A client with diabetes mellitus has a glycosylated hemoglobin A1c level of 10%. Based on the result, the nurse plans to teach the client about the importance of:
A. Maintaining the result.
B. Preventing hypoglycemia.
C. Preventing hyperglycemia.
D. Avoiding infection.
Correct Answer: C. Preventing hyperglycemia.
Glycosylated hemoglobin A1c level of 8% higher indicates poor diabetic control. Elevations indicate continued need for teaching related to the prevention of hyperglycemic episodes. The test shows an average of the blood sugar level over the past 90 days and represents a percentage. The test can also be used to diagnose diabetes.
Option A: For an A1c test to classify as normal, or in the non-diabetic range the value must be below 5.7 %. Anyone with an A1c value of 5.7 % to 6.4 % is considered to be prediabetic, while diabetes can be diagnosed with an A1c of 6.5% or higher. Hemoglobin A1c serves as an indicator of overall glycemic control and a reflection of the average blood sugar over the past three months.
Option B: A falsely low A1c value can result from several conditions including high altitude, pregnancy, hemorrhages, blood transfusions, erythropoietin administration, iron supplementation, hemolytic anemia, chronic kidney failure, liver cirrhosis, alcoholism, folic acid deficiency, sickle cell anemia, and spherocytosis.
Option D: A1c provides a measure of the glucose concentration over three months. Hemoglobin A1c is often used as an outcome measure to determine if an intervention in a population is successful by showing a decrease in A1c by a certain percentage. Levels of A1c should be measured twice a year in stable patients and at least four times in patients who have glucose fluctuations or those who have had a change in their diabetic treatment.