Glycated hemoglobin (clinical analyzes)



Hemoglobin is a protein found inside red blood cells and is responsible for transporting oxygen from the lungs to the whole body.

Circulating glucose in the blood can bind to hemoglobin in red blood cells, thus forming molecules of glycated or glycosylated hemoglobin (HbA1c or A1c). In non-diabetic people, glycated hemoglobin is less than 6.5% of the total hemoglobin. In people with diabetes, if there are high levels of glucose in the blood, more glycated hemoglobin is formed which, therefore, exceeds 6.5% of the total hemoglobin.

The HbA1c test is performed on the blood and provides an "indication of the average blood glucose levels in the last two or three months prior to the blood draw. The glycated hemoglobin dosage is, therefore, a good clinical indicator for monitoring glycemic control. over time and the effectiveness of diabetes care over the past three months.

In addition, this test can be prescribed by the doctor to diagnose diabetes or to identify people at high risk of diabetes, in which high levels of glycated hemoglobin will be found, or to monitor the effectiveness of diabetes treatment in the last three months.

The test

The measurement of hemoglobin (HbA1c) is a very simple test, has no contraindications and is carried out by simply taking blood from a vein in the arm.

The HbA1c test can be performed at any time of the day and does not require any special preparation such as, for example, fasting.After the blood sample, you can go back to normal activities.


The results of the glycated hemoglobin (HbA1c) test can be expressed in two ways:

  • in millimoles / molar (mmol / mol), SI units (International System)
  • in percentage (%)

The reference values ​​are as follows:

  • HbA1c less than 39 mmol / mol (5.7%): normal values
  • HbA1c of 39-46 mmol / mol (5.7-6.4%): impaired glucose tolerance
  • HbA1c 47 mmol / mol (6.5%) or higher: diagnosis of diabetes or poor treatment efficacy

In healthy people, the glycated hemoglobin (HbA1c) value remains around 5%.

The American Diabetes Association recommends that people with diabetes keep values ​​below 7%. Recent studies have shown that people with diabetes who maintain HbA1c levels within 7% are more likely to prevent, and possibly delay, the complications that this disease can entail.

Values ​​above 8-9% indicate a high risk of developing or witnessing a worsening of chronic diabetes complications.

The result of the examination can be influenced by some factors:

  • haemolytic anemia
  • sickle cell anemia
  • Mediterranean anemia
  • hemorrhage
  • iron deficiency
  • pregnancy
  • kidney failure
  • splenectomy (the surgery to remove the spleen)
  • blood transfusions

The glycated hemoglobin, therefore, represents one of the most important parameters used by the doctor to define the most appropriate care for the person with diabetes.

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