On a quiet afternoon, Mr. Lee, a retired teacher with a passion for gardening, found himself feeling unusually tired while working with the flowers in his garden. This exhaustion was accompanied by thirst and frequent nighttime wake-ups, symptoms that gradually deprived him of his joy in life. The doctor's diagnosis shocked him – abnormal glucose metabolism, a term he thought would only be mentioned in TV commercials, was now a part of his life. The doctor mentions a metric – glycosylated hemoglobin (HbA1C), which is a key indicator to assess blood sugar control. The value of glycosylated hemoglobin is more than just a number. It is like a time capsule, recording the history of blood sugar levels over the past few months, and is an important indicator used by doctors to determine whether glucose metabolism abnormalities are being properly managed. However, the ideal range for this number, and how to reach it to reduce the risk of complications, is a complex path that requires careful navigation.
Glycosylated hemoglobin (HbA1C) is an important biochemical indicator that reflects an individual's average blood sugar level over the past two to three months. This metric is important because it provides a long-term view of glycemic control and complements daily blood glucose monitoring. In understanding the role of HbA1C, it is important to recognize that it goes beyond the limitations of a single blood glucose measurement and is able to reveal long-term trends in blood glucose fluctuations. Stability of glycemic control is essential to prevent complications associated with glucose metabolism. Long-term glycemic stability can help reduce the risk of cardiovascular disease, neuropathy, nephropathy, and retinopathy, all of which can significantly affect quality of life and increase the risk of death.
With regard to the ideal HbA1c level, the widely accepted target is less than 7% (53 mmol mol), and this target applies to most patients with glucose dysmetabolism. However, individual differences mean that target values need to be adjusted for the specific situation of the patient. Individuals who are younger, not at risk of major complications, and able to safely implement ** measures may have more stringent HbA1c goals. Conversely, for older patients, those with multiple complications, or those at risk of hypoglycaemia, a more lenient goal may be more appropriate. Individualized goal setting emphasizes the importance of working closely with healthcare providers to ensure that the program is both safe and effective.
Strategies to effectively control HbA1c levels are multifaceted and include, but are not limited to, dietary management, physical activity, medications**, and a combination of lifestyle modifications. In terms of diet, it is recommended to eat foods rich in fiber and low in sugar, as well as eating regularly and quantitatively. Physical activity has a significant effect on improving insulin sensitivity and lowering blood glucose levels, and at least 150 minutes of moderate-intensity activity per week is recommended. Medications** should be selected appropriately for the individual situation and may include oral hypoglycemic drugs and/or insulin**. Lifestyle changes, such as weight loss, quitting smoking, and reducing alcohol intake, are also key factors in controlling HbA1C.
While controlling HbA1c within the target range is the primary goal, excessive control can pose risks, especially the risk of hypoglycemia. Hypoglycemia not only immediately endangers the health and safety of the patient, but it can also have long-term adverse effects on heart health. Therefore, it is crucial to remain vigilant and take steps to prevent hypoglycemia in the pursuit of ideal HbA1c levels.