Category Archives: HbA1C

Managing diabetes during Covid-19

Due to various reason I was not able to write posts regularly, especially on this pandemic people lost jobs, lost dear ones and their day to day activities got severely affected on all front i.e. financially , emotionally etc.

As we all know that diabetes is chronic illness and very vulnerable to infections due to compromised immune system, what we can do about it and how do make sure that we can keep ourself safe and make people around us safe ?

  • Wash hands thoroughly and regularly.
  • Try to avoid touching your face before you have washed and dried your hands.
  • Clean and disinfect any objects and surfaces that are touched frequently.
  • Don’t share food, glasses, towels, tools etc.
  • When you cough or sneeze, cover your mouth and nose with a tissue or use the crook of your arm if you don’t have a tissue to hand (dispose of the tissue appropriately after use).
  • Try to avoid contact with anyone showing symptoms of respiratory illness such as coughing.
  • Think whether you can make changes that will help protect yourself or loved ones. For example, can you avoid unnecessary business travel? Can you avoid large gatherings? Can you avoid public transport?
  • If you are ill with flu-like symptoms, stay at home.

Please look at the treatment protocol issued by AIIMS https://covid.aiims.edu/protocols-for-management-of-people-with-diabetes-in-covid-facilities/

Stay safe and be safe 🙂

HbA1C test reliable enough to diagnose T2DM

Red blood cell was the most common type of blood cell , its principal work was to delivering oxygen to body tissues via blood flow through the circulatory system, its structure as shown below

cell-structure-and-organisation-23-728

 

Life time : 100 to 120 days after that new cells will be developed from bone marrow

Hemoglobin : iron containing oxygen transport protein in red blood cells

Glycated Hemoglobin:  Due to non-enzymatic glycation pathway  by hemoglobin’s  exposure to plasma glucose . As average amount of plasma glucose increases  the fraction of glycated hemoglobin also increases in predictable way so to measure average glucose level over 3 months this will be useful to find out the control of blood glucose level in type 2 diabetic patients.

Hb_HbA1c_Comparison_2

 

Is HbA1C is good candidate to diagnose T2DM ?

The answer might be sometimes false positive due to various reasons or other conditions people might face that might require additional test such as Post prandial blood sugar might be needed to confirm.

Given below were some of the cases HbA1c may be spuriously elevated or depressed

  • Recent transfusion
  • Hemolysis or blood loss
  • asplenia
  • Anemia
  • Hemoglobin C disease
  • Chronic alcohol [Skew]
  • ingestion of large amount of vitamin C & E [Skew]

since HbA1c measurement was crucial one so its good to be familiar with factors affecting the test  in general and limitations.

HbA1c was the gold rule to find out the control mechanism of diabetes in that no one has doubt but when it comes to diagnose new diabetic patients that test might interfere with other conditions which will falsify the test result so if there was skewed / elevated result of HbA1c its worth to measure PPBS to confirm or diagnose Type 2 diabetes.