What is HbA1c?
HbA1c stands for glycated hemoglobin, a form of hemoglobin (the oxygen-carrying protein in red blood cells) that gets coated with sugar. But to understand HbA1c, we first need to understand glycation.
What is glycation?
Think about when you toast bread or grill meat: it turns brown. This happens because sugars react with proteins, creating a browning effect. This same process, called glycation, happens inside your body when sugar sticks to proteins.
Your body also has a similar but controlled process called glycosylation, which requires enzymes. However, glycation happens without enzymes and can cause problems if sugar levels get too high.
How does this relate to HbA1c?
Red blood cells carry oxygen throughout your body and depend entirely on glucose for energy. Since blood contains both glucose and hemoglobin, some hemoglobin naturally gets coated in sugar. This sugar-coated hemoglobin is called HbA1c.
Red blood cells live for about 120 days, so HbA1c is a measure of your average blood sugar levels over 2 to 3 months.
- Normal HbA1c: below 5.4 to 5.5%
- Prediabetes: between 5.7% and 6.4%
- Diabetes: 6.5% and above
If your HbA1c is 7%, your average blood sugar is around 150 mg/dL, which is dangerously high.
Why is high HbA1c so dangerous?
Excess sugar doesn’t just stick to hemoglobin. It attaches to many proteins in your body, including collagen (a protein that keeps skin and joints healthy). This leads to issues like:
- Skin darkening (acanthosis nigricans). High sugar levels cause patches of dark, thickened skin.
- Stiff blood vessels. Excess sugar makes arteries rigid, increasing the risk of high blood pressure, heart disease, stroke, and kidney damage.
- Organ damage. High blood sugar affects the eyes, nerves, kidneys, and heart, leading to blindness, nerve pain, kidney failure, and even amputations.
Diabetes damage starts early
The damage doesn’t start when you’re diagnosed with diabetes. It begins the moment your HbA1c goes above the optimal range.
Even slightly high sugar levels increase the risk of serious diseases over time.
That’s why keeping blood sugar in check is crucial, not just for diabetics but for everyone.
Also published on Medium.