‫كلية الحكمة الجامعة‬

‫قسم طب االسنان‬
‫‪Biochemistry lab‬‬
‫‪Blood glucose and HbA1c‬‬
‫م‪.‬م صفا ناجي‬
GLUCOSE TEST
• Glucose is the most important carbohydrate fuel in the body. In the fed state, the majority
of circulating glucose comes from the diet; in the fasting state, gluconeogenesis and
glycogenolysis maintain glucose concentrations.
• Laboratory determinations are usually done on venous sample.
• Glucose concentration may be determined in whole blood, plasma, or serum samples. If
whole blood is used, the concentration will be lower than if plasma or serum is used. This
is due to the greater water content of the cellular fraction.
WHEN GLUCOSE TEST IS PREFORMED

• Your healthcare provider may have ordered routine bloodwork called a

basic metabolic panel (BMP) or a comprehensive metabolic panel (CMP), which both
include a glucose blood test.
• You may be having symptoms of high blood sugar or low blood sugar, which could
indicate diabetes or another condition.
• If you take a long-term medication that affects your blood sugar levels, such as
corticosteroids, you may need routine glucose blood tests to monitor your levels.
 SYMPTOMS OF
SYMPTOMS OF DIABETES AND
LOW BLOOD SUGAR INCLUDE:
HIGH BLOOD SUGAR INCLUDE:

• Feeling very thirsty (polydipsia). • Shaking or trembling.

• Frequent urination (polyuria).
• Sweating and chills.
• Fatigue.
• Dizziness or lightheadedness.
• Feeling very hungry (polyphagia).
• Faster heart rate.
• Unexplained weight loss.

• Blurred vision. • Intense hunger.

• Slow healing of cuts or sores. • Anxiousness or irritability.

TYPES OF GLUCOSE TESTS:

• Fasting plasma glucose test: This test measures the amount of glucose in your blood
after you have gone without eating or drinking anything but water for at least 8 hours.
• Random plasma glucose test: This test also measures the amount of glucose in the blood
but may be performed at any time of the day, whether or not you’ve eaten recently.
• Glucose tolerance test: This test measures how much glucose is in your bloodstream
after you fast overnight and then drink a sugary drink. A glucose tolerance test typically
requires more than one blood draw over the course of several hours.
• Urine glucose test: Urine glucose testing is often part of routine urinalysis. Urine glucose
test results are less accurate than blood glucose testing.
GLYCATED HEMOGLOBIN (HBA1C)

• Glycated Hemoglobin (HbA1c) is formed When blood glucose enters the erythrocytes, it
glycates the ε-amino group of lysyl residues and the amino terminals of hemoglobin. The
fraction of hemoglobin glycated, normally about 5%, is proportionate to blood glucose
concentration.
• Since the half-life of an erythrocyte is typically 60 days, the level of glycated hemoglobin
(HbA1c) reflects the mean blood glucose concentration over the preceding 6 to 8 weeks.
• Measurement of HbA1c provides valuable information for diagnosis and management of
diabetes mellitus.
FORMATION OF HBA1C
WHEN HBA1C IS DONE?

• Type 2 diabetes. With type 2 diabetes your blood glucose gets too high because your
body doesn't make enough insulin to move blood sugar from your bloodstream into your
cells, or because your cells stop responding to insulin.
• Prediabetes. Prediabetes means that your blood glucose levels are higher than normal,
but not high enough to diagnosed as diabetes.
• 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
• NOTE: Values may vary according to reference.
• Fasting is not needed for this test.
• Certain conditions, such as uremia, aspirin ingestion, and alcoholism, can cause spurious
elevations of glycosylated hemoglobin.
• Falsely low percentages of glycosylate hemoglobins can be caused by uremia, anemia,
variant hemoglobins such as hemoglobin S, and pregnancy.
DISCUSSION

• What is the difference between glucose test and HbA1c?

• Which test is better for the diagnosis of diabetes?