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Precose (Acarbose)

A single blood glucose measurement tells you what your glucose level is at that moment. It does not tell you what your glucose level was ten minutes ago or what it was earlier the same day. If you test several times a day and record all your results you can build up a picture of what is happening to your blood glucose level over weeks or months. If you wish, you can calculate your average blood glucose level at a given time of day or throughout a given period, as in the computer system I have just mentioned. Alternatively, hospital clinics are now using a single blood test which can give an indication of your average blood glucose level over a period of several weeks before the blood was taken. This is the glycosylated hemoglobin or hemoglobin A1c test.
Hemoglobin carries oxygen in the blood stream, inside the red blood cells, and is responsible for their red colour. Each person has several types of hemoglobin including one called hemoglobin A1c. During the 120 days in the life of a red blood cell the hemoglobin A1c (like many other body proteins) is exposed to the prevailing blood glucose levels. Glucose is ‘attached’ to the hemoglobin A1c to form glycosylated hemoglobin. The percentage of glycosylated hemoglobin depends on how high the blood glucose level has been during the life of the red cells. Different hospital laboratories have different ways of measuring glycosylated hemoglobin, and thus different normal ranges, but as a rough guide, your glycosylated hemoglobin should be below about 8 per cent. The test is useful as a check on whether finger prick blood tests are giving a representative picture of what is happening to the blood glucose level. It is especially useful for diabetics who rarely or never test their blood glucose level. For example, Mark, who is thirty-nine, works in a horse racing stable and finds that his hands are too dirty to allow finger prick tests. When he went to his clinic, his blood glucose level (from a vein) was 7 mmol/1 (126 mg/dl) which looked very good. Then we saw that his glycosylated hemoglobin level was 18 per cent, indicating that he had had very high blood glucose levels over the preceding few weeks. His glucose level was 7 mmol/1 that day because he had missed his lunch rushing to get to the clinic. One of the difficulties in interpreting the glycosylated hemoglobin result is that a normal level may represent relatively high blood glucose concentrations alternating with hypoglycemia. Also, if you are anaemic or have any condition in which the life of the red blood cells is shortened, the result of the test is difficult to interpret. Nevertheless, it is a helpful test and some clinics now use it instead of blood glucose estimations.

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