Standard values

The HbA1c value is the proportion of glycated hemoglobin in total hemoglobin. It is measured in mmol/mol Hb, but in clinical practice the percentage has become more common. The standard value is an HbA1c of 4-6%, which means that 4-6% of the total hemoglobin contains a glucose residue. There is also the possibility of converting the HbA1c into a mean blood glucose value, which is usually easier for patients to understand. For example, an HbA1c of 5.0% corresponds to a mean blood sugar of 70 mg/dl.

Costs for the determination of HbA1c

The costs for an HbA1c determination range from 12-14 Euro depending on the laboratory. If diabetes mellitus has already been diagnosed, i.e. if the value is determined for follow-up purposes, it can be billed as a benefit to the health insurance company. The Association of Statutory Health Insurance Physicians for the Early Diagnosis of Diabetes Mellitus stipulates that the determination of glucose in blood and urine should be carried out from the age of 36. A HbA1c-measurement is not part of the precaution and is therefore not billed as a health insurance benefit, but as an individual health service (IGeL), the costs must be paid by the patient himself.

Are there alternatives to the HbA1c value?

An alternative to the HbA1c value is the simple determination of blood sugar. The disadvantage of this value, however, is that it depends on many factors and also fluctuates in the course of the day. Therefore, an assessment of the course of the disease would always have to be carried out with a sober mind and would never be realistic, as the value only shows a snapshot and depends on the patient’s behavior before the measurement, especially diet and physical activity.

This value can be easily measured at home after appropriate training and can be used as a daily self-monitoring, but the HbA1c is much better suited for the course and adjustment of therapy. The HbA1c value can also be used for diagnosis: Diabetes mellitus is diagnosed at a value above 6.5% or excluded below 5.7%. A good alternative is to perform an oral glucose tolerance test (oGTT), which must be performed anyway if the HbA1c is between 5.7-6.5%. This test is more complicated to perform, but provides reliable results.