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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12816
Experience:  Emergency Medicine and Family Practice for over 26 years
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Does a hemoglobin a1c of 6.4 mean you are diabetic.

Customer Question

Does a hemoglobin a1c of 6.4 mean you are diabetic.
Submitted: 6 years ago.
Category: Medical
Expert:  Dr. Amir replied 6 years ago.
Thanks for the question. I would say that first of all HBA1C levels are use to monitor the progress of diabetes. The definitive test for diabetes should be fasting blood glucose, random blood glucose or oral glucose tolerance tests. But your HBA1C (glycosylated hemoglobin) is on the higher side that does not mean you have diabetes so I will suggest to have fasting blood sugar or random blood sugar tests and see your physician for complete evaluation because there is risk of having diabetes. Best wishes.

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Best of luck and keep in touch
Dr. Amir Javed.

Edited by Dr. Amir on 12/20/2010 at 12:32 AM EST
Customer: replied 6 years ago.
Relist: Answer quality.
Expert:  Family Physician replied 6 years ago.
The latest guidelines for the diagnosis of diabetes now includes use of the hemoglobin A1c.

A patient is now considered to be diabetic with a hemoglobin A1c of 6.5%. Your result (6.4%) places you in the "pre-diabetes" range (5.7-6.4%). Pre-diabetes includes two subtypes; impair fasting glucose and impaired glucose tolerance. Additional testing would need to be performed to determine which of these categories a patient is placed in.

In either case, weight loss (at least 10% if you are overweight), and possibly starting a medication such as metformin can reduce the risk of developing diabetes.
Here is some additional information
Customer: replied 6 years ago.
Why should the A1c not be used to diagnosis people with diabetes that have vitamin b12 defeciency. I am on monthly IM injections for low vitamin b12.
Expert:  Family Physician replied 6 years ago.
When a patient is FIRST treated for anemia (iron deficiency or Vitamin B12 deficiency), the rapid production of new blood cells can artificially lower the hemoglobin A1c since this test identifies the percentage of hemoglobin that has glucose attached to the protein. The longer the red blood cells are in circulation, the higher this percentage. The average life of a red blood cell is about 120 days. In a normal person, you have a relatively equal distribution of new and older red cells. When you decrease the life-span of the blood cells (as in hemolytic anemia) OR when you shift the distribution of cells to younger cells, you artificially decrease this value.

If however, you have been on treatment for this B12 deficiency for more than 3-4 months, you would not expect this to have any significant effect on the result.