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PubMed Simonis-Bik, Annemarie M C; Eekhoff, Elisabeth M W; Diamant, Michaela; Boomsma, Dorret I; Heine, Rob J; Dekker, Jacqueline M; Willemsen, Gonneke; van Leeuwen, Marieke; de Geus, Eco J C In an extended twin study we estimated the heritability of fasting HbA1c and blood glucose levels. Blood glucose was assessed in different settings (at home and in the clinic). We tested whether the genetic factors influencing fasting blood glucose levels overlapped with those influencing HbA1c and whether the same genetic factors were expressed across different settings. Fasting blood glucose was measured at home and during two visits to the clinic in 77 healthy families with same-sex twins and siblings, aged 20 to 45 years. HbA1c was measured during the first clinic visit. A 4-variate genetic structural equation model was used that estimated the heritability of each trait and the genetic correlations among traits. Heritability explained 75% of the variance in HbA1c. The heritability of fasting blood glucose was estimated at 66% at home and lower in the clinic (57% and 38%). Fasting blood glucose levels were significantly correlated across settings (0.34 < r < 0.54), mostly due to a common set of genes that explained between 53% and 95% of these correlations. Correlations between HbA1c and fasting blood glucoses were low (0.11 < r < 0.23) and genetic factors influencing HbA1c and fasting glucose were uncorrelated. These results suggest that in healthy adults the genes influencing HbA1c and fasting blood glucose reflect different aspects of the glucose metabolism. As a consequence these two glycemic parameters can not be used interchangeably in diagnostic procedures or in studies attempting to find genes for diabetes. Both contribute unique (genetic) information. Hosking, Joanne; M Continue reading >>
The Normal A1c Level
Wow Richard, 70 lbs? I have lost 24 lbs from low carb diet due to SIBO. It also helped my AC1 go down three points from 6.2 and my cholesterol is lower, which surprised me. I can’t afford to lose anymore weight because I was small to begin with. I had noticed much bigger people in the UK over the last 5 years compared to 15-20. Was quite shocking. I thought we had the patent on obesity! I am not diabetic that I know of but I had weird symptoms… Thirst that continued all day and night. My husband called me a camel. Dry eyes, rashes, strange dark discolouration on arm, under the arm to the side, some circulation issues and blurred vision. Eye specialist could not figure out why. Sores in the mouth also. I had observed about three weeks into super low carbs (30 Gms carb/day) that athlete’s foot symptom, sores in mouth and rashes were clearing up. So, lowering carbs for SIBO actually turned out for the best. By the way, I love your final paragraph. Research is what led me to SIBO diagnosis, and I then told the GI what to look for! He was barking up the wrong tree for months. Said I needed to eat more carbs so I don’t lose weight. Well, carbs fed the bacterial overgrowth!!! Dang fool. On Saturday, June 23, 2012, Diabetes Developments wrote: There is a new comment on the post “The Normal A1C Level”. Author: Richard Comment: I think part of the problem is that doctors are trained over many years to treat with pills, not with food. We continue to do what we are trained to do no matter what. I do believe they want to help us but don’t have the nutritional knowledge because that is not their expertise. When you have a hammer, etc. Nutritionist are no better unless they are those involved in research. They just peddle the messages they are told to. Then again, why wo Continue reading >>
- What Is a Normal Blood Sugar Level?
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
On A Personal Note: How To Interpret Simple Blood Tests
In an earlier post we talked about eight simple blood tests that you should have done to help you keep track of your health. I recently had my yearly check-up at my primary care physciacns office so I thought I’d share my lab results and how to read simple blood tests. How To Read Blood Tests When I wrote about eight simple blood tests that people should have there are three that come to mind that I like to have done on a yearly basis: a lipid panel, a complete metabolic panel (CMP), and a compelte blood count (CMP). A simple lipid panel will tell you if your cholesterol is something you should be worried about, a CMP gives you some insight on your electrolyte levels, liver function, and kidney function. Lastly, a CBC can tell you if you have anything that might hint that you could have cancer, anemia, or some sort of crazy infection going on. Luckily, everything on my tests came back okay (heck I’m only 31), but I figure I could explain the blood tests in detail so some people have some insight as to what blood tests results could mean if they’re taking a look at their results for themselves. The BMP takes a look at a few different things inside of your body and can give you some pretty good insight into how things are functioning over all. Let’s break it down. Kidney Function: Test Name Result Range Blood Urea Nitrogen 25 mg/dl 7-25 Creatinine 0.95 mg/dl 0.60-1.35 GFR 106 > or = to 60 The GFR is the rate at which your kidneys filter your blood. If your rate starts dropping below 60, it’s not a good thing. A BUN and Creatinine can also indicate poor kidney function if levels are abnormal. But it can also indicate other things like dehydration. Elevated creatinine levels can also be related to rhabdomyolosis (rapid muscle breakdown) from either malnutrition or Continue reading >>
Why Raise Your A1c?
Have you been ordered by your doctor to get your A1C (HbA1c) level up? More people are having this confusing experience, as doctors try to implement the 2013 ADA treatment guidelines. Do these orders make sense? Not much, I’d say. What is happening here? In 2012, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) changed the targets doctors should aim for in treating diabetes. They went from a one-size-fits-all target of 7.0% HbA1c to a three-tiered guideline. HbA1c is the test that gives an idea of the average blood glucose level for the previous two months or so. An A1C of 7.0% equals an average blood glucose of around 154 mg/dl, and many people think that number is too high to protect against complications. So there was pressure to lower the guideline. At the same time, many older people found the 7.0% goal too strict. A few studies found an increased risk of falls in older people who run low glucose levels. There was concern about increased risk of hypoglycemia (low blood glucose). As Diane Fennell wrote here, many think that aiming for lower A1C levels leads to an increase in low blood glucose episodes. As many readers commented, hypos are dangerous and unpleasant. For many, they are the worst fact of life with diabetes. So the experts finally recognized that one size does not fit all. Unfortunately, their new guidelines have been misunderstood by some doctors, leading to people being told to raise their A1C numbers, even if doing so increases their complication risk. According to the new guidelines, older or sicker people, or those with many hypoglycemic episodes, might shoot for 7.5% to 8.0%. Younger, healthier, people might want to get their A1C below 6.5%, or even lower. People in between on age and health mi Continue reading >>
Hemoglobin A1c Test (hba1c, A1c, Hb1c)
Hemoglobin A1c definition and facts Hemoglobin A1c is a protein on the surface of red blood cells that sugar molecules stick to, usually for the life of the red blood cell (about three months). The higher the level of glucose in the blood, the higher the level of hemoglobin A1c is detectable on red blood cells. Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time period. Normal ranges for hemoglobin A1c in people without diabetes is about 4% to 5.9%. People with diabetes with poor glucose control have hemoglobin A1c levels above 7%. Hemoglobin A1c levels are routinely used to determine blood sugar control over time in people with diabetes. Decreasing hemoglobin A1c levels by 1% may decrease the risk of microvascular complications (for example, diabetic eye, nerve, or kidney disease) by 10%. Hemoglobin A1c levels should be checked, according to the American Diabetic Association, every six months in individuals with stable blood sugar control, and every three months if the person is trying to establish stable blood sugar control. Hemoglobin A1c has many other names such as glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin, and HbA1c. To explain what hemoglobin A1c is, think in simple terms. Sugar sticks to things, and when it has been stuck to something for a long time it's harder to the get sugar (glucose) off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die. When sugar (glucose) sticks to these red blood cells by binding to hemoglobin A1c, it gives us an idea of how much glucose has been around in the blood for the preceding three months. Hemoglobin A1c is a minor component of hemoglobin to which gl Continue reading >>
The Abcs Of Diabetes: A1c, Blood Pressure, And Cholesterol
Three important diabetes measures There is so much to think about when you have diabetes, but this easy-to-remember acronym will help you focus on what’s important and take control of your health. Read our breakdown and talk to your doctor about what’s right for you. A = AIC What is it? An A1C blood test measures the percentage of hemoglobin (the oxygen-carrying protein in your red blood cells) coated with sugar. It measures your average blood glucose (sugar) level over the past two to three months. The A1C test gives you and your health care provider a measure of your progress. Most people with diabetes should have an A1C test every three to six months; people who are meeting their treatment goals may need the test only twice a year. Why is it important? The A1C test is a good measure of how well your glucose is under control. It can also be a good tool for determining if someone with prediabetes is progressing toward or has developed type 2 diabetes. Adults over age 45 with hypertension, obesity, or a family history of diabetes also are advised to get an A1C test because they have a greater risk of developing type 2 diabetes. Finding out you have an elevated A1C is a cue to make positive changes to your lifestyle. What do the numbers mean? 5.7% or lower = normal blood glucose levels 5.8–6.4% = elevated blood glucose levels (prediabetes) 6.5% or higher = diabetes What should my numbers be? For years, people with type 2 were told to strive for an A1C of 7 percent or less, but new research indicates that one level doesn’t fit all. Based on your health status, age, and risk factors, you and your health care provider should determine an A1C goal for you. Here are the American Diabetes Association’s new general guidelines: Person newly diagnosed with type 2 diabet Continue reading >>
What Is The A1c Test? How Does A1c Relate To Blood Glucose?
Anyone with diabetes will be familiar with finger-prick testing for monitoring blood glucose to see how well they are managing their disease. This kind of regular testing is essential for most people with diabetes, but what role does an occasional hemoglobin A1C blood test play in controlling blood sugars, and how does it work? Contents of this article: What is the A1C test? The abbreviation A1C is used in the US (sometimes with a lower-case 'c' - A1c) and is short for glycated hemoglobin (sometimes called 'glycosylated' hemoglobin or glycohemoglobin). The other abbreviations in use are: HbA1c (widely used internationally) HbA1c Hb1c HgbA1C. The A1C test is a blood test used to measure the average level of glucose in the blood over the last two to three months. This test is used to check how well blood sugar levels are being controlled in a person with diabetes and can also be used in the diagnosis of diabetes.1 Hemoglobin is the protein in red blood cells which is responsible for transporting oxygen around the body. When blood glucose levels are elevated, some of the glucose binds to hemoglobin and, as red blood cells typically have a lifespan of 120 days, A1C (glycated hemoglobin) is a useful test because it offers an indication of longer term blood glucose levels.2 The particular type of hemoglobin that glucose attaches to is hemoglobin A, and the combined result is call glycated hemoglobin. As blood glucose levels rise, more glycated hemoglobin forms, and it persists for the lifespan of red blood cells, about four months.2 Therefore, the A1C level directly correlates to the average blood glucose level over the previous 8-12 weeks; A1C is a reliable test that has been refined and standardized using clinical trial data.3 There are two key things to know about the appl Continue reading >>
- Home blood glucose test: How to test for diabetes at home
- Diabetes and the A1C Test: What Does It Tell You?
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
The Diabetic Report Card
What’s in a number? Numbers mean different things to different people. Many people are focused on such things as the number on a scale, or the number in their bank account. There are people who are so focused on their age, that they obsess about the number and waste years away thinking they are old when before you know it they’ve missed out on life entirely. Often times we are so hard on ourselves based on whatever number we are so laser focused on that we forget why we are shooting for the goal associated with that number. These all may sound like motivational sentences that you may have read in the latest Malcolm Gladwell inspiration but there is indeed a reason behind whatever number you are obsessed with. I know for me, the numbers that I focus on every day have a greater meaning and taking the time to actually figure out why and how I react to the result has helped me deal with the weight of it all. My hemoglobin A1c (HbA1c) is my diabetes report card. It gives me my three month average of how my blood sugars are trending and indirectly tells me what kind of damage I have either done or saved myself from. I beat myself up mentally and emotionally more times than I can count if this number comes back well below my standards. Having worked in the diabetes industry for eight years, I have seen many A1c’s from many different types of patients. Unfortunately, many patients have not fully understood what that one little percentage on their lab results really means and how it correlates with the risk of diabetes complications. The overall goal for an A1c is 7% which equals an average blood sugar of about 170. What the doctors don’t always explain to their patients is that this is in fact an average… which means the blood sugar could be an average of 250 and 70 a Continue reading >>
Ada 52nd Annual Advanced Postgraduate Course
At the General Session of the 2005 American Diabetes Association Postgraduate Course addressing "New Approaches to Diabetes Treatment," Janet McGill, MD, Washington University School of Medicine, St. Louis, Missouri, discussed approaches to oral agent combination therapy.[ 1 ] She pointed out that "expenditures for medications are a very small part of total diabetes care," with oral agents not only far less costly than inpatient care but also less costly than insulin with associated supplies. She noted the American Diabetes Association and American Association of Clinical Endocrinologists respective A1C goals of 7.0 and 6.5, pointing out that A1C 6.3 vs 7.3 may be predicted to decrease the time to onset of retinopathy by 15 years and to reduce nephropathy risk by 40%, so we should "go as low as we can with acceptable risk." In epidemiologic studies, at fasting blood glucose ~110 "we begin to see retinopathy," she stated. The United Kingdom Prospective Diabetes Study (UKPDS) epidemiologic analysis showed no evidence of a "lower limit," while there is "a [ cardiovascular disease risk] plateau after we reach an A1C of 8 to 9."[ 2 ] These considerations suggest that therapeutic approaches that will allow maintenance of near euglycemia are optimal. However, only a minority of patients have A1C at target. The problem with monotherapy in the UKPDS fashion is that there is progressive deterioration in control, largely because of worsening beta-cell function. Current trends are to use combination approaches ("goal-oriented approach") rather than a variety of different individual agents followed by the addition of insulin and then the adoption of a complex insulin regimen over decades, as had been previously recommended. Monotherapy with either a sulfonylurea or metformin[ 3 ] m Continue reading >>
The A1c Test: Uses, Procedure, Results
The A1C test, also known as an HbA1C, hemoglobin A1c,glycated hemoglobin, or glycosylated hemoglobin test, is a blood test that shows your average blood sugar levels for the past two to three months. It's a broader test than conventional home glucose monitoring , which measures your blood sugar at any given moment. It's used to diagnose and monitor diabetes. Hemoglobin A, a protein found inside red blood cells, carries oxygen throughout your body. When there's glucose in your bloodstream, it can stick (glycate) to hemoglobin A. The more glucose that's in your blood, the more it does this, creating a higher percentage of glycated hemoglobin proteins. Once glucose sticks to a hemoglobin protein , it typically remains there for the lifespan of the hemoglobin A protein (as long as 120 days). This means that, at any moment, the glucose attached to the hemoglobin A protein reflects the level of your blood sugar over the last two to three months. The A1C test measures how much glucose is actually stuck to hemoglobin A, or more specifically, what percent of hemoglobin proteins are glycated. Hemoglobin with glucose attached to it is called A1C. Thus, having a 7percentA1C means that 7 percent of your hemoglobin proteins are glycated. Your doctor may order an A1C test for these reasons: If you're overweight or obese and you have one or more other risk factors for developing type 2 diabetes , your doctor will likely order an A1C test as part of your normal medical exam every year. Such risk factors include: High-risk ethnicity (Native American, African American, Latino, Asian American) The majority of people who end up with type 2 diabetes have prediabetes first, which means that your blood sugar is higher than normal, but not high enough to be diagnosed with diabetes. The A1C tes Continue reading >>
What Is The A1c Test For Diabetes?
Hemoglobin A1c is a test used to tell you your average blood sugar over time. In this video, Ronald Tamler, MD, clinical director of the Mount Sinai Diabetes Center, explains the test and what its results mean. For someone who doesn't have diabetes, a normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time might have an A1C level above 9 percent. A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. For someone who doesn't have diabetes, a normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time might have an A1C level above 9 percent. For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan. Remember, the higher your A1C level, the higher your risk of diabetes complications. An A1C test is a quick lab test that allows your doc to get a sense of your average day and night blood sugars for the last three months. Your A1C score should be between 6.0 and 6.9. If you have diabetes, you should have an AIC test four times a year. Diabetes Warrior: Be your own knight in shining armor. How to stay healthy and happy with diabetes. You survived the first year: now there is more to learn... Knights? Dragons? Diabetes?! Yep, armed with a wickedly sharp sense of humor and a medieval metaphor, Taming the Tiger author William Lee... The A1C test is a test that measures a person's avera Continue reading >>
Sugar High Sugar Low: Preparing For Pregnancy
Before conceiving I had a lot of things to contemplate such as being fit, healthy, eating well, having tight control of my blood glucose levels and most important of all achieving at least an A1c of 7.0%. Both diabetes and pregnancy combined have their own unique challenges. I knew that I would have a lot of hard work ahead of me. My diabetes appointments are usually quarterly at the diabetic centre. My previous appointment showed that my A1c was 7.5%, so I decided to visit my diabetic team and inform them of my plan, as I did with my first pregnancy. The diabetic nurse retested my A1c and after two weeks I found out my A1C was actually 7.3%. Blood glucose control is vital during pregnancy because if you can imagine even before you’re aware of your pregnancy, your baby’s brain, spinal cord, heart and other organs have already started to form. This totally freaks me out because without tight control I could have possibly affected the way in which my child developed. I was given the opportunity to have a trial run of the dexcom G4 sensor for a month which I talked about in my post, “Cyborg for a month or perhaps longer”. Dexcom G4 – is a continuous glucose monitoring (CGM) sensor which is inserted into the body and is able to give blood glucose readings every five minutes. The sensor automatically transmits this reading to my insulin pump (Animas Vibe) and creates a graph. With my insulin pump I am able to set an ideal blood glucose range. If my blood glucose level goes above or below this range my insulin pump alarms to alert me of either an increase or decrease in blood glucose level. My trial run actually went on for longer than a month and it was during that time that I conceived. My pregnancy journey had started and with my team we made the decision to cont Continue reading >>
Average blood glucose and the A1C test Your A1C test result (also known as HbA1c or glycated hemoglobin) can be a good general gauge of your diabetes control, because it provides an average blood glucose level over the past few months. Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you check blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target of 7% or lower recommended by the American Diabetes Association (ADA) for many adults who are not pregnant. For some people, a tighter goal of 6.5% may be appropriate, and for others, a less stringent goal such as 8% may be better.1 Talk to your doctor about the right goal for you. GET YOURS FREE The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management. See how average daily blood sugar may correlate to A1C levels.2 Enter your average blood sugar reading and click Calculate. *Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes. What is A1C? Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a Continue reading >>
5 Simple Ways To Lower Your A1c This Week
The A1C blood test is a simple test that analyzes your glucose (blood sugar) levels by measuring the amount of glycated hemoglobin in your blood. Hemoglobin is a protein in your red blood cells; when glucose enters the blood, it attaches to the hemoglobin. The result is glycated hemoglobin. The more glucose in your blood, the higher your glycated hemoglobin. The A1C is a valuable indicator of how well your diabetes management plan is working. While your individual A1C goal will depend on factors including your age and your personal medical profile, most people with diabetes aim to keep their A1C below 7 percent. By keeping your A1C number within your target range, you can reduce the risk of diabetes complications. While it is important to develop a long-term diabetes management plan with your physician, there are several steps you can take right away to help reduce your A1C. Small changes add up, so consider trying some of these strategies to lower your A1C this week. 1. Try Short Sessions of High Intensity Exercise According to research presented at the American Heart Association's Scientific Sessions 2015, type 2 diabetes patients who did 10 minutes of exercise three times a day, five days a week at 85 percent of their target heart rate had a twofold improvement in A1C levels compared to patients who exercised for 30 minutes a day at 65 percent of their target heart rate. Be sure to check with your doctor before trying high intensity exercise, and wear a heart rate monitor so you don’t overdo it. 2. Shrink Your Dinner Plate Instead of a large dinner plate for your meals, use a smaller salad plate. This simple swap can trick your eyes and brain into thinking you’re eating more than you really are, and you’ll feel satisfied with less food. It’s especially helpfu Continue reading >>
Type 1s, How Many Carbs Do You Eat/day And What Is Your A1c?
Type 1s, how many carbs do you eat/day and what is your A1c? A1C 6.9-7.3. Carbs in a day 90-135. This has been the staple for me for the last 11 years. Use to have 3-5 reactions in a week. Doctor and I talked to figure out the best plan for me. a medium red pepper is 7 carbs and the fiber is 2.5 so you would bolus for 4.5 carbs? Thats what Id do! Carbs are carbs, except when theyre fiber. Some may be a bit quicker to digest than others, but theyre all just carbs to me. Ive been diabetic for seven years and on insulin for five. During most of this time I consumed between 120 and 150 carbs daily and had an A1c on MDI of between 5.5 and 5.9. Recently I got down to a scrawny 101 pounds and have been trying to gain weight, so I sometimes increase carbs to 180. My last two A1cs have been 6.1 and 6.0. I also got a CGM (Freestyle Libre) in February and dose mostly from those readings, rather than taking finger stick readings to dose. I was age 70 before I became diabetic, so I probably allow myself a wider range of BG variability than many younger people prefer. I consider my target range from 70 to 180, and now that Im desperately trying to gain some weight, I dont even get too excited if my BG goes a bit over 200 occasionally. At my age the chances of living long enough to worry about complications are far less than for the majority who get type 1 much younger. I have no signs of complications after seven years. To eat that many carbs without having BG go high, I do have to spread my eating out with many meals and snacks, though. As a retiree, thats not a problem. Id have had a much more difficult time if Id had to try it while I was still employed. My A1cs are usually around 7. Yesterday I had around 290 g of carbs. But it varies day to day. I dont necessarily have the same Continue reading >>