Evaluation of Diabetes Treatment with HbA1c Examination

What is Diabetes Mellitus
Diabetes Mellitus according to the American Diabetes Association (ADA) is a metabolic disease characterized by hyperglycemia. Chronic hyperglycemia in diabetes sufferers is associated with long-term damage, dysfunction or failure of several body organs. 

Blood sugar checks can provide useful information for managing diabetes, including:

• Track the effects of diabetes medications on blood sugar levels.
• Adjust the dose of diabetes medication
• To find out whether blood sugar levels are high or low. The goal is to determine the right medication to treat high blood sugar or consume fast-acting carbohydrates to treat low blood sugar.
• See  progress in achieving treatment goals
• Learn how diet and exercise can affect blood sugar levels.

Ideally, checking blood sugar levels should be carried out at least once every 3 months after the first visit, which includes checking fasting blood sugar levels, blood sugar levels 2 hours after eating, and checking Glycosylated Hemoglobin (HbA1c). This HbA1c examination functions as an indicator in monitoring long-term blood sugar control, diagnosis, determining prognosis, and management of diabetes mellitus sufferers.

HbA1c examination
HbA1c is an examination to evaluate blood sugar levels by showing the average blood sugar levels over the last 90 days. HbA1c can be used to diagnose pre-diabetes and diabetes or evaluate diabetes treatment. HbA1c examination has several advantages, namely easy blood sampling and can be taken at any time without the need to fast for 8 - 14 hours. The results of the HbA1c examination are not influenced by the glucose consumed, exercise, and medication consumed. The HbA1c examination is classified as normal if the HbA1c value is < 5.7%, pre-diabetes HbA1c 5.7% to 6.4% and diabetes if the HbA1c is  6.5.

Targets of  HbA1c and Blood Sugar in Diabetics 
The HbA1c target in diabetes sufferers is <7% and 7.5-8.5% in elderly patients and fasting blood sugar levels of 80-130 mg/dL and blood sugar 2 hours after eating <180 mg/dL. 
The higher the HbA1c in diabetes mellitus sufferers, the greater the risk of developing complications. Every 1% reduction in HbA1c will reduce the risk of blood vessel disorders by 35%, other complications of diabetes mellitus by 21% and reduce the risk of death by 21%.

Reference:
PERKENI. (2021). Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe. 2 Dewasa di Indonesia.
Glycemic Targets: Standards of Medical Care in Diabetes—2022. American diabetes association. Diabetes Care 2022;45(Suppl. 1):S83–S96 
https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628