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According to a study by researchers at the Johns Hopkins Bloomberg School of Public Health measurements of haemoglobin A1c (HbA1c) more accurately identifies people at risk for diabetes and other clinical outcomes than the more commonly used fasting glucose measurement.

HbA1c levels were shown in this study to accurately predict future diabetes, and better predict stroke, heart disease and all cause mortality as well. The study appeared in the March 4, 2010 issue of the New England Journal of Medicine (NEJM), by Elizabeth Selvin and colleagues. The study measured HbA1c in blood samples from more than 11,000 adults (both black and white) who had no history of diabetes.

This study follows the wave of change in the recommended way doctors diagnose diabetes. In January 2010, the American Diabetes Association revised their clinical practice guidelines for the screening and diagnosis of diabetes. The revised ADA recommendations include for the first time the use of HbA1c to diagnose diabetes and to identify people at risk of developing diabetes in the future, called pre diabetes. The ADA stated that Hb1Ac may be added to fasting plasma glucose and the oral glucose tolerance test as an option for diabetes screening and diagnosis.

HbA1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months. It does this by measuring the concentration of glycated (also called glycosylated depending on which side of the Atlantic one is) haemoglobin A1c. This test is usually used to monitor diabetes treatment in someone who has been diagnosed with diabetes. It helps to evaluate how well their glucose levels have been controlled by treatment over time.

HbA1c has some advantages over fasting glucose measurements: low day to day variability in glucose levels; the results are more stable and less affected by stress and illness; and the patient is not required to fast prior to performing the test.

The new findings can help doctors and patients interpret HbA1c test results in clinical practice and help identify people who need treatment the most. In this study, people with HbA1c levels between 5.0 – 5.5 were identified as within the ‘normal’ range. With each incremental HbA1c increase, the study found the incidence of diabetes increased as well. For more details on how to interpret the levels please click here.

Selvin E et.al (2010) Glycated haemoglobin, diabetes and cardiovascular risk in nondiabetics adults. NEJM, 362 (9):800-811.

American Diabetes Association (2010) Standards of Medical Care in Diabetes – 2010. Diabetes Care, 33:S11-S61

American Diabetes Association (2010) Summary of Revision for the 2010 Clinical Practice Recommendations. Diabetes Care, 33:S3

American Diabetes Association (2010) Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 33:S62-S69.

Lisa Fouladi Balance Ur Bod Nutrition Consultancy

Lisa, principle consultant and founder of balance ur bod nutrition consultancy is a qualified nutrition therapist (dip.ION), a Nutrition Therapy Council registered practitioner, and a current member of the British Association of Applied Nutrition and Nutrition Therapy (BANT) and is bound by their codes of ethics and practice. She is fully insured, and dedicated to continuous study of current research and industry developments through Continued Professional Development (CPD).

In keeping with her quest for knowledge, Lisa is currently enrolled in yet another degree program, an MSc at the University of London (London School of Hygiene and Tropical Medicine) which she hopes to complete someday.

Although based in Zürich, Switzerland, she sees clients in the Geneva area, in Germany (Münster area) and in the UK (London and Windsor areas).

Lisa conducts one to one consultations with clients, advising on all aspects of nutrition and the effect food and lifestyle choices have on health and well being. Lisa works closely with her clients, assessing and identifying imbalances and individual needs, and supporting them in making the necessary dietary and lifestyle changes. She is deeply committed to supporting her client’s health through nutrition and stays at their side throughout the process.