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Glycated Hemoglobin- GHB (Hemoglobin A1c)

What is it?
This test is a very important measure of how well your diabetes is controlled. It measures the average of the blood sugar levels over the last three months.


How does it do that?
Hemoglobin is the part of the red blood cell that carries oxygen from the lungs to the rest of the body. Because it is a protein, some sugar sticks to it and stays there for the three-month lifespan of the red blood cell. How much sugar sticks to the red blood cell depends on how long and how often the sugar has been high.


How often is it done?
The GHB is tested along with other routine blood work every three months by finger pick.


What is a good GHB result?
For people without diabetes, the GHB is usually 4-6%.
For children with diabetes, target levels for GHB vary with the age of the child.


Age GHB Level
GHB
Before meals
Under 6 yr
< 8.5 %
6-12 mmol/l
6-12 yr.
< 8.0 %
4-10 mmol/l
13 yr and older
< 7.0 %
4-7 mmol/l


Improvement is needed when GHB levels exceed the suboptimal levels. This calls for team work between the child, the family and the diabetes team to improve blood sugar levels and ultimately the GHB result.


But I thought sugars under 10 were pretty good?
Because the GHB is a different substance, the units are different. The following chart shows how GHB levels compare to blood sugar levels.

Blood Sugar
GHB
5%
6%
7%
8%
9%
10%
11%
12%

Canadian

mmol/l

5.0
6.5-7.0

8.0-

9.0

9.5-

11.0

11.0-

13.0

12.5-

15.0

14.0-

17.0

15.5-

19.0


Does it really matter what the GHB is?

The binding of sugar to protein is one way diabetes causes injury. A near normal GHB is a sign that you are helping to prevent the long- term health problems that can result from diabetes.


Remember to ask the diabetes team about your GHB at every visit.

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