Hemoglobin A1C, Insulin and Glucose

The Hemoglobin A1C, Insulin and Glucose panel contains 3 tests with 3 biomarkers.

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Glucose

A blood glucose test measures the amount of a sugar called glucose in a sample of your blood. Glucose is a major source of energy for most cells of the body, including those in the brain. The hormones insulin and glucagon help control blood glucose levels.

Also known as: A1c, Glycated Hemoglobin, Glycohemoglobin, Glycosylated Hemoglobin, HA1c, HbA1c, Hemoglobin A1c, Hemoglobin A1c HgbA1C, Hgb A1c

Hemoglobin A1c

The A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months. It does this by measuring the concentration of glycated (also often called glycosylated) hemoglobin A1c. Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs). There are several types of normal hemoglobin, but the predominant form – about 95-98% – is hemoglobin A. As glucose circulates in the blood, some of it spontaneously binds to hemoglobin A. The hemoglobin molecules with attached glucose are called glycated hemoglobin. The higher the concentration of glucose in the blood, the more glycated hemoglobin is formed. Once the glucose binds to the hemoglobin, it remains there for the life of the red blood cell – normally about 120 days. The predominant form of glycated hemoglobin is referred to as HbA1c or A1c. A1c is produced on a daily basis and slowly cleared from the blood as older RBCs die and younger RBCs (with non-glycated hemoglobin) take their place. This test is used to monitor treatment in someone who has been diagnosed with diabetes. It helps to evaluate how well their glucose levels have been controlled by treatment over time. This test may be used to screen for and diagnose diabetes or risk of developing diabetes. In 2010, clinical practice guidelines from the American Diabetes Association (ADA) stated that A1c may be added to fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) as an option for diabetes screening and diagnosis. For monitoring purposes, an A1c of less than 7% indicates good glucose control and a lower risk of diabetic complications for the majority of diabetics. However, in 2012, the ADA and the European Association for the Study of Diabetes (EASD) issued a position statement recommending that the management of glucose control in type 2 diabetes be more "patient-centered." Data from recent studies have shown that low blood sugar (hypoglycemia) can cause complications and that people with risk of severe hypoglycemia, underlying health conditions, complications, and a limited life expectancy do not necessarily benefit from having a stringent goal of less than 7% for their A1c. The statement recommends that people work closely with their doctor to select a goal that reflects each person's individual health status and that balances risks and benefits.

Also known as: Insulin (fasting)

Insulin

Insulin is a hormone that is produced and stored in the beta cells of the pancreas. It is vital for the transportation and storage of glucose at the cellular level, helps regulate blood glucose levels, and has a role in lipid metabolism. When blood glucose levels rise after a meal, insulin is released to allow glucose to move into tissue cells, especially muscle and adipose (fat) cells, where is it is used for energy production. Insulin then prompts the liver to either store the remaining excess blood glucose as glycogen for short-term energy storage and/or to use it to produce fatty acids. The fatty acids are eventually used by adipose tissue to synthesize triglycerides to form the basis of a longer term, more concentrated form of energy storage. Without insulin, glucose cannot reach most of the body's cells. Without glucose, the cells starve and blood glucose levels rise to unhealthy levels. This can cause disturbances in normal metabolic processes that result in various disorders, including kidney disease, cardiovascular disease, and vision and neurological problems. Thus, diabetes, a disorder associated with decreased insulin effects, is eventually a life-threatening condition.
*Process times are an estimate and are not guaranteed. The lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.