This blood test measures the percentage of RBCs (red blood cells) saturated with glucose. RBCs live about 120 days. During that span they can slowly be glycosylated by high levels of serum glucose. Assuming the average age of an RBC to be 60 days, this test reveals what your glucose levels have averaged over the course of the past two months. By comparison, the fasting glucose only measures the glucose level after eight or more hours for fasting, with no stress on glucose metabolism.
For the past several years the A1c has been used to monitor diabetics to see how effective they are managing their disease. However, in July of 2015, the A1c was established as the medical standard for diagnosing diabetes. This big step forward that has met with either resistance or indifference from the medical community as less than half of primary care physicians currently order this test for their patients.
The new standard recommends physicians begin to test patients who are obese between the ages of 40 and 45. I have been using this test on my patient population for several years. I do not restrict the test by age or weight status. Clinically, I have found that this test often begins to elevate in patients by their late 20’s, even when they are at ideal weight.
The normal range for the A1c is 4.8 to 5.6%. However, the diagnosis of diabetes is restricted to levels at or above 6.5%. A “well controlled diabetic” will have an A1c of 7% or less. Levels between 5.6 and 6.5% are considered “pre-diabetic”. Currently, over 50% of all Americans are estimated to be either diabetic or pre-diabetic and that percentage is still increasing.
In my office, anyone exhibiting symptoms of metabolic syndrome – central obesity, hypertension, high serum lipids, hypothyroidism, or insulin resistance – is a candidate for A1c testing, regardless of age. Additionally, using the QA (Quintessential Applications) protocol, if a patient tests for sesame seed oil to block prostaglandin inflammation (PG2) I also recommend an A1c. Clinically, over 90% of patients demonstrating a need for sesame seed oil have an elevated A1c. The remaining 10% typically have altered serum lipids or hypothyroidism.
