Blood is composed of four key elements: red blood cells, white blood cells, platelets and plasma.
• Red blood cells or hemoglobin are responsible for transporting oxygen and carbon dioxide in the body.
• White blood cells are an integral part of the body’s immune response.
• Platelets facilitate clotting.
• Plasma is a yellowish fluid composed primarily of water which makes up 55% of the total blood volume.
When glucose is present in the blood stream, it attaches itself to hemoglobin through glycosylation. The process is permanent, and the glucose remains attached to the hemoglobin for the life of the red blood cell (approximately 120 days).
Physicians utilize A1C tests to measure the amount of glucose attached to a person’s red blood cells, allowing the analysis of overall glucose regulation. The normal level of A1C in healthy non-diabetics is 5% or less, and glucose management often works to achieve A1C levels under 7% in diabetic patients.
Measuring A1C levels provides physicians an opportunity to assess the overall effectiveness of therapy, which gives insight into the long-term health of the patient. The greatest concern for diabetics who poorly mange their disease is the high concurrent risk of developing serious co-morbidities later in life. Maintaining consistent A1C levels is a gauge of how effective the current therapy is at limiting the long-term risk. However, A1C levels are not fully indicative of a patient’s glucose management, as they do not capture unwanted glucose level fluctuations that may be occurring on a daily basis. The concept of glucose variability is becoming widely accepted with improvements in diagnostic technology.