Diabetes: Significance of HbA1c Testing

What is Diabetes?

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Hyperglycemia, also called raised blood glucose or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels.

Diabetes’ effect in the World

According to World Health Organization, Diabetes is a major threat to global public health that is rapidly getting worse. International Diabetes Federation (2006) predicted that Asia will have the largest absolute increase from 66,993,000 to 99,401,000 estimated individuals with diabetes between 2007 and 2025. As of 2019, International Diabetes Federation (IDF) data showed that in the Western Pacific, the Philippines ranks fifth—behind China, Indonesia, Japan, and Thailand—in the number of diabetics. IDF, an umbrella organization of over 230 national diabetes associations in 170 countries and territories, projected that by 2030, the number of adults with diabetes in the Philippines will further rise to 5,289,700 and an estimated 7,267,400 by 2045.

Diabetes in the Philippines

In the Philippines, diabetes is rapidly becoming a major public health issue, as in other low- and middle-income countries. Availability and affordability of care and medicines are crucial to control diabetes. According to the data gathered by the Philippine Health Statistics, as of 2023, Diabetes is the fourth leading cause of death among Filipinos. As of 2019, International Diabetes Federation (IDF) data showed that 3,993,300 of the then total 63,265,700 Filipino adult population have diabetes, with a 6.3 percent prevalence of diabetes in adults. As a chronic illness, diabetes can also bring about an increased risk of developing heart disease and stroke. Furthermore, if diabetes is left untreated, there are more serious complications may occur such as blindness, kidney and heart failure, loss of limb, and reduced life expectancy. The mortality rate among Filipinos from the disease has also increased during the past years. Data from Philippine Statistics Authority shows that from the average 32,991 deaths between 2015 to 2019, the figure rose to 37,265 in 2020.

Rapid urbanization with increasing dependence on electronic gadgets and sedentary lifestyle contributes significantly to this epidemic. It cannot be ignored that diabetes is a prevalent disease among many Filipinos. However, unlike many diseases whose symptoms can be treated easily, diabetes has no known cure. It can only be monitored and controlled, with some individuals even going into remission. To better manage diabetes, management of blood sugar levels complemented by a good understanding of the disease would be required. 

What is HbA1c?

The hemoglobin A1c (HbA1c) test measures the amount of blood sugar (glucose) attached to your hemoglobin. Hemoglobin is the part of your red blood cells that carries oxygen from your lungs to the rest of your body.

High A1C levels are a sign of high blood glucose from diabetes. Diabetes can cause serious health problems, including heart disease, kidney disease, and nerve damage, but with treatment and lifestyle changes, you can control your blood glucose levels.

HbA1c is your average blood glucose (sugar) levels for the last two to three months. If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below. Knowing your HbA1c level and what you can do to lower it will help you reduce your risk of devastating complications. This means getting your HbA1c checked regularly.

Why is testing HbA1c important?

While fasting and post-meal blood glucose tracking are crucial for managing diabetes, its important to recognize their limitations. These tests provide a snapshot of your blood sugar levels at a specific moment, influenced by recent meals and other factors. In contrast, HbA1c test offeres a comprehensive view, reflecting your average blood glucose levels over the past three months. This makes it a more reliable indicator of long-term blood sugar control, free from the biases of daily fluctuations. Understanding these differences can empower you to make informed decisions about your health management.

For persons having diabetes, HbA1c numbers give a fair idea of how controlled their diabetes is. As per scientific evidence, having a smaller HbA1c number means lesser risk of developing complications due to diabetes. Raised HbA1c value has also been regarded as an independent risk factor for heart disease and stroke in people with or without diabetes. 

A1C results tell you what percentage of your hemoglobin is coated with glucose. The percent ranges are just a guide to what is normal. What's normal for you depends on your health, age, and other factors.



To diagnose diabetes or prediabetes, the percentages commonly used are:
Normal: A1C below 5.7%
Prediabetes: A1C between 5.7% and 6.4%
Diabetes: A1C of 6.5% or higher

Who needs and HbA1c Test?

The U.S. Centers for Disease Control (CDC) recommends A1C testing for diabetes and prediabetes if:
You are over age 45.

• If your results are normal, you should repeat the test every 3 years.
• If your results show you have prediabetes, you will usually need to be tested every 1 to 2 years. Ask your provider how often to get tested and what you can do to reduce your risk of developing diabetes.
• If your results show you have diabetes, you should get an A1C test at least twice a year to monitor your condition and treatment.

You are under 45 and are more likely to develop diabetes because you:

• Have prediabetes.
• Are overweight or have obesity.
• Have a parent or sibling with type 2 diabetes.
• Have high blood pressure or high cholesterol levels.
• Have heart disease or have had a stroke.
• Are physically active less than 3 times a week.
• Have had gestational diabetes (diabetes during pregnancy) or given birth to a baby over 9 pounds.
• Are African American, Hispanic or Latino, American Indian, or an Alaska Native person. Some Pacific Islander and Asian American people also have a higher risk of developing diabetes.
• Have polycystic ovarian syndrome (PCOS).

You may also need an A1C test if you have symptoms of diabetes, such as:

• Feeling very thirsty
• Urinating (peeing) a lot
• Losing weight without trying
• Feeling very hungry
• Blurred vision
• Numb or tingling hands or feet
• Fatigue
• Dry skin
• Sores that heal slowly
• Having more infections than usual

The Gold Standard in HPLC Technology

Ion-Exchange HPLC System: D-10: Aid Physicians to Diagnose Pre-Diabetes, Diabetes and Monitor Patients Living with Diabetes

• Confidently report accurate HbA1c results in the presence of HbAS, HbAC, HbAD, HbAE and elevated HbF
• Streamline your operational efficiency by testing for pre-diabetes and diabetes on a single platform
• Monitor patients living with diabetes to see how well their treatment plan is working
• Physicians can make treatment decisions using a HPLC "Gold Standard" method free from variant and drug interference

Experience the Proven Power of the D-10

Why Clinicians Value HPLC for Accurate A1c Results?

Not all HbA1c assays are created equally. Given our history and experience in HbA1c and β-thalassemia testing, it’s no wonder that over 9,000 of your peers around the world have chosen the D-10 System over other methods.

Bio-Rad ion-exchange HPLC provides a complete picture.

Our HPLC technology provides both a numerical result and a visual picture of the separated hemoglobins, distinguishing hemoglobin fractions based on charge differences. Other methods cannot provide this clinical information. A chromatogram helps clinicians see potential interferences that may affect their patients’ HbA1c results and help explain discordant results in the presence of interferences so they can choose the appropriate treatment.

Trusted by over 230 institutions and laboratories nationwide!