HbA1c and Its Relationship to Foot and Ankle Disease
What is Hemoglobin A1c (HbA1c)?
Hemoglobin A1c (HbA1c) is a blood test that provides information about a person’s average
blood sugar level over the past 3 months and is used to diagnose and monitor diabetes mellitus.
How can an elevated HbA1c impact my general health?
An elevated HbA1c means the average blood glucose levels over the last 3 months are high.
High blood sugar levels are usually related to diabetes mellitus, which is a disease where your
body does not use insulin appropriately. Diabetes mellitus can lead to a number of
complications including heart disease and heart attack, stroke, blindness, nerve damage, kidney
disease, long-term disability and death.
How can elevated HbA1c impact foot and ankle disease?
Elevated blood sugar levels cause a number of problems in feet and ankles including:
 Peripheral Neuropathy
 Peripheral Vascular Disease
 Foot Ulcers
Peripheral neuropathy is nerve damage that can occur in your feet or ankles that can cause
pain, decrease your ability to feel pain or temperature or cause deformities. People with
peripheral neuropathy often are unable to feel a rock in their shoe, heat on their feet leading to
burns or other foot injury including blisters or sores.
Peripheral vascular disease is poor circulation, or blood flow, in your extremities. With diabetes,
the blood vessels in the feet become hard and narrow, decreasing the blood flow to the area,
which can cause pain and tissue death resulting in ulcers and in severe cases amputation.
Foot ulcers or sores may develop on your feet or ankles due to peripheral neuropathy,
peripheral vascular disease or even poorly fitting shoes. Healing can take longer when your
blood sugar levels high. If the foot ulcer is not properly treated, it can get infected. In severe
cases the infection can eventually lead to an amputation.
Although it is important to have regular foot and ankle examinations, the most important way to
prevent foot and ankle complications is to control your blood sugar levels and lower your HbA1c.
How can I lower my HbA1c?
Your primary care physician or diabetes health care provider can help you manage your
diabetes and may recommend lifestyle changes like diet and exercise as well as medications to
help regulate your blood sugar levels.
Source:
 National Diabetes Information Clearinghouse (NDIC). (March 2014) The A1c Test and Diabetes. Retrieved
from http://diabetes.niddk.nih.gov/dm/pubs/A1CTest/.
 American Diabetes Association.(11 March 2014) Foot Complications. Retrieved from
http://www.diabetes.org/living-with-diabetes/complications/foot-complications/.
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