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A1c 7.2 Average Blood Sugar

Understanding The New Hba1c Units For The Diagnosis Of Type 2 Diabetes

Understanding The New Hba1c Units For The Diagnosis Of Type 2 Diabetes

In the absence of overt symptoms of hyperglycaemia, the diagnosis of diabetes has been based on plasma glucose concentrations that are associated with an increased risk of its specific microvascular complications, in particular retinopathy.1,2 The precise criteria have always been determined by consensus among experts and are based principally on several large observational cohort studies. The criteria have been repeatedly modified over time as more high quality data have become available. Most recently many international diabetes societies have adopted the measurement of glycated haemoglobin (HbA1c) as a legitimate diagnostic test for the diagnosis of diabetes using a “cut point” for the diagnosis of ≥6.5%.3–5 Recently there has been a change in the reporting units for HbA1c from percent to mmol/mol that has been driven by the International Federation of Clinical Chemistry (IFCC) and is linked to the standardisation of routine assays for HbA1c to a new reference method.6 The validity of the process has been accepted by many international diabetes societies (American Diabetes Association, Canadian Diabetes Society, European Association for the Study of Diabetes and International Diabetes Federation) as well as by the New Zealand Society for the Study of Diabetes (NZSSD).7 A NZSSD Working Party, made up of members representing clinicians, academics, laboratory staff, general practitioners and population health experts, has developed and now published a new position statement for the diagnosis of diabetes.7 This article explains the changes in use of HbA1c recommended in that statement and expands on the evidence behind these modifications. New units All methods used to measure HbA1c in New Zealand are now standardised through traceability to the IFCC reference me Continue reading >>

Update: Racial And Ethnic Differences In The Relationship Between Hba1c And Blood Glucose: Implications For The Diagnosis Of Diabetes

Update: Racial And Ethnic Differences In The Relationship Between Hba1c And Blood Glucose: Implications For The Diagnosis Of Diabetes

Received 2011 Jun 29; Accepted 2011 Dec 13. Copyright 2012 by The Endocrine Society This article has been cited by other articles in PMC. Hemoglobin A1c (HbA1c) is widely used as an index of mean glycemia in diabetes, as a measure of risk for the development of diabetic complications, and as a measure of the quality of diabetes care. In 2010, the American Diabetes Association recommended that HbA1c tests, performed in a laboratory using a method certified by the National Glycohemoglobin Standardization Program, be used for the diagnosis of diabetes. Although HbA1c has a number of advantages compared to traditional glucose criteria, it has a number of disadvantages. Hemoglobinopathies, thalassemia syndromes, factors that impact red blood cell survival and red blood cell age, uremia, hyperbilirubinemia, and iron deficiency may alter HbA1c test results as a measure of average glycemia. Recently, racial and ethnic differences in the relationship between HbA1c and blood glucose have also been described. Although the reasons for racial and ethnic differences remain unknown, factors such as differences in red cell survival, extracellular-intracellular glucose balance, and nonglycemic genetic determinants of hemoglobin glycation are being explored as contributors. Until the reasons for these differences are more clearly defined, reliance on HbA1c as the sole, or even preferred, criterion for the diagnosis of diabetes creates the potential for systematic error and misclassification. HbA1c must be used thoughtfully and in combination with traditional glucose criteria when screening for and diagnosing diabetes. In the late 1960s, hemoglobin A1 was first recognized as a glycated form of hemoglobin that was increased in patients with diabetes ( 1 ), and in 1976, hemoglobin A1c (HbA Continue reading >>

Why Should My A1c Be 7 Per Cent Or Less?

Why Should My A1c Be 7 Per Cent Or Less?

Share: Over the last several years a significant amount of research has proven that control matters, and good control is now defined as an A1C of < 7 per cent. What is an A1C? An A1C test shows your blood glucose control over the last 2 or 3 months. Research from both the Diabetes Control & Complications Trial (DCCT) and its follow up study (EDIC) proves that having an A1C of 7 per cent is definitely worthwhile for persons with type 1 diabetes. Exactly 1441 volunteers aged 13 to 39, all with type 1 diabetes, took part. These people agreed to randomly be assigned to either conventional treatment - taking about two insulin injections a day - or to intensive treatment (IT) - taking either multiple dose insulin (MDI, about 4 injections a day) or an insulin pump. During the study the A1C of each group was compared: the conventional therapy group had an average A1C of 9.1 per cent (normal 4-6 per cent) the intensive therapy group had an average A1C of 7.2 per cent The purpose was to finally demonstrate whether or not good blood sugar control was really important to prevent the complications of diabetes. And indeed it is – as you can see below, complications developed at a much lower rate in the intensively treated group compared to the conventional group. Effect of intensive therapy on: Those with no complications at beginning of study: Those with some complication at beginning of study: Eye Disease (retinopathy) 76% overall reduction 54% less progression 45% less risk of needing laser therapy Kidney Disease (nephropathy) 34% less microalbuminuria 56% less proteinuria Nerve Disease (neuropathy) 69% less occurrence 57% less occurrence Heart Disease Trend towards reduction in risk factors Trend towards reduction in risk factors The reduction in risk for eye disease (the prima Continue reading >>

Managing Your Blood Sugar

Managing Your Blood Sugar

Blood glucose (sugar) is the amount of glucose in your blood at a given time. It is important to check your blood glucose (sugar) levels, because it will: Provide a quick measurement of your blood glucose (sugar) level at a given time; Determine if you have a high or low blood glucose (sugar) level at a given time; Show you how your lifestyle and medication affect your blood glucose (sugar) levels; and Help you and your diabetes health-care team to make lifestyle and medication changes that will improve your blood glucose (sugar) levels. How often should you check your blood glucose (sugar) levels? How frequently you check your blood glucose (sugar) levels should be decided according to your own treatment plan. You and your health-care provider can discuss when and how often you should check your blood glucose (sugar) levels. Checking your blood glucose (sugar) levels is also called Self-Monitoring of Blood Glucose (SMBG). How do you test your blood glucose levels? A blood glucose (sugar) meter is used to check your blood glucose (sugar) at home. You can get these meters at most pharmacies or from your diabetes educator. Talk with your diabetes educator or pharmacist about which one is right for you. Once you receive a meter, ensure you receive the proper training before you begin to use it. Ask your health-care provider about: How and where to draw blood How to use and dispose of lancets (the device that punctures your skin) The size of the drop of blood needed The type of blood glucose (sugar) strips to use How to clean the meter How to check if the meter is accurate How to code your meter (if needed) Note: Your province or territory may subsidize the cost of blood glucose (sugar) monitoring supplies. Contact your local Diabetes Canada branch to find out if this appli Continue reading >>

How To Calculate Your A1c

How To Calculate Your A1c

The Hemoglobin A1c (HbA1c or simply A1c for short) test is a blood test used to measure the average blood glucose concentration in your body in the past 1-3 months. For diabetics, this is the standard way of determining how well the diabetes is controlled. An A1c of less than 7% is considered good. Getting the test every 3 months (usually during a doctor visit) is usually enough. But sometimes you may want to just estimate your A1c level based on the data from your regular self-tests. The formula below could help in this case. Accuracy, of course, could vary depending on how often and when you check your blood sugar. I found it pretty accurate last time I used it. My calculation was off only by 0.1%. This is the same formula GlucoseTracker uses in the app's dashboard. Glucose in mg/dL: A1c = (46.7 + average_blood_glucose) / 28.7 Glucose in mmol/L: A1c = (2.59 + average_blood_glucose) / 1.59 So, for example, if your average blood glucose level in the past 3 months is 130 mg/dL (7.2 mmol/L) , your estimated A1c is 6.15%. There are also cheaper devices you can buy that will allow you to do the actual A1c tests yourself, like this one. If you need to do these tests more often, say every month, then it could save you money in the long run as lab tests could get expensive. It may not be as accurate as the lab tests, but my guess is it's probably good enough. Continue reading >>

What Is A Normal Fasting Blood Sugar Level?

What Is A Normal Fasting Blood Sugar Level?

My Dad is a fit and healthy guy, loves exercising and is very lean/generally healthy. He discovered on a routine test that his Hemoglobin A1C (a 3 month average of a person’s blood sugar) was around 6.0. Kinda high and definitely considered pre-diabetic! Here is a nice chart to generally go by: I think some of the numbers on there might be a little high, so just assume lower is better. At the end of the day, my Dad cut sugar out of his diet completely and lowered carb intake while upping his exercise time and all that only lowered his A1C to 5.8, still solidly in the pre-diabetic range! He was kinda pissed because he loves his cookies. Not until he implemented Intermittent Fasting and a monthly Fasting Mimicking Diet did he get down to 5.5 A1C. A solid number for a guy his age. Hope all this helps! Continue reading >>

David’s Guide To Getting Our A1c Under 6.0

David’s Guide To Getting Our A1c Under 6.0

The A1C test is our best scorecard to show how well we are controlling our diabetes. It measures how much glucose has been sticking to our red blood cells for the previous two or three months. Since our bodies replace each red blood cell with a new one every four months, this test tells us the average of how high our glucose levels have been during the life of the cells. The experts recommend that we should get our A1C level tested at least twice a year. People who take insulin need to get it about four times a year. If the test shows that our blood glucose level is high, it means that we have a greater risk of having diabetes problems. Think of the A1C as an early warning system for the insidious complications that we can get down the road when we don’t control our condition. But what do we mean by a “high” A1C level? Here the experts disagree. The American Diabetes Association says that we need to keep our A1C results below 7.0 percent. The American Association of Clinical Endocrinologists sets the target at 6.5 percent. The International Diabetes Federation, or IDF, also recommends that most people with diabetes keep their levels below 6.5 percent. The more our A1C level is higher than normal, the greater the likelihood that we will suffer from one or more of the complications of diabetes. And here too the experts disagree with how they define “normal.” People who don’t have diabetes have A1C levels below 6.0 percent. That’s the gist of what I wrote here recently in “The Normal A1C Level.” The IDF agrees. But more aggressive endocrinologists say that a truly normal A1C ranges from 4.2 percent to 4.6 percent. That’s what Dr. Richard K. Bernstein wrote in Dr. Bernstein’s Diabetes Solution. No matter what our level is, we can be sure that lower is Continue reading >>

Hba1c Of 7.2 - Medication Necessary?

Hba1c Of 7.2 - Medication Necessary?

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community My Hba1c level in January this year was 7.2 and my GP prescribed metformin. I tried the regular for 1 month, had to come off due to digestive problems, then tried slow release but after 2 months it too seemed to neutralise my digestion and I felt pretty awful; in fact my blood sugar readings worsened, and I came off, with an initial IMPROVEMENT in levels. In my July test, after 3 months of no medication, reading was again 7.2 but my doctor still wants me to medicate, and suggests sitagliptin. I am reluctant to try something that is also reported to give digestive problems. I have had mild digestive problems most of my life, now 54. However am fully aware of the dangers of diabetes. Is 7.2 a level at which I need to medicate, or can it be postponed? I did feel that the digestive problems seemed to make me sufficiently ill that the cure was as bad or worse than the diabetes, but I am of course just not sure. My GP is even suggesting insulin, but surely 7.2 is too low a level to justify that? I was first diagnosed pre-diabetic 8 years ago and lost a lot of weight giving 2 years of perfect non-diabetic results, and a "you are not diabetic" from my GP, but although have kept most of weight off it seems to have eventually caught up with me. I was diagnosed earlier this year with an HbA1c of 7.8% in March. That was down to 7% at the end of May after eliminating all added sugar, sweet treats, most crisps and junk food and by adding a lot more fresh and raw. I was trying to follow a low glyceamic index diet at that point. After the last Hba1c I went low carb, eliminating bread, pasta, rice, potatoes and anything obviously starchy and testing my blood several t Continue reading >>

Hemoglobin A1c (hba1c) Test For Diabetes

Hemoglobin A1c (hba1c) Test For Diabetes

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes. Hemoglobin is a protein found in red blood cells. It gives blood its red color, and it’s job is to carry oxygen throughout your body. The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher change of getting of diabetes. Levels of 6.5% or higher mean you have diabetes. The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. A combination of diet, exercise, and medication can bring your levels down. People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year. People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can Continue reading >>

Blood Sugar Monitoring For Type 2 Diabetes: How To Use Your Results

Blood Sugar Monitoring For Type 2 Diabetes: How To Use Your Results

Having to take time out of your day to check blood sugars can be a hassle. Sometimes your fingers get sore and strips can get costly. So why do you do it? If you are checking your blood sugars ONLY because your doctor told you to then you are wasting a lot of time, money and hassle. Your doctor certainly needs to look at those results but if you check daily and only see your doctor every 3-6 months, then only the most recent few weeks before your appointment are usually relevant. How can YOU use your results to better manage diabetes? The first step is to know your A1c. That’s the lab test your doctor does that tells what your average blood sugar has been for the past 2-3 months. Know what your goal is and where you are with respect to that goal. For example if your A1c is 7.2 and your goal is to be <7 then you know that overall your blood sugars are running higher than you want. But when are the high blood sugars happening? Knowing when to check is the next step. With Type 2 diabetes or prediabetes there are 2 best times of day to check blood sugars to gather information: Fasting Blood Sugar in the morning before having anything except water. 2 hours after the start of meals. Fasting Blood Sugar Normal fasting blood sugar is 70-100. Your diabetes goal should be somewhere in the 70-120 range depending on the goals you and your doctor have discussed. Fasting blood sugars are usually elevated due to insulin resistance, meaning that your body has insulin but it does not use it effectively. During the night we are very inactive, we may not sleep well, we might have pain, or hormones such as with menopause could be affecting blood sugars. All of these conditions require the body to use more insulin and with diabetes it does not work as well as it should and we end up with Continue reading >>

Testing Your Blood Glucose?

Testing Your Blood Glucose?

Testing your blood glucose, also known as Self-Monitoring of Blood Glucose (SMBG), is a method of checking how much glucose (sugar) is in the blood using a glucose meter -- anywhere, anytime. Here, you’ll learn some basics about: Blood sugar targets for adults How your doctor tests your blood The importance of self-testing When to test and what to look for How to share results with your doctor Blood glucose targets for non-pregnant adults2 Before meal: 4.4 -7.2 mmol/L After meal: less than 10.0 mmol/L How your doctor tests your blood -- the A1C test Your doctor uses what is called an A1C (Glycosylated Hemoglobin) test to see what your average blood glucose level has been over the last two to three months. Used for both Type 1 and Type 2 diabetes, it gives you and your doctor an indication on how well you are responding to your treatment regimen, and if any adjustments are necessary. The goal is to keep your level below seven percent (7%).2 The A1C test is sometimes referred to as the hemoglobin A1c, HbA1c or glycohemoglobin test. The connection between A1C and average blood sugar levels.3 Your A1C test result will not show the daily effects of food choices and your activity. A blood glucose meter is the best way to observe and track the immediate effects of food choices and activity on your blood glucose levels. This allows you to take immediate action to bring your glucose levels within range if needed. Your doctor will also rely upon your blood glucose meter results to assess and adjust your treatment regimen. When to test and what to look for – a practical guide Use this simple chart to remind you when to test and what to observe to help you manage your blood glucose level on a daily basis. When to test What to look for First thing in the morning, before you eat Continue reading >>

Glycemic Variability: Looking Beyond The A1c

Glycemic Variability: Looking Beyond The A1c

In Brief Hyperglycemia in diabetes is known to be associated with both micro- and macrovascular complications. However, multiple studies have raised the question of whether variation in glucose levels, in addition to average glucose, might be a risk factor for these complications. This article summarizes the available data on glycemic variability and how they might contribute to complications in both type 1 and type 2 diabetes. Hyperglycemia in both type 1 and type 2 diabetes is associated with diabetes complications, including retinopathy, nephropathy, and cardiovascular disease (CVD). Clinicians typically gauge glycemic control with A1C, which reflects the average glucose level over the previous 2–3 months. However, a number of studies1–4 have questioned whether, in addition to average glucose, glucose variability could be an independent risk factor for diabetes complications. The Diabetes Control and Complications Trial (DCCT)5 studied the effect of intensive versus conventional insulin therapy on the occurrence and progression of microvascular complications in patients with type 1 diabetes. The results showed a 50% relative risk reduction in retinopathy, nephropathy, and neuropathy in the intensively treated group, which could largely be explained by improvements in A1C. However, when patients from different treatment groups at the same A1C level were compared, those in the conventional group had higher rates of complications, suggesting that factors other than the average blood glucose level were contributing to the risk of complications.6 Subsequent analysis of the DCCT data found this initial finding to be erroneous, and reanalysis found 96% of the treatment group effect was in fact due to A1C.7 However, the authors concluded that total glycemic exposure, a c Continue reading >>

Glycated Hemoglobin

Glycated Hemoglobin

Glycated hemoglobin (hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also referred to as being Hb1c or HGBA1C) is a form of hemoglobin that is measured primarily to identify the three-month average plasma glucose concentration. The test is limited to a three-month average because the lifespan of a red blood cell is four months (120 days). However, since RBCs do not all undergo lysis at the same time, HbA1C is taken as a limited measure of 3 months. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. HbA1c is a measure of the beta-N-1-deoxy fructosyl component of hemoglobin.[1] The origin of the naming derives from Hemoglobin type A being separated on cation exchange chromatography. The first fraction to separate, probably considered to be pure Hemoglobin A, was designated HbA0, the following fractions were designated HbA1a, HbA1b, and HbA1c, respective of their order of elution. There have subsequently been many more sub fractions as separation techniques have improved.[2] Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous three months before the measurement as this is the lifespan of red blood cells. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, neuropathy, and retinopathy. A trial on a group of patients with Type 1 diabetes found that monitoring by caregivers of HbA1c led to changes in diabetes treatment and improvement of metabolic control compared to monitoring only of blood or urine glu Continue reading >>

Blood Glucose Monitoring For Assessment Of Glycemic Control

Blood Glucose Monitoring For Assessment Of Glycemic Control

Blood glucose levels can be affected by a number of factors, including the amount and type of food intake, physical activity, medications, and comorbid conditions. Glucose monitoring—either by the patient with self-monitoring of blood glucose (SMBG) or by the provider with measurement of A1C—is important to help guide and evaluate diabetes management goals. Achievement of glycemic goals can be partially attributed to the efficacy of the diabetes treatment, diet, and exercise plan.1 The integration of glucose monitoring results into the diabetes management plan may help guide nutritional therapy, physical activity recommendations, and adjustment of pharmacological therapy. Self-monitoring of Blood Glucose SMBG measures capillary glucose levels, and allows patients to track blood glucose fluctuations throughout the day, with the frequency and timing of testing dependent on the patient’s specific needs and goals.1 SMBG is especially important for insulin-treated patients to help monitor blood glucose levels and guide treatment.1 Patients who are taking intensive insulin regimens (patients with type 1 or type 2 diabetes taking multiple-dose insulin therapy) may need to perform SMBG testing 6-10 times daily, including prior to meals and snacks, postprandially, at bedtime, prior to exercise, when they suspect low blood glucose, after treating low blood glucose until they are normoglycemic, and prior to critical tasks such as driving.1 The frequency and timing of SMBG should be re-evaluated at each routine visit.1 For some patients, particularly children, teens, and young adults and patients with hypoglycemia unawareness and/or frequent hypoglycemic episodes, continuous glucose monitoring (CGM) may be useful as an adjunct to SMBG.1 For more information about CGM, visit T Continue reading >>

Hba1c Conversion Chart

Hba1c Conversion Chart

The HbA1c test measures how much haemoglobin in the blood has become glycated (chemically bonded with glucose). ••••• HbA1c values have changed and are now reported as a measurement in mmols/mol instead of the percentage previously given. To make sense of the new units and compare these with old units and vice versa, use our HbA1c units converter table below. Old unit = NGSP unit = %HbA1c New unit = IFCC unit = mmol/mol HbA1c Old HbA1c New HbA1c Old HbA1c New 4.0 20 8.1 65 4.1 21 8.2 66 4.2 22 8.3 67 4.3 23 8.4 68 4.4 25 8.5 69 4.5 26 8.6 70 4.6 27 8.7 72 4.7 28 8.8 73 4.8 29 8.9 74 4.9 30 9.0 75 5.0 31 9.1 76 5.1 32 9.2 77 5.2 33 9.3 78 5.3 34 9.4 79 5.4 36 9.5 80 5.5 37 9.6 81 5.6 38 9.7 83 5.7 39 9.8 84 5.8 40 9.9 85 5.9 41 10 86 6.0 42 10.1 87 6.1 43 10.2 88 6.2 44 10.3 89 6.3 45 10.4 90 6.4 46 10.5 91 6.5 48 10.6 92 6.6 49 10.7 93 6.7 50 10.8 95 6.8 51 10.9 96 6.9 52 11.0 97 7.0 53 11.1 98 7.1 54 11.2 99 7.2 55 11.3 100 7.3 56 11.4 101 7.4 57 11.5 102 7.5 58 11.6 103 7.6 60 11.7 104 7.7 61 11.8 105 7.8 62 11.9 107 7.9 63 12.0 108 8.0 64 Sit down with your child to decide what kind of meter they would prefer out of the options available. Hypos Hypos occur when your blood glucose falls too low. PLAY A healthy diet for someone with diabetes is the same as a healthy diet for anyone else. Find out what… Living with diabetes during pregnancy can be challenging, but you can still lead a healthy life. Take control of your… Glucose testing is the process used to measure the amount of glucose in your blood and can be carried out… FreeStyle Optium Neo has a choice of tools designed to help people who use insulin. Understanding your blood glucose level is a beneficial part of diabetes self-management and can help you and your healthcare team… Continue reading >>

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