The hemoglobin A1C is a test that tells us the average level of blood sugar over about two to three months.

So hemoglobin, as we all know, is this protein that's in our red blood cells.

It gives the red blood cells the red color and it carries oxygen.

The sugar in our blood is called glucose, and glucose does

tons of things in our body, but among them it binds to hemoglobin in our red blood cells.

And since the red blood cells live for about three months, the hemoglobin A1C test can tell us what the average level of glucose is in our blood

for about two to three months.

It's an adjunct test.

It doesn't tell the whole story.

You could have a very high hemoglobin A1C and yet have had several periods of clinical hypoglycemia.

What we're looking at with a hemoglobin A1C is the glycosylated hemoglobin bound to the erythracite,

which is directly proportional to the amount of glucose available to it over the 120-day

life cycle of the red blood cell.

About 1% of your red blood cells, your erythrocytes, are made and destroyed every day.

And as those red blood cells hit the circulation, there's only a little bit of glucose attached. But the thing

about red blood cells is they are freely permeable to glucose. Now, not everybody's the same,

particularly when you have medical conditions. So there are certain medical conditions, for instance,

where you have a rapid red blood cell turnover.

So that would happen in hemolysis.

And for diabetics who have had a hemolysis event, you will have a falsely low hemoglobin A1C

because the urethracite just hasn't been around long enough.

glucose attaches to certain proteins like hemoglobin A1C in hyperglycemia over time.

...