Over the years, unintended discoveries in medicine have resulted in huge benefits for patients.
The chance discovery of Penicillin by Alexander Fleming in 1928 is considered by some to be among the most significant achievements of the 20th century.
Another chance discovery of practical value involved the connection between diabetes and Hemoglobin A1c. In 1976, two scientists, Cerami and Koenig were conducting experiments in an effort to find a cure for sickle cell anemia. Their efforts failed because the treatment caused unacceptable side effects.
However, their “eureka moment” happened when the findings suggested there was a special correlation between blood glucose levels and hemoglobin A1c. The higher the glucose levels, the higher the percentage of A1c in the blood. They simply asked; “How could the correlation between glucose and hemoglobin A1c in the blood be put to good use?”
Hemoglobin is a protein found in the red blood cells that gives blood its red color. It carries oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs.
The A1c is a blood test used to diagnose diabetes 2 and pre-diabetes. It also can be used to monitor how well you’re managing diabetes.
When glucose (sugar) becomes elevated in the bloodstream, for example after a meal, it attaches itself to the hemoglobin in the red blood cell. The A1c test measures how much glucose is attached to hemoglobin. It reports this finding in percentages as an average blood glucose level over the past two to three months.
Below is a comparison of A1c to the corresponding average blood glucose in mg.
A1c (%) Average Blood Glucose (mg)
- 6 % = 126 mg
- 6.5 % = 141 mg
- 7% = 154 mg
- 7.5% = 169 mg
- 8% = 183 mg
- 8.5% = 198 mg
- 9% = 212 mg
- 9.5% = 226 mg
- 10% = 240 mg
- 11% = 269 mg
- 12% = 298 mg
IFCC — International Federation of Clinical Chemistry and Laboratory Medicine
The pre-diabetic laboratory finding noted below indicates the body is becoming more resistant to insulin and implies you might benefit by participating in a wellness program
Laboratory Results for Hemoglobin A1c
- Normal range — 4% to 5.6%
- Pre-diabetic — 5.7% to 6.4%
- Diabetic — 6.5% and above
Wellness
If you are pre-diabetic there are actions steps you can take to prevent diabetes and the complications of diabetes. The first steps to consider involve diet, exercise and a program to reach and maintain an ideal body weight. There are fitness programs available to assist you from a nutritional and physical standpoint. Genetic testing may also be a valuable resource as part of a dietary and fitness program.
If you are a diabetic, consider having the A1c test done at least twice a year to monitor your glucose level and any adjustments needed to reach your goals. Remember to inform the physician if you're taking vitamins, herbal or other supplements since they might interfere with an accurate A1c lab report. Also, anemia, liver and kidney disease can cause an inaccurate A1c report.
Glossary
Various names for Hemoglobin A1c:
A1c
Hb A1c
Glycohemoglobin
Glycated hemoglobin
Glycosylated hemoglobin
Diabetes Type 1. The body does not produce insulin.
Diabetes Type 2. The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance).
Pre-diabetes. The body is becoming resistant to insulin
References
Koenig RJ, Peterson CM, Jones RL, Saudek C, Lehrman M, Cerami A (1976). "Correlation of glucose regulation and hemoglobin AIc in diabetes mellitus". N. Engl. J. Med. 295 (8): 417–20.
Sandler Courtney, MD; McDonnell Marie, MD; The role of hemoglobin A1c on the assessment of diabetes and cardiovascular disease; Cleveland Clinic, Journal of Medicine May, 2016
WHO; Use of Glycated Hemoglobine (HbA1c) in the Diagnosis of Diabetes Mellitus; 2011
Ban, Thomas, MD; Role of Serendipity in Drug Discovery; Dialogues in Neurosci; Sept, 2006
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.