A1C test helps determine diabetes risk
Q: I switched to a new doctor, and she wants me to get a bunch of blood tests. One is a blood test called an A1C. She says it's for diabetes, but I already know I'm not diabetic. I don't need insulin, and sugar doesn't bother me. Are all of these tests really necessary?
A: It sounds as if your new physician is doing a complete work-up to get a sense of your general health. This typically begins with your personal medical history, which includes details about your lifestyle, allergies, previous illnesses or surgeries, any medications or supplements that you're taking, and immunizations that you have had. Information about a family history of illness, such as cancer, is also important.
In addition to a medical history and a physical exam, some doctors may also ask for blood tests, often referred to as blood work. These can include a complete blood count, which analyzes your blood and its components, and a metabolic panel, which looks at certain chemicals, enzymes and lipids in the blood. Blood tests can reveal a lot about your metabolism, immune system and organ function. They are also important tools in helping to identify a range of diseases and conditions. Any blood work you have done now will serve as a baseline against which any future changes to your health can be assessed.
While you don't have Type 1 diabetes, which requires insulin injections or an insulin pump to keep blood sugar levels within a healthful range, you may still be at risk of developing Type 2 diabetes. That's a condition in which the body doesn't produce enough insulin, and the cells within the body don't respond to insulin adequately. This results in too much glucose circulating in the blood, which poses a serious health risk. And although you say sugar doesn't bother you, unfortunately, high blood glucose isn't something that you can necessarily feel.
The A1C test measures your average levels of blood glucose, or blood sugar, over the previous three months. Glucose attaches to the part of the blood known as hemoglobin. The higher the level of glucose in your bloodstream, the more of it will attach to the hemoglobin. The result of an A1C test shows whether someone has prediabetes or Type 2 diabetes. It can also indicate whether or not someone living with diabetes is successfully managing the disease.
Risk factors for prediabetes and Type 2 diabetes include being overweight, storing fat in the abdomen, being sedentary and having a family history of the disease. Because the risk of developing the disease increases with age, an A1C test is often recommended for people over the age of 45.
Type 2 diabetes can adversely affect the heart and kidneys, contribute to high blood pressure, and lead to damage to the eyes, blood vessels and nerves. It also increases the risk factors of a range of chronic diseases. If you have any of these risk factors, agreeing to the A1C test would be wise.
• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to email@example.com.