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# Free Evidence Based Practice Essay Sample

This evidenced based-testing of diabetes presented by Gills makes use of a widely accepted A1C test laboratory tool. Initially, A1C test was utilized in determining the average blood glucose for a patient diagnosed with diabetes over a period between two or three months. To present a diabetes diagnosis, physicians made the use of fasting blood glucose tests that provided real-time results. These results could present inaccurate readings if the individual was sick or had not had enough food to eat. The approach is based on a research that through the use of A1C tests as a tool of diagnosis, the physician could have a better analysis of what the blood glucose of the patient has been averaged looking at the %ge system without errors observable with a fasting blood glucose test. The use of A1C test as a tool of diagnosis has also added the benefit of not demanding fasting from the patient for eight hours prior to the exercise. All the same, A1C results, while significant for physicians, are somehow difficult for particular individual patients to understand since the results are founded on a percentage system that can at times be confusing to them.

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There has been a concerned effort of making A1C test friendly to the patient. There is no enough research on how the A1C results can be converted to an average glucose number to make it easier for patients to comprehend and thus an international study called The A1C-Derived Average Glucose Study (ADAG) was carried out. The main objective was to test whether the results of the A1C test could be articulated in average levels of glucose using similar units applied in daily monitoring glucose. The ADAG was effective in establishing a mathematical equation that was used to convert the A1C %ge to an estimated average glucose (eAG) that is evaluated in similar units of mg/dl as the home glucometer of the patient. The depiction of the A1C conversion to eAG for quick understanding of the control of diabetes is as shown below.

A1C (%) / eAG (mg/dl)                                              A1C (%) / eAG (mg/dl)

• 5.0 / 97
• 5.5 /111
• 6.0 /126
• 6.5 /140
• 7.0 /154
• 7.5 /169
• 8.0 /183
• 8.5 /197
• 9.0 /212
• 9.5 /226
• 10.0 /240
• 10.5 /255
• 11.0 /269
• 11.5 /283

Average blood sugar can be evaluated through a hemoglobin A1C test. This is very crucial in controlling type 1 diabetes. The hemoglobin A1C test takes measurements of blood sugar control for a period of either two or three months. A1C test works under the knowledge of hemoglobin in the human body. Hemoglobin is the red blood cells part that normally carries oxygen in the human body. Some of the sugar entering the human body ultimately reaches hemoglobin and lives there for the red blood cell life, which is normally not more than a period of three months. Elevated values of sugar in blood as is the case with many diabetes patients, causes more sugar to attach to the red blood cells over the short life of the red blood cells. A simple test of blood measures the quantity of sugar in percentage form.

### Performing an A1C Test

The A1C test requires a small blood portion/sample and is normally carried out in the office of the patient’s doctor. The blood sample is then sent to a laboratory for testing and the results sent back to the doctor again. However, A1C home testing kits are now available. Even though there is some kind of concern amongst practitioners that these home tests are not very much reliable when compared to the ones conducted in the laboratory. All the same, quite a good number of people have found them useful. Home testing is affordable and can present crucial information concerning a person’s management between the visits of the doctor.

### Interpreting A1C Test Results

Every person, no matter their diabetes status, has some amount of sugar that is normally fixed to the red blood cells. An individual without diabetes may naturally have a hemoglobin A1C test of about 5%. The category of individuals having ‘type 1’ diabetes can record A1C test results that are much higher like 25% if the management of diabetes in the body is poor. Essentially, the goal of this procedure in controlling diabetes is to achieve an A1C test result below 7%. In the event that the result turns out to be 8% or even more than that, the implication is that changes are urgently required to manage the levels of the glucose. However, research has shown that the cutoff point in the elderly (adults above the age of seventy years) could be pegged at about 6 percent. The elderly population would need a confirmation with an oral glucose tolerance test since the A1C test has been found to decline in accuracy with increasing age.

### Managing Blood Sugar

The management of blood sugar is very essential in the body of human beings. The results produced by Diabetes Control and Complications Trial (DCCT) have convincingly proved that people who have diabetes managing their sugar in blood well with levels of about 7% can delay the start or may be even prevent any complications related to diabetes that impinge on the eyes, nerves and kidneys. The DCCT proved that even an 8% A1C test result can significantly increase the risks of such related complications. The American Diabetes Association has been promoting the estimated Average Glucose (eAG) as discussed by Owen. The eAG accurately helps individuals to convert the A1C test result into a figure that well corresponds to the glucose matter in mg/dl (Owen 2011). For instance, according to the conversion presented by Owen, a test result of 7.5% is equivalent to an estimated Average Glucose of 169 ml/dl.

### Frequency of A1C test

With the process of management and control of type 1 diabetes, comes the question of how often the A1C test can be carried out. The proposal made for the conducting of A1C test is usually soon after diagnosis has been made. Later on, the test can be performed at least two times per year. Recommendations are made by quite a number of endocrinologists that those with ‘type 1’ diabetes should undergo the test in a period of every three months. This corresponds to the archetypal life span of the red blood cells and offers a person a continuous image of diabetes control. All the same, the A1C test cannot be used as a substitute for daily testing. It is expected that the A1C test must be applied in addition to the daily testing of blood sugar. The A1C test is merely an average of what a person’s blood sugar has been for a period of three months. The only way through which a person can know for sure the level of blood sugar at any given moment is to conduct a test. Therefore, it is very important that people test the blood several times each day if effective control and management of diabetes is to be realized.

Evidence based practice has produced excellent diagnostic tools in health care practice. For diabetes, A1C test has been useful in the management and control of diabetes as explained in this article. A series of research based on the treatment of diabetes have been the core foundation for the development of the A1C test. With the A1C test, individuals can easily regulate the amount of sugar in their blood stream for the purposes of maintaining good health. The procedures of A1C testing coupled with a daily check monitoring and control of sugar in blood has promoted good healthy habits amongst patient populations over and above the conventional A1C test used in determining the average blood glucose for a patient diagnosed with diabetes over a period between two and three months.

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