How the A1C test works
The full name of this test is the heamoglobin A1c (HbA1c) test. If you cast your mind back to your school biology lesson, you'll recall that haemoglobin sits inside of red blood cells and is reponsible for transporting oxygen and glucose to cells.
When the haemoglobin binds to the glucose (blood sugar
), it converts to haemoglobin A1C which stays that way for the lifetime of the red blood cell - which is about two to three months.
And, that's what the A1C test measures. The percentage of haemoglobin A1C in your blood over a two to three month period.
But there are a number of things that skew the results of this test - find out below what they are - and also about another more accurate test you should ask your doctor for.
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When the A1C test says you're diabetic or pre-diabetic and you're not...
The following circumstances can raise your A1C test results:
Deficiency in iron, vitamin B12, or folate (vitamin B9)
If you're low on these nutrients, your body can't make enough new red blood cells to replace old, dying ones, so the test measures the percentage of A1C in old, saturated red blood cells.
Kidney failure or chronic kidney disease
Malfunctioning kidneys lead to a low absorbtion of vitamins and minerals, which also means your body isn't able to make new red blood cells as well as it used to.
Very high triglycerides
Triglycerides are a type of fat
in your blood. Too much of it - over 1,750 mg/dL - makes your A1C levels seem higher than they really are. If you have heart problems, know your triglyceride levels.
If you've had your spleen removed
The spleen's job is get rid of old, damaged red blood cells. Without the spleen to tidy up, you have more old red blood cells in your bloodstream which makes your A1C test results higher.
The test can also yield inaccurate results the other way too - keep reading...
When the A1C test says you don't have pre-diabetes or diabetes but you really do...
High doses of iron and B vitamins
If you're taking iron or B vitamins in high doses, for the treatment of anaemia for example, your body is making more red blood cells than it normally does which can lower the results of the A1C test.
You've donated blood
If you've lost a significant amount of blood, your body goes to work straight away to make more red blood cells, more quickly than it noremally does, which can skew the test results.
During the first two trimesters of pregnancy, your body is very busy making lots of new red blood cells to get oxygen to the baby. This too will skew results.
If you're taking high doses of vitamin E, it can reduce the number of red blood cells that have glucose attached to them. This can cause your A1C test to be falsely low.
Treatment after chemo, and a few other pharmaceutical drugs can alter the results of A1C levels, as can an autoimmune disease like haemolysis.
Now that you know what can affect your blood sugar test, you'll know to tell your doctor so that he can perform an entirely different test to measure your blood sugar levels more accurately. Find out which test to ask your doctor for below...
The more accurate blood sugar test
There is another test that's far more accurate, but if you think you may need it, remember to fast overnight before the test (opt for a morning doc appointment). Your doctor will ask you to drink a sugary drink before the test.
It's called the oral tolerance glucose test, and you should ask for it if any of the above situations apply to you - or you just want to be sure.