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Use of glycosylated hemoglobins in the long-term management of diabetes.

Glycosylated hemoglobin levels are a reflection of a patient's average blood sugar for the two preceding months. Knowing a patient's glycosylated hemoglobin levels better equips a health care practitioner to manage the patient's diabetes and thus helps forestall diabetic complications. This test gives an estimation of what the patient has been eating for the past several weeks and how well the patient has been adhering to the medication regimen, not just how well the patient has prepared for the office visit. The use of glycosylated hemoglobins should motivate patients with diabetes to maintain higher degrees of control and help practitioners work with patients on their treatment programs. Advantages to using glycosylated hemoglobin levels include the patient need not fast prior to the test; the test is not affected by recent physical and/or emotional fluctuations; and the test may be performed on anyone at any time without prior instructions. Nurse practitioners in primary health care roles are in excellent positions to use glycosylated hemoglobin levels and evaluate their effectiveness in managing diabetes.