Hemoglobin A1c Test

- also called HbA1c, glycated hemoglobin or glycohemoglobin - is an important blood test used to determine if your diabetes is well controlled.

Hemoglobin A1c is a means of monitoring blood glucose over a period of 6 to 12 weeks, used in combination on glycemic control at home to establish an adequate glucose profile for adjustments to the treatment of diabetes.

Hemoglobin is a essence in red blood cells to carry oxygen to the body. When diabetes is notbalanced (meaning blood sugar is excessively high), glucose accumulates in the blood and combines with hemoglobin thus constituting "glycated hemoglobin". Therefore, the average amount of glucose in the blood can be determined by measuring the hemoglobin A1c for determining the blood glucose levels through a period of 120 days.

The collection ...

Blood collection for analysis of HbA1c is a venous blood on a peripheral vein (usually veins of the back of the hand or the bend of the code) on a tube containing an anticoagulant. It would be preferable to indicate any treatment taken and report it.

Normal HbA1c

For normal people, normal value of hemoglobin A1c is between 4% and 6%. Studies have repeatedly shown that poorly controlled diabetes leads to complications in the long short, the goal for people with diabetes is an A1C less than 7%. The elevated the hemoglobin A1c, the upper the risk of occurrence of diabetic complications is important.

How often should HbA1c be measured?

A person with diabetes should perform this test each 3months to determine if their blood sugar has reaching into the target stage of control. Those who have diabetes well balanced may be able to space the Hb A1c blood tests, but experts recommend checking at least two times a year.

Changes in HbA1c

A patient having diseases upsetting hemoglobin such as anemia might obtain irregular results with this test. Further abnormally may affect the domino effect of hemoglobin A1c such as overload of vitamins such-as vitamins E and C and higher cholesterol, kidney and liver can also affect the test of hemoglobin A1c.

What is Proteinuria?

Proteinuria is the most common urinary abnormalities, it is defined by the presence of protein in the urine (proteinuria) at a rate greater than 150 mg (0.15 g) in 24 hours.

Proteinuria can be detected at the dipstick when the rate is> 300 mg / l and must be confirmed by a laboratory quantitation (proteinuria of 24).

Proteinuria is always pathological, except in one situation where the normal proteinuria 300mg/24: pregnancy.

Proteinuria is an analysis that is done on the urine of 24 hours.

Note: The dipstick only detects albumin from all other proteins that may exist in the urine.

Assay of proteinuria and urine collection.

The urine collection:

empty the bladder in the morning at 08 am without collecting the urine.
collect all the urine (even those of the night) until the next 08h,
Interest of the determination of proteinuria.

Proteinuria of 24 hours in a quantitative and qualitative interest:

Quantitative study: dosing of 24h (24h urine collection), there is a physiological proteinuria of 50-150 mg/24 h, when proteinuria is> 150mg/24 h is a pathological proteinuria.
Qualitative study: urinary protein electrophoresis of 24 is used to find the selectivity of proteinuria and detection of multiple myeloma.

Selectivity of proteinuria.

Selective proteinuria> 80% albumin, purity criteria of nephrotic syndrome.
Non-selective proteinuria <80% albumin, test impure nephrotic syndrome.
Circumstances of discovery of proteinuria

Proteinuria can be discovered in of exploring an edematous syndrome, screening with a dipstick,
record of hypertension or systemic disease, monitoring of pregnancy.

The main situations in which proteinuria increases.

the main situations in which proteinuria increases are:

1. Intermittent proteinuria

It proteinuria that occurs and disappears after the disappearance of the cause can be:

heart failure,
effort,
febrile illnesses in children,
haematuria macroscopic

2. Proteinuria contemporary a urinary tract infection

3. Orthostatic proteinuria

encountered in children and young adults,
may be abundant, but without clinical signs
confirmed by measurement of urine collected in strict supine for several hours (disappearance of proteinuria).

4. Proteinuria and hypertension

Hypertension old: nephro-angiosclérose
pregnant women: pre-eclampsia

5. The nephrotic syndrome post-infective

Kidney due to infection

6. Nephrotic syndrome

7. Other causes of proteinuria

There are other situations where one can find an increased proteinuria:

Urinary tract infection,
Diabetes ,
Cancer
the general glomerular diseases (eg systemic diseases)
chronic interstitial nephropathy
8. Special case: proteinuria of multiple myeloma.

Proteinuria is abundant, not detected by the dipstick because the proteins other than albumin, protein electrophoresis gives a spike in multiple myeloma.

Conclusion

In conclusion, proteinuria should be taken as a symptom and not a disease in itself: it is not to treat the proteinuria but to seek and address the causes that led to the installation of this urinary abnormality.

Medical Health Information