates its partial failure.
- If the glycated hemoglobin exceeds the 12% mark, then the treatment does not give the desired result and requires correction.
Determination of the level of glycated hemoglobin is informative in terms of detecting diabetes mellitus. It allows you to assess the risk of developing complications of this disease.
The analysis is carried out for different purposes:
- Detection of the latent course of diabetes mellitus.
- Evaluation of the effectiveness of the treatment and control of the development of the disease.
- Assessment of carbohydrate metabolism in the body, assessment of the degree of compensatory capabilities of the body.
In addition, this study expands the information that the doctor receives during the glucose load test. It is recommended for people with suspected diabetes mellitus, but with an undetermined diagnosis. For the detection of diabetes in pregnant women, other research should be based. The level of glycated hemoglobin during the period of gestation does not allow obtaining the most reliable information.
The relationship of glycated hemoglobin and glucose
Blood glucose and glycated hemoglobin levels are closely related to each other. It is reflected in the table.
| The percentage of glycated hemoglobin in the blood | Average blood glucose level in mol / l | Average blood glucose in mg / dL |
| 2.6 | 47 | |
| five | 4.5 | 80 |
| 6,7 | 120 | |
| 8.3 | 150 | |
| eight | 10.0 | 180 |
| nine | 11.6 | 210 |
| ten | 13.3 | 240 |
| eleven | 15.0 | 270 |
| 12 | 16.7 | 300 |
Why does the level of glycated hemoglobin rise and fall in the blood?
Glycated hemoglobin increases in the blood not only against the background of diabetes mellitus, but also under other conditions, including:
- High fetal hemoglobin levels lead to an increase in glycated hemoglobin levels. A similar situation can be observed in children under the age of one year. In the future, all indicators should return to normal.
- Iron deficiency in the body leads to an increase in the level of glycated hemoglobin.
- The absence of a spleen in the body after the operation can contribute to various changes in the blood picture. Including, lead to an increase in the level of glycated hemoglobin.
If doctors encounter high rates quite often, then a low level of this hemoglobin in the blood is rarely diagnosed.
Its insufficient concentration is observed in the following cases:
- Low blood sugar.
- Increased production of hemoglobin in the body.
- Postponed bleeding, which was accompanied by massive blood loss. After such pathologies, the hematopoietic system is activated, which can lead to a decrease in the level of glycated hemoglobin.
- Hemolytic anemia, accompanied by accelerated destruction of erythrocytes, which are carriers of hemoglobin.
- Pronounced disorders in the work of the kidneys.
- Blood transfusion.
Although an increased and decreased level of glycated hemoglobin in the blood can accompany a number of other pathologies, nevertheless, it is more often determined precisely for the diagnosis of diabetes mellitus.
How to take?
To determine the level of glycated hemoglobin, blood donation from a vein is required. For the study, it is taken in an amount of 3 ml.
No prior preparation is required. It is not necessary to come to the laboratory on an empty stomach. Glycated hemoglobin is present in the blood for a long time and meals before the test have no effect on its level.
For people with diabetes mellitus, the study is carried out 1 time in 3 months. This allows the doctor to monitor the course of the disease and evaluate the effectiveness of the therapy. If the analysis raises any doubts, for example, with a patient's hemolytic anemia, then additional studies are prescribed. To assess the quality of carbohydrate metabolism in the body, it is possible to donate blood to determine the level of fructosamine. This study provides information on spikes in blood glucose over the past 2-3 weeks.
To undergo research on your own initiative, you can contact a paid laboratory. The average cost of the analysis is 700-800 rubles (for megalopolises), although the cost of the study varies, depending on the specific settlement and the medical and diagnostic institution.
The author of the article: Shutov Maxim Evgenievich | Hematologist
Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.
