Technology is a wonderful thing. Sometimes products of technology may be entertaining, while others are incredibly impactful. The A1C test is an example of the latter.
When I started providing diabetes education, we didn’t have glucometers, the devices that test blood sugar in seconds. Instead, folks had to check their urine to see if sugar was “spilling” into their urine. Type 1 diabetics had the choice of either bovine (from cattle) or porcine (from pigs) insulin and often developed antibodies to it as it was from another species, complicating blood sugar control.
Now glucometers are common, and we have insulin that not only matches what humans produce, but have it modified to act quickly or slowly. The number of other medications to manage diabetes is mind-boggling, as are the modes of actions used to accomplish that management. Technology has had a huge impact on diabetes care and the A1C test is another example of this.
According to the National Institute of Health Diabetes, Digestive & Kidney Diseases, the A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past three months. The A1C test has been used for decades to help folks with diabetes understand their blood sugar control. Since it reflects an average, it provides more information than a simple blood sugar check, which tells you what it is only for that moment in time.
An example of the practical side of this would be an individual testing fasting blood sugars with consistently normal results. If that individual’s A1C is high, then the message it provides is that maybe the fasting blood sugar is good, but blood sugar is elevated later in the day. Why is that important? A primary goal of good blood sugar control is to avoid the complications of diabetes, such as damage to the eyes, kidneys, heart, and lower extremities. An elevated A1C could indicate that goal is not being met.
Now, just as we have glucometers to instantly check blood sugar, we also have a machine that tests A1C. Results are available in three minutes! So why is this valuable? As stated above, the fasting blood sugar check has been valuable as a screen and management tool for diabetes or pre-diabetes, but it simply reflects that moment’s blood sugar. An A1C test could be more reflective of individual’s actual blood sugar status over the past several months.
The 2011 Diabetes in Iowa supplement to the 2009 Iowa Chronic Disease Report states that 174,000 of Iowa adults have diabetes, 120,000 have undiagnosed diabetes, and 670,000 have pre-diabetes. The A1C test is a good indicator of blood sugar management which takes the whole picture into consideration, instead of just a piece. Technology has once again given us a tool that may help us avoid the damage of diabetes before it gets a foothold.