To comprehend diabetes testing, we must first comprehend the disease. Diabetes is a demand of, or improper use of, the insulin that our body produces. Our digestive system breaks down the foods we take into a sugar substance, called glucose, which our body uses as fuel. When glucose enters our bloodstream, growth and energy occur. Our body’s cells require insulin in the blood to use glucose. Insulin is produced in the pancreas. While we eat, the pancreas creates insulin.

This production moves the glucose from the blood cells to other cells so that it can create energy and growth. If enough insulin is unsuccessful to be produced, or our cells don't use it properly, you end up with the disease known as diabetes. Insulin is essential in regulating the body’s blood sugar levels.

Diabetes, if untreated can establish to be life-threatening or may cause some other serious effects. It should be tested as and when you find any symptoms. There are various tests known worldwide to diagnose diabetes and ruling it out. One such test is sugar level test. This test requires a pinch of blood to measure the level of glucose in the blood. In this test, you will be asked to refrain anything eatable or liquid at least up to 8 hours before the test.

But unfortunately, these tests are not found to be accurate for patients who are already on dialysis. For the hemodialysis patients, the hemoglobin test doesn’t establish to be a true glucose control test. Even though controlling glucose level is necessary as the high level hardens the arteries thereby leading to more kidney diseases, heart attack, stroke, nerve alteration and blindness. In the process of hemodialysis, blood is passed through the artificial kidney organisation for cleansing which is used in the case of kidney failure. There is one more test known as peritoneal dialysis often conducted at home in which fluid is passed in to the abdomen. The diabetic dialysis patients have very high blood sugar level and hence A1C test may not establish to be accurate for them.

The A1C test reacts with the glucose in a patient’s blood, measuring the hemoglobin percentage. The glycated-albumin test measures how the glucose reacts to albumin, a accelerator in plasma. For patients on hemodialysis, the glycated-albumin test brought higher blood sugar levels, than those that were tested with the A1C method. The difference might be due to the fact the A1C test relies on the red blood cells, which for patients on dialysis, don't survive for long. Patients on dialysis receive medication to help stimulate the red blood cells production rate.

The A1C test is helpful in measuring the hemoglobin percentage which actually reacts with glucose. The blood sugar controlled in last 120 days is reflected through this test. The A1C test was compared with glycated-albumin test which also measures the amount of blood sugar that reacts with albumin, a accelerator in the plasma. This test shows the control in blood sugar for past 3-4 weeks. Current blood sugar levels were also determined. But this test brought about higher blood sugar and glycated-albumin level for patients on hemodialysis as compared to the A1C test which brought lower levels in comparison to patients with no kidney failure. This difference is due to the fact that A1C test depends on rbc’s (red blood cells) survival which doest not resist for too long in patients of hemodialysis. The medication given to dialysis patients stimulates the production of RBCs in blood.

According to some researchers, the glycated-albumin test is more accurate than A1C test when it comes to measuring the blood sugar among patients who are on hemodialysis. This information is also confirmed by the Asian diabetic patients. This glycated-albumin test is yet to be evidenced with patients on peritoneal dialysis as well as to patients with kidney disease but not yet on dialysis.