A woman with a diagnosis of type 2 diabetes has been ordered a hemoglobin A1C test for the first time by her primary care provider. The woman states, "I don't see why you want to test my blood cells when its sugar that's the problem."
What aspect of physiology will underlie the care provider's response to the client?
A)
The amount of glucose attached to A1C cells reflects the average blood glucose levels over the life of the cell.
B)
Hemoglobin synthesis by the bone marrow is inversely proportionate to blood glucose levels, with low A1C indicating hyperglycemia.
C)
The high metabolic needs of red cells and their affinity for free glucose indicate the amount of glucose that has been available over 6 to 12 weeks.
D)
Insulin is a glucose receptor agonist on the hemoglobin molecule, and high glucose suggests low insulin levels.
Ans:
A
Feedback:
Glucose entry into red blood cells is not insulin dependent, and the rate at which glucose becomes attached to the hemoglobin molecule depends on blood glucose levels. A1C levels thus indirectly indicate glucose levels. Hemoglobin synthesis, the metabolic needs of hemoglobin, and an agonist role of insulin do not underlie the A1C test.
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