Diabetes and Hemogloblin A1C

In my previous post on diabetes, I wrote about how diabetes can affect pregnancy.  Today, I want to let you know about a blood test used to tell us how well we are managing diabetes.  This blood test is called hemoglobin A1C.


If you are diabetic, do you know your Hgb A1 C level?  Hgb A1 C is a blood test called glycoslated hemoglobin that measures the average sugar level in our blood over a period of time.  When glucose or sugar levels are high, the sugar attaches to the red blood cell.   The longer the high sugar levels remain,  more and more sugar attaches to the red blood cell.  The sugar stays attached to the red blood cell and never leaves.  Our red blood cells have a life span of 100-120 days before it is replaced by a new red blood cell.  The job of a red blood cell is to carry oxygen to the organs of our bodies and remove the waste.   Excess sugar on the red blood cell does not allow the red blood cell to do its job effectively.

The Hgb A1C levels are checked usually every 90 days to see if treatment is working.  This is because of the red blood cell’s life span of 100 days or so.  As the sugar levels become better controlled, there are less red blood cells with excess sugar on them.  The opposite is also true.  The less controlled the sugar the higher the red blood cells with excess sugar, and the higher the Hgb A1C.  The doctor can look at the levels to see if treatment is working.


Why is this Hgb A1 C level so important for pregnancy?   In early pregnancy, the baby makes the organs.  This period of time is coined organogenesis.  If a diabetic woman has high sugar levels, her blood cells don’t work as well.  This can affect the developing baby causing major birth defects.  If high sugar levels continue through the pregnancy, this can lead to stillbirth.  Mom is also at higher risk of problems with  pregnancy such as pre- eclampsia or high blood pressure in pregnancy.  Good sugar control early on but poor sugar  control in the 2nd and 3rd trimesters can result in large babies and complications for mom and baby.

If you are NOT pregnant, the excess sugar in your blood can cause many problems also.  Poorly controlled diabetes can affect every part of our bodies.  Did you know that people with diabetes have a higher risk of heart attack and stroke than those without diabetes?  Diabetes can take away vision and is a leading cause of blindness in the United States.

If our red blood cells are laden with sugar, oxygen cannot get to our tissues, this is especially important to our lower extremities or legs.  Diabetics are at higher risk for amputations of the toes, feet, and legs.  Some diabetics have trouble with their nerves causing pain, numbness, and weakness.  There may be difficulty with walking or performing previously simple tasks.   It could mean difficulty with urinating or having sex.  It could result in kidney failure as the kidneys can no longer remove waste from the body.  It also could mean difficulty with digestion.  And finally, it could mean that the warning signs of a heart attack are muted or silenced.

Diabetics have a harder time fighting infection.   And, once again it is due to the excess sugar interfering with the job of the blood cell.  It is important for a diabetic to see a physician early on if there is a possible infection.  Believe it or not, but oral care also is affected by diabetes.  Dental problems of the mouth and gums are higher in the diabetic.

If you or a loved one has diabetes, it is important to work with your health care provider as a team to keep the sugar in control.   Check your sugars regularly, know your Hgb A1C level, have your blood pressure checked, and have not only your eyes checked but your feet also.  For more information, see your health care provider.  You can also get information
from the CDC or The Center for Disease Control and Prevention.


Cynthia Wilkes MD

Stafford Womens Health Associates

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