Timely diagnosis and management is critical to preventing diabetes complications

1000 people will be tested for HbA1c in the forthcoming 26th Perfect Health Mela in memory of Shri Arun Jaitley

The A1c or glycosylated haemoglobin test is recommended as a diagnostic test for diabetes by the American Diabetes Association (ADA).

In a 2009 consensus report, an International Expert Committee recommended that A1c level ≥6.5% be used to diagnose diabetes. This cut-off has been affirmed by the ADA. A1c level ranging between 5.7 and 6.4%, along with a repeat A1c test has been confirmed by the ADA as indicative of increased risk for developing diabetes

A1c offers several advantages over glucose testing such as increased patient convenience since it requires no special preparation or timing (or fasting); less daily variability and correlation of A1c levels with retinopathy.

A1c goals in patients with diabetes should be individualized and balanced with the demonstrated benefits with regard to prevention and delay of microvascular complications and the risk of hypoglycemia.

  • A reasonable goal of therapy might be an A1c level of ≤7.0% for most patients (using a Diabetes Control and Complications Trial [DCCT]/United Kingdom Prospective Diabetes Study [UKPDS]-aligned assay in which the upper limit of normal is 6.0%). To achieve this value, the target blood sugar levels usually recommended are fasting glucose 80-130 mg/dL and postprandial glucose less than 180 mg/dL.
  • In the elderly and patients with comorbidities, a history of severe hypoglycemia or other significant adverse medication effects or polypharmacy, or a limited life expectancy and little likelihood of benefit from intensive therapy, the A1c goal should be set somewhat higher (e.g., <8%).
  • More strict control is indicated during pregnancy (A1c <6%)
  • The A1c goal for patients with type 1 diabetes is suggested to be <6.5%, if this can be achieved safely.
  • A1c should be tested twice in a year in patients who are meeting treatment goals and who have stable glycemic control, whereas patients whose therapy has changed or requires adjustment, or who are not meeting glycemic goals should be tested quarterly.
  • If interpretation of the A1c result is problematic (hemoglobinopathies, hemolytic anemia), resulting in discrepancies between A1c and true mean glycemia (detected by more intensive or targeted self-monitoring of blood glucose or use of continuous glucose monitoring), glucose testing should be used to assess degree of control.

The complications of diabetes, both microvascular (nephropathy, neuropathy, retinopathy) and macrovascular (coronary artery disease, peripheral arterial disease, stroke) are well-known to all. A timely diagnosis followed by appropriate management is critical to preventing or delaying the onset of these complications.

Heart Care Foundation of India (HCFI) is organizing a free Diabetes Check-up camp at the 26th Perfect Health Mela starting 18-20 October at Delhi Jawahar Lal Nehru Stadium.

As part of this camp, 1000 people will be tested for HbA1c in memory of Shri Arun Jaitley. Every day, 300 people will be tested for A1c levels. The testing will be done by Dr Dangs Lab.

We thank Sh Arun Rai Ji and Sh Saurabh Goenka Ji for their help.

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