What is HbA1c Levels & How can it predict Diabetic Retinopathy

HbA1c levels (glycated hemoglobin) is a blood test that could be defined as average blood sugar levels taken for 2 to 3 months. It shows how well blood sugar is being controlled over time.

As we all know that diabetes is growing globally and a major health concern, with complications ranging from cardiovascular disease to kidney damage. In the event of Type 2 diabetes the patient experiences serious microvascular complications of Type 2 Diabetes Mellitus (T2DM) is Diabetic Retinopathy (DR), a leading cause of blindness worldwide.

Researchers continuously look out for reliable markers to predict DR onset, and Hemoglobin A1C (HbA1C) levels have been extensively studied for this purpose. But how effective is HbA1C in predicting DR, and what are the implications for clinical practice?

What is the normal HbA1c level?

Hb1ac level is a key parameter in deciding whether you have diabetes or you are prone to diabetes. If your Hb A1c i.e. glycated hemoglobin is below 5.7. People who are prediabetes will have a range from 5.7% – 6.4%. People with Hb1Ac levels at 6.5 % or above are considered diabetic.

What is normal HbA1c by age?

Talking about HbA1c levels, it remains the same for almost all the adults, and varies based on age and health conditions. In children and young adults it is below 5.7% whereas in middle aged adults it can go up to 6.5% for diabetics and for individuals above 65 years Hb1Ac levels must be below 7.0% in physically weak individuals.

What should be the random blood sugar level?

Normal Diabetes levels	Below 140mg/dl ( 7.8mmol/L)
Prediabetes	140 -199mg/dL ( 7.8-11.0 mmol/L
Diabetes	200mg/dL (11.1mmol/L) or higher

What is a dangerous level of HbA1c?

Talking about dangerous levels of HbA1cwhen above 7.0 % means that the diabetes is high and needs proper control. While above 9.0 % there is a high risk that along with high diabetes you can expect kidney disease and vision related problems. But when above 12.0 %, it is a critical level and requires immediate hospital care.

How can we reduce HbA1c level?

We can definitely reduce HbA1c level by following a specific diet regimen, pranayama and other activities. You can start consuming fiber-rich foods, avoid refined carbs, and reduce sugar intake. Make sure you do regular exercise like walking, jogging or strength training activities.

Always try following a doctor and drink plenty of water to help control blood sugar levels. Doing pranayama, yoga and meditation could ease stress levels and improve HbA1c levels in the body.

How to control HbA1c?

For maintaining your HbA1c levels you need to monitor blood sugar on a regular basis, consume a low carbs diet and food with high fibre and exercise daily for 30 minutes.

Can HbA1C Levels Predicting Diabetic Retinopathy

HbA1C is widely recognized as a key biomarker reflecting average blood glucose levels over the past two to three months of an individual. It is often used to monitor long-term glycemic control in diabetic patients. Since chronic hyperglycemia is a major contributor to Diabetic Retinopathy , researchers hypothesize that HbA1C levels might serve as a predictive tool for identifying at-risk patients before severe retinal damage occurs.

Various studies suggest that higher HbA1C levels are associated with a higher risk of developing diabetic retinopathy, as prolonged elevated blood sugar can damage the retinal blood vessels, leading to vision complications. Along with HbA1C being a useful indicator, other factors such as blood pressure, duration of diabetes, and genetic predisposition also play a role in the development of Diabetic Retinopathy. Regular eye screenings and blood sugar control are essential for preventing or slowing the progression of diabetic retinopathy.

Key Findings

Prevalence of DR: The study found that 29.8% of the participants had DR.
Optimal HbA1C Cut-Off Point: The analysis determined that an HbA1C level of 8.15% was the best threshold for distinguishing between patients with and without DR.
Sensitivity and Specificity: The identified cut-off point provided a sensitivity of 58.3% and a specificity of 70.1%, suggesting that while HbA1C is a useful indicator, it should not be the sole diagnostic criterion.

Can HbA1C Alone Predict Diabetic Retinopathy?

It’s true that HbA1C is a strong indicator to predict diabetes control in patients suffering from diabetic retinopathy, but it is not the sole predictor. There are many other factors that impacts the development and progression of the condition, such as:

Diabetes duration – The more longer a person has diabetes, the higher the complication
Maintain proper B.P. levels – Hypertension can worsen retinal damage so maintain your B.P.
High Cholesterol levels – People who have very high cholesterol levels can contribute to inflammation of blood vessels vascular complications.
Genetic factors – individuals with a history of diabetic complications are also prone to get diabetic retinopathy.

Prevention and Management of Diabetic Retinopathy

Deciding whether you are suffering from Diabetic Retinopathy is difficult as there are no symptoms in its early stages. Along with this regular eye screenings is equally important as it can help in early detection of the eye disorder. Patients with diabetes should follow these preventive measures and that too under a

Keep Monitoring the HbA1C levels on a regular basis and make sure you keep them below 7%.
Keep a check on cholesterol levels to reduce the risk of vascular damage.
Annual eye exams to be done twice in year to detect any early signs of diabetic retinopathy.
Adopt a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking.

Conclusion

It’s true that HbA1C levels provide valuable insights into diabetes management and the risk of complications but it could not be considered as the sole factor in predicting diabetic retinopathy. Along with HbA1C levels regular eye screenings, overall metabolic control, and lifestyle modifications are necessary to prevent or slow the progression of diabetic retinopathy. By keeping your HbA1C levels under control and taking proactive steps, individuals with diabetes can significantly reduce their risk of vision loss.