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HBA1C for Diagnosis PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Hba1c for diagnosis"by Dr Karen Adamson.

This medical PowerPoint presentation talks about HbA1c (hemoglobin A1c), a blood test that is used to diagnose and monitor diabetes. It measures the average blood sugar level over the past two to three months. A diagnosis of diabetes is made when the HbA1c level is 6.5% or higher.

However, it is important to note that HbA1c levels can be affected by certain conditions, such as anemia, kidney disease, and liver disease, among others. Additionally, some medications, such as iron supplements and vitamin C, can affect HbA1c levels. Therefore, it is important to discuss any underlying medical conditions or medications with your healthcare provider before using HbA1c as a diagnostic tool.

Overall, HbA1c is a useful tool for diagnosing and monitoring diabetes, but it should be used in conjunction with other tests and evaluations to make a definitive diagnosis.

Tags : HbA1c, hemoglobin A1c, blood test, diabetes, endocrinology, endocrinology PowerPoint presentation

Published on : Apr 18, 2023 | Views : 2090 | Downloads : 0

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Slide 1-

Hba1c for diagnosis Dr Karen Adamson
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β-chain α-chain Glucose bound to N-terminal valine of β-chain
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What is HbA1c? • Glucose binds irreversibly to haemoglobin in red blood cells, forming HbA1c • The higher the glucose, the higher the HbA1c • HbA1c reflects the prevailing blood glucose over the preceding 2-3 months
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Why Measure HbA1c? • Serial measures show how an individual’s glucose control, and thus risk of complications, change in response to alterations in management • Measure 2-6 monthly • Set individual target levels
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What Are The Limitations of HbA1c Measurement? • Abnormal red cell turnover • Abnormal haemoglobin • Renal disease • Liver disease • Pregnancy – HbA1c falls by ~0.5 %
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HbA1c as an Indicator of Glycaemic Control
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Available Measures of Glycaemic Control Fasting Plasma Glucose (FPG)* Preferred test for diagnosis (mmol/l or mg/dL) Snapshot of glycaemia Oral Glucose Tolerance Test (OGTT) Response to glucose challenge, can be used to diagnose disease HbA1c (Glycated Haemoglobin) Long-term measurement of glycaemic control (~3 months) Postprandial Glucose (PPG) Glucose level after eating (mmol/l or mg/dL)** Random Blood Glucose (RBG) Measures blood sugar at any point in time, normal levels not defined Continuous Glucose Monitoring (CGM) Assesses how blood glucose levels react to insulin, exercise and meals *measured after at least 8 hours of fasting; **measured 1- 2 hours after eating
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Not suitable for HbA1C Rapid onset of diabetes Suspected T1DM – see symptomatic patient flowchart Drug-induced: steroids, anti-psychotics, immunosuppressants – a fasting glucose may not be sufficient. Seek advice from diabetes team. Pancreatic disease. Seek advice from diabetes team. Pregnancy – HbA1C reduced in pregnancy. Gestational diabetes should be diagnosed by OGTT. N.B. OGTT diagnostic criteria are lower than for the general population. Conditions affecting Hb turnover / HbA1C assay Haemoglobinopathy Haemolytic anaemia Severe blood loss, Blood transfusion Splenomegaly / Splenectomy Renal dialysis +/- erythropoitein Anti-retrovirals, ribavarin, dapsone
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Symptomatic patient + random glucose fasting glucose ≥7.0 mmol/L ≥11.1 mmol/L Thirst, polyuria Recurrent infection Unexpected weight loss Blurring of vision Discoloured/ulcerated feet or = DIABETES Diagnosis of diabetes mellitus in symptomatic patients Severe symptoms URGENT HOSPITAL ADMISSION Mild symptoms ?ketotic vomiting / dehydration URGENT discussion with diabetes team (may need insulin therapy) ketonuria (or ketonaemia*) *ketones can be measured on some POC glucometers young age OR Full assessment & initiate management of Type 2 Diabetes
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suitable for HbA1C? * YES NO HbA1C OGTT not diabetic high risk diabetes ≥48 mmol/mol 42 – 47 mmol/mol ≤41 mmol/mol not diabetic high risk diabetes fasting glucose ≤6.0 2-hr glucose mmol/L mmol/L ≤7.7 AND OR OR 6.1 – 6.9 7.8 – 11.0 ≥ 11.1 ≥ 7.0 All glucose measurements used for diagnosis must be laboratory samples Diagnosis of diabetes mellitus in asymptomatic patients random glucose fasting glucose ≥7.0 mmol/L ≥11.1 mmol/L not diabetic high risk diabetes ≥7.0 mmol/L 6.1 – 6.9 mmol/L ≤6.0 mmol/L INITIAL lab glucose repeat fasting glucose (repeat blood test on a separate day) Consider HbA1C (repeat on separate day) (random OR fasting)