A typical goal for people with diabetes, and one suggested by the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, is a glycohemoglobin test result of less than 7 percent. A level of 7 percent means that 7 percent of the hemoglobin is combined with glucose (blood sugar). It also means that the average plasma blood glucose level for the previous two to three months was about 170 milligrams per deciliter (mg/dL).

The International Diabetes Federation (IDF), which includes organizations in 150 nations, issued new guidelines in 2005 urging that people with type 2 diabetes aim for a maximum glycohemoglobin result of 6.5 percent to reduce the risk of diabetic complications. However, the IDF acknowledged that most diabetic individuals fell short of this target. The American College of Endocrinology and the American Association of Clinical Endocrinologists also recommend aiming for 6.5 percent or less. In 2005, though, they released a nationwide study of more than 157,000 people with type 2 diabetes that showed only one-third meeting this goal.

Patients can convert their glycohemoglobin test results as follows:

Some studies have indicated that black and Hispanic people could have greater levels of glycohemoglobin than people of other racial and ethnic groups who have similar levels of glucose. An international effort is under way to ensure the accuracy of using glycohemoglobin to estimate blood glucose in various populations.

When a patient’s test result is higher than the physician-recommended goal, the physician may make changes to the patient’s diabetes care plan. A change in treatment plan is usually recommended when results are higher than 8 percent. A physician may recommend changes in meal plan, exercise plan or medication. If changes are made, the patient may need to have glycosylated hemoglobin retested in three months to monitor the effectiveness of the new treatment.

A goal of 6.5 percent or 7 percent is not realistic or appropriate for everyone. Patients who are pregnant or trying to become pregnant may have a recommended target of closer to 6 percent, if they are not suffering from too many episodes of hypoglycemia (low blood glucose). Children under the age of 7, the elderly and people with certain health conditions may have goals higher than 7 percent to prevent hypoglycemia.

Patients with hyperglycemia are encouraged to lower their glucose levels to prevent or delay the onset of diabetic complications. Research studies have shown that for every 1 percent reduction in glycohemoglobin test results, the risk of developing eye, kidney, nerve and blood vessel disease is significantly reduced.

Because of the rising incidence of diabetes in recent years, New York City in 2006 began requiring most laboratories to report results of glycohemoglobin tests to the city’s health department. The stated purpose of this requirement is to improve residents’ care and reduce diabetic complications. Patients may be contacted by mail or telephone unless they submit a form to opt out of the registry. Concerns about privacy have kept this concept from catching on elsewhere.