Johns Hopkins Guides provide diagnosis, management, and treatment guidance for infectious diseases, diabetes, and psychiatric conditions. Explore these free sample topics:
~~ The first section of this topic is shown below ~~
- Hemoglobin A1c (HbA1c) is a stable adduct of glucose on the beta-chain of hemoglobin (N-[1-deoxyfructosyl]hemoglobin).
- Formed by a largely irreversible reaction, post-translationally and non-enzymatically, when hemoglobin circulating in a red blood cell is exposed to ambient glucose
- Alternate terms: "A1c" (preferred for use in communication with patients), "glycated hemoglobin" (the most accurate term), glycosylated hemoglobin.
- Expressed most often as the percent of hemoglobin that is glycated (alternatively, as mmol glycated hemoglobin per mole total hemoglobin).
- The single best test to monitor overall blood glucose control in diabetes 
- Reflects the average blood glucose over about 3 months previously, although somewhat disproportionately weighted to recent blood glucose levels 
- A strong indicator of risk for long-term diabetic complications, especially retinopathy, neuropathy and nephropathy (DCCT).
- Also an indicator of cardiovascular disease (CVD) risk, although glucose control is less strong of a risk factor for CVD than lipids, blood pressure and smoking 
- Recently, HbA1c > 6.5% is recommended as a criterion for diagnosing diabetes  .