What are the A1C diabetes benefits? A1C test help better assesses diabetes; its management and prevent diabetes complications.
6 Benefits of A1C in Diabetes Control
Blood glucose and A1C test have many advantages that help people with diabetes to achieve the target.
- Useful to cross-check self-testing results - A1C tests help, how correctly you are doing self-monitoring. Many errors in your home glucose test became known and help you to correct it. Thus value for your money, time, and efforts.
- Assess diabetes treatment - Help confirms whether the treatment regimen suits you or need modification. If your A1C result is not within the target, then you need to change for effective diabetes treatment.
- Help to fix healthy choices - A1C helps assess your diabetes medication. Additionally, contributing to evaluating other lifestyle changes you have just adopted.
- Improves diabetes treatment - Once you have achieved your A1C target. Try achieving next stringent goal by enhancing the treatment.
- Help to avoid diabetes complications - Achieving good A1C range stops various diabetes complications. Common among them is nerve damage, eye & oral problems, heart attack, sexual dysfunction, and depression.
- Diagnose pre-diabetes & diabetes – A1C is a useful tool for early diagnosis of pre-diabetes and diabetes. Additionally, it helps to change your lifestyle to stop its progression towards diabetes.
The wise man forgets insults as the ungrateful forget benefits. ~ Chinese Proverb
A1C Use in Diabetes Diagnosis
International Organization recommends A1C as one of the tests for diabetes and pre-diabetes diagnosis.
You know type 2 diabetes progress for months before full-blown diabetes. During this time, your blood glucose level may fluctuate, and you may miss out the high level. A1C shows the 3-month average, thus helps early diagnosis of diabetes.
Impaired glucose tolerance and fasting glucose tests are still necessary tests for a diabetes diagnosis. It is because A1C has drawbacks due to anemia or other conditions that result in false low or high.
An A1C test percentage result is useful in diabetes diagnosis. The result range and its meaning are:
- Optimal: 4.1-4.6%,
- Sub-optimal: 4.7-5.1%,
- Normal: 5.2-5.6%,
- Pre-diabetes: 5.7-6.4%,
- Diabetes: 6.5% & over.
How practical is the A1C test for diabetes diagnosis?
Diabetes and pre-diabetes screening with A1C test differ from oral glucose tolerance tests (OGTT). The proposed A1C diagnostic criteria are insensitive and race-wise disagreeable for detection. It might miss most Americans with undiagnosed diabetes and pre-diabetes. Reference: "Screening for Diabetes and Pre-Diabetes with Proposed A1C-Based Diagnostic Criteria." Diabetes Care 2010 Oct; 33(10): 2184-2189.
Advisable to use A1C, Fasting blood glucose and OGTT combination for early diabetes diagnosis.
A1C test sensitivity limits its applicability for a diabetes diagnosis. It might miss or delay the diagnosis of type 2 diabetes. OGTT is also failing to identify a vast number of individuals with A1C of more than 6.5%.
Studies confirm A1C importance to avoid diabetes complications.
Popular studies DCCT, UKPDS, EDIC & EPIC-Norfolk, confirms the link between A1C and diabetes complications.
Popular studies establish the connection between A1C and diabetes complications; they are:
- The Diabetes Control and Complications Trial (DCCT) Study Findings; Intensive BS control reduces the risk of eye disease by 76%, kidney disease by 50%, and nerve disease by 60%. In participants who had eye damage at the beginning of the study, stringent control slowed its progression by 54%.
- The United Kingdom Prospective Diabetes Study (UKPDS) showed a continuous relationship between the risks of microvascular complications and glycemia. For every percentage decrease in Hba1c (e.g., 9 to 8%), there was a 35% reduction in the risk of complications.
- Epidemiology of Diabetes Interventions and Complications (EDIC) Study shows intensive BS control reduces diabetes complications. It shows to reduce the risk of cardiovascular disease by 42%, nonfatal heart attack, stroke, or death from cardiovascular causes by 57%.
- Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk) Study shows people with 6% compared to those with a 5%, had a 28% increase in cardiovascular death.
A1C of 8% for the last 5 years may have a lesser risk than A1C of 7% for the last 20 years. The risk is a product of these two factors A1C and length of time.
HbA1C is the only parameter used in all studies. It is a gold standard shown to correlate well with the risk of complications. Another critical factor is duration.
Is there any proof that lowering A1C can reduce the chances of complications?
Studies DCCT & UKPDS showed A1C lowering slow or prevent the development of nerve, eye, and kidney disease. The studies also showed if people with diabetes lower their A1C by any amount would improve their health.
A 1% reduction in A1C has shown to lower the risk of many complications by 37% in people with diabetes.