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Pre Diabetes A1c

Diagnosis

Diagnosis

Print The American Diabetes Association (ADA) recommends that blood glucose screening for adults begin at age 45, or sooner if you are overweight and have additional risk factors for prediabetes or type 2 diabetes. There are several blood tests for prediabetes. Glycated hemoglobin (A1C) test This test indicates your average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. In general: An A1C level below 5.7 percent is considered normal An A1C level between 5.7 and 6.4 percent is considered prediabetes An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (hemoglobin variant). Fasting blood sugar test A blood sample is taken after you fast for at least eight hours or overnight. In general: A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes. Oral glucose tolerance test This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours. In general: A blood sugar level less than 140 mg/dL (7.8 mmo Continue reading >>

What Is Pre-diabetes?

What Is Pre-diabetes?

Q What is pre-diabetes? A Pre-diabetes is when your blood sugar is higher than normal but not as high as it would be with diabetes. Q Is pre-diabetes serious? A Yes, pre-diabetes is serious. • Pre-diabetes can lead to heart problems. • If you have pre-diabetes, you are at much higher risk of getting type 2 diabetes. • Type 2 diabetes can lead to other serious health problems with your eyes, kidneys, nerves and feet. Q How will I know if I have pre-diabetes? A • Ask your doctor for a blood test for pre-diabetes. • Even if you do not feel bad, you should get tested anyway. • 57 million people in the United States have pre-diabetes and do not know it. Q Who should be tested for pre-diabetes? A • All people 45 years and older should be tested for pre-diabetes. • You should also be tested if you are overweight and have one of the following: – Have a brother or sister or parent with diabetes. – Not physically active. – Have high blood pressure or a heart problem. – Cholesterol is not normal. – Had diabetes when you were pregnant or had a baby that weighed nine pounds or more. – Are Hispanic, African-American, American Indian or Asian. – Were ever told you had a “touch of diabetes,†“a little sugar†or “borderline diabetes.†Q What are the tests for pre-diabetes? A There are two blood tests that check your blood sugar: 1. Fasting Blood Sugar Test • You will fast for 8 hours before you take this test. • If your blood sugar is 100-125, you have pre-diabetes. • If your blood sugar is 126 or higher, you have diabetes. 2. A1C Test • This test measures your average blood sugar control for the last three months. • If your A1C is Continue reading >>

Hemorheological Alterations In Adults With Prediabetes Identified By Hemoglobin A1c Levels

Hemorheological Alterations In Adults With Prediabetes Identified By Hemoglobin A1c Levels

Highlights • Subjects with HbA1c-defined prediabetes have increased blood viscosity and hematocrit. • HbA1c is an independent contributor of blood viscosity and hematocrit. • Blood viscosity and hematocrit are associated with carotid intima-media thickness. • Carotid intima-media thickness is increased in subjects with HbA1c-defined prediabetes. • A HbA1c value of 5.7–6.4% may identify subjects with increased cardio-metabolic risk. Abstract A link between increased blood viscosity and type 2 diabetes has been previously reported. Herein, we investigated the association of blood viscosity with prediabetes, identified by glycated hemoglobin A1c (HbA1c) according to the new American Diabetes Association criteria, and subclinical atherosclerosis. The study cohort includes 1136 non-diabetic adults submitted to anthropometrical evaluation, an oral glucose tolerance test and ultrasound measurement of carotid intima-media thickness (IMT). Whole blood viscosity was estimated using a validated formula based on hematocrit and total plasma proteins. After adjusting for age, and gender, individuals with HbA1c-defined prediabetes (HbA1c 5.7–6.4% [39–47 mmol/mol]) exhibited significantly higher values of hematocrit, and predicted blood viscosity as compared with controls. Increased levels of IMT were observed in subjects with HbA1c-defined prediabetes in comparison to controls. Predicted blood viscosity was positively correlated with age, waist circumference, blood pressure, cholesterol, triglycerides, fibrinogen, white blood cell, HbA1c, fasting and 2-h post-load glucose levels, fasting insulin, IMT and inversely correlated with HDL and Matsuda index of insulin sensitivity. Of the three glycemic parameters, i.e. HbA1c, fasting and 2-h post-load glucose, only HbA1c sho Continue reading >>

Prediabetes? What Does It Mean For Your Kidneys?

Prediabetes? What Does It Mean For Your Kidneys?

Prediabetes describes the condition of someone who is on their way to developing diabetes. Before having diabetes, people usually have “pre-diabetes.” This is a new name for a condition in which blood glucose (sugar) levels are higher than normal but not yet high enough to be diagnosed as diabetes. A person with prediabetes cannot handle sugar as well as they should. Even though diabetes is not full blown, high sugar levels in prediabetes can be causing problems throughout the body. One of the main organs that can be damaged is the kidney. People with prediabetes often have unrecognized chronic kidney disease (CKD), according to new research. In this large study, more than one third of the people with prediabetes were found to have two signs of kidney disease: protein in the urine (called albuminuria). Albuminuria is not normal. reduced estimated glomerular filtration rate (eGFR). This is a measure of how well the kidneys work; the eGFR tells the stage of kidney disease. In the people with prediabetes, the stage of chronic kidney disease was just as advanced as people with diabetes. Many people with either prediabetes or diabetes were found to have stage 3 or 4 chronic kidney disease. There are 5 stages of chronic kidney disease. When the disease reaches stage 5, the person will need kidney replacement therapy, either transplantation or dialysis. The U.S. Department of Health and Human Services estimates that about one in four U.S. adults aged 20 years or older—or 57 million people—have pre—diabetes. Without patients and their doctors taking action, prediabetes is likely to become type 2 diabetes in 10 years or less. People with prediabetes should know that the long—term damage to their body—especially to the heart, kidneys and blood vessels — may alread Continue reading >>

Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents

Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents

Margaret T. Hartig, Ph.D. Donna K. Hathaway, Ph.D. Matthew W. Strum, Pharm.D. Mona N. Wicks, Ph.D. Although the American Diabetes Association (ADA) adopted the use of the glycated hemoglobin (A1C) test as a method of diabetes and prediabetes diagnosis, the ADA has not developed firm guidelines concerning the use of the A1C test in children and adolescents, as research has not validated thresholds in this group. Diabetes and prediabetes are diseases influenced by multiple factors, including race and ethnicity, age, vitamin D deficiency, and body mass index (BMI). The purpose of this study was to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the A1C test compared to the gold standard use of the fasting plasma glucose (FPG) and 2-hour oral glucose tolerance test (OGTT) to detect diabetes and prediabetes in a children and adolescents considered to be at higher risk for impaired glucose metabolism. In addition, ROC curve analysis was performed to determine optimal thresholds for the diagnosis of prediabetes in available groups of the research sample. The study also to examined the correlation between A1C and race and ethnicity, age, vitamin D levels, and body mass index, in addition to comparing the relationship of A1C to beta cell dysfunction and insulin sensitivity. A retrospective review of 902 patient electronic medical records in an urban endocrinology clinic was conducted. Based on FPG and 2-hr glucose during the OGTT, patients were classified based on the ADA 2014 criteria as having diabetes or prediabetes Subjects ranged in age from 2-18 (11.6 ± 3.32), were predominantly minority (70.7% African American, 17.3% Hispanic, 12.0% Caucasian) and female (60.7%). The results yielded a high specificity (99.7% Continue reading >>

Comparison Between Prediabetes Defined By Hemoglobin A1c (a1c) 5.7-6.4% And That Defined By Impaired Fasting Glucose (ifg) In A Japanese Population

Comparison Between Prediabetes Defined By Hemoglobin A1c (a1c) 5.7-6.4% And That Defined By Impaired Fasting Glucose (ifg) In A Japanese Population

1Department of Internal Medicine, Tachikawa Medical Center, Japan 2Medical Check-up Center, Tachikawa Medical Center, Japan 3Department of Research and Development, Tachikawa Medical Center, Japan Citation: Suzuki H, Oda E, Aizawa Y (2011) Comparison between Prediabetes Defined by Hemoglobin A1c (A1C) 5.7-6.4% and that Defined by Impaired Fasting Glucose (IFG) in a Japanese Population. J Diabetes Metab 2:153. doi:10.4172/2155-6156.1000153 Copyright: © 2011 Suzuki H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Keywords Prediabetes; Hemoglobin A1c; Impaired fasting glucose; HDL cholesterol; Total bilirubin Introduction Hemoglobin A1c (A1C) at a range of 5.7-6.4% was proposed as a marker of prediabetes [1] in addition to impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) although the World Health Organisation has not recommended using A1C for diagnosis of prediabetes. A1C was significantly associated with risks of cardiovascular disease (CVD) and death from any cause adjusting for fasting glucose (FG), while FG was not significantly associated with risks of CVD and death from any cause adjusting for A1C in non-diabetic adults [2]. Saukkonen et al. reported that overlap between A1C 5.7-6.4%, IFG, and IGT was uncommon and isolated A1C 5.7-6.4% was associated with higher BMI, higher triglycerides, and lower HDL cholesterol compared with isolated IFG among an aging white population [3]. The overlap between A1C 5.7-6.4% and IFG was only 2% in their population [3]. In the present study, we investiga Continue reading >>

Asknadia: Pre-diabetes And How The Glycemic Index Affects My A1c

Asknadia: Pre-diabetes And How The Glycemic Index Affects My A1c

Dear Nadia: I am currently on a “pre-diabetic” watch because of excessive thirst and urination. My current A1c is 5.7. My last fasting glucose at eight hours was 106; at 12 hours 93. After those readings I had a freshly squeezed carrot/apple juice ( two apples, two carrots) drink. An hour later my glucose was 77. I looked a little pale but was feeling OK. Do apples lower glucose even when combined with the sweet carrots? Thank you! Elena Dear Elena: There are several facets to your question. Let me start with your A1C results. Your fasting A1C of 5.7 and your fasting glucose of 106 puts you in the pre-diabetes range. The fasting glucose reading of 93 puts your A1C at 4.9 which boarder’s pre-diabetes. Adding anther layer to these numbers is the variance of plus or minus .5 percent accuracy in the test itself. Your 5.7 A1C test result plus the .5 difference (assuming the test is erring on the higher end of the spectrum) will put your A1C at 6.2. Meaning your average glucose level would be 131 mg/dL, bringing you closer to the 140 mg/dL diabetes diagnosis. The 5.7 and 6.2 A1C would alert your healthcare professional team to recommend a few lifestyle changes. Primarily your diet and exercise. Kudos for knowing your blood sugar level after eating. 77 mg/dL gives you an A1C of 4.3. Hypoglycemia for most people is 70 mg/dL. It goes without saying, everyone is different. Work with your physician to determine your hypoglycemia, low blood sugar range and diet. Apples and or carrots are not categorized as foods that lower your blood sugar. From the exactness of your readings, I can assume that you already have a blood glucose meter and test strips. You obviously are very aware of your numbers and are at a point where you are tracking the possible effects of food and your blo Continue reading >>

Why Prediabetes?

Why Prediabetes?

Can we answer the question of how you can have a pre-disease that increases your risk of death? You either have it or you don’t! The ADA, ESAD, and AACE say that if you have an A1c of 5.7% to 6.4% you are prediabetic or have prediabetes. ADA says if you have an A1c of 7% or higher you have diabetes and the AACE says that if you have an A1c of 6.5% or higher you have diabetes. So the question is, who is correct? How can you have two major medical organizations saying two different things? Who should we believe? What do we tell our patients? On the other hand, what difference does it make? Both numbers mean that the amount of sugar in your blood is causing damage to every organ in your body. If you lose your eyesight or lose a leg or a kidney or even die from a heart attack, what difference does it make for your patients? Study data show fasting glucose concentrations of at least 100 mg/dL (5.6 mmol/L) or an HbA1c of at least 5.7% (39 mmol/mol) were determining factors.1 New research has shown that if you have prediabetes your risk for heart attacks and strokes goes up. So why do we wait for an A1c of 6.5 or 7% before we start to treat our patients? I guess we need to look to the FDA, ADA and other diabetes organizations to ask the question, “Why don’t we have any approved medications to treat prediabetes?” We have drugs like metformin that could make a major difference in preventing elevated blood sugars. We now have drugs like the SGLT-2 inhibitors that have been shown to reduce the risk of cardiovascular disease and even death by up to 38%. And if that is not a reason to treat patients earlier, than what about a drug like cycloset that has been shown to reduce heart attacks and strokes (MACE) by 58%? Do you remember when the definition of diabetes was a fasting Continue reading >>

Corrigendum To “optimal Hemoglobin A1c Levels For Screening Of Diabetes And Prediabetes In The Japanese Population”

Corrigendum To “optimal Hemoglobin A1c Levels For Screening Of Diabetes And Prediabetes In The Japanese Population”

Journal of Diabetes Research Volume 2017 (2017), Article ID 7072538, 2 pages 1Department of Internal Medicine, Iida Municipal Hospital, 438 Yawata-machi, Iida, Nagano 395-8502, Japan 2Division of Companion Diagnostics, Department of Pathology of Microbiology, Nihon University School of Medicine, 30-1 Ooyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, Japan Copyright © 2017 Masanori Shimodaira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Continue reading >>

The Pros And Cons Of Diagnosing Diabetes With A1c

The Pros And Cons Of Diagnosing Diabetes With A1c

An International Expert Committee was convened in 2008 by the American Diabetes Association (ADA), the European Association for the Study of Diabetes, and the International Diabetes Federation to consider the means for diagnosing diabetes in nonpregnant individuals, with particular focus on the possibility to indicate A1C as an alternative if not a better tool (1). After reviewing the available literature and a thorough discussion on the advantages and the limits of previous diagnostic strategies (essentially based on fasting glucose assessment) and the considered alternative approach (based on A1C measurement), a consensus was reached that the latter (i.e., A1C) should be included among diagnostic tools for diabetes and, with the exception of a number of clinical conditions, should even be preferred in diabetes diagnosis in nonpregnant adults. The main conclusion of the International Expert Committee was implemented in the most recent clinical recommendations issued by the ADA. However, in these guidelines, A1C is indicated as a diagnostic tool alternative but not superior to blood glucose, leaving to the health care professional the decision about what test to use in an individual. The World Health Organization is currently examining the proposal made by the International Expert Committee and is carefully addressing the controversial issues still remaining, most of which have been the subject of letters to the editor and articles recently published in the literature. Nevertheless, the use of A1C for diagnosing diabetes is rapidly becoming a reality in many Western countries. In the text that follows, one of us (E.B.) will present the main points supporting A1C (pros) and the other (J.T.) will illustrate the main counterpoints challenging A1C (cons) as the primary tool Continue reading >>

The A1c Blood Sugar Test May Be Less Accurate In African-americans

The A1c Blood Sugar Test May Be Less Accurate In African-americans

A widely used blood test to measure blood-sugar trends can give imprecise results, depending on a person's race and other factors. This test means diabetes can sometimes be misdiagnosed or managed poorly. Doctors have been cautioned before that results from the A1C test don't have pinpoint accuracy. A study published Tuesday underscores that shortcoming as it applies to people who carry the sickle cell trait. Glucose levels in the blood rise and fall all the time, so it can be tricky to look at a single exam to diagnose diabetes or manage the disease in people who have it. But one test gets around this problem. The A1C test measures sugar that binds to hemoglobin molecules in red blood cells. It provides an average of blood sugar over the past three months, "so this has turned out to be an incredibly powerful test, both for the diagnosis and treatment of diabetes," says Dr. Anthony Bleyer, a kidney specialist at the Wake Forest School of Medicine who was not involved in the study. The problem is that the test results can vary, depending on circumstance. For example, people with anemia may get inaccurate readings. So do people who carry unusual types of hemoglobin, the best known being sickle cell trait. Eight to 10 percent of African-Americans carry the sickle cell trait. But only people who inherit two copies of the sickle cell trait, one from each parent, develop the disease. And a few years ago, scientists realized that A1C readings for African-Americans typically don't match those from whites. They are generally higher. "The test was really standardized based on white individuals, and there were just a small number of African-American individuals in that study," Bleyer says. And while the difference isn't large, it can matter a lot, especially for people who are clo Continue reading >>

Utility Of Hemoglobin A1c For Diagnosing Prediabetes And Diabetes In Obese Children And Adolescents

Utility Of Hemoglobin A1c For Diagnosing Prediabetes And Diabetes In Obese Children And Adolescents

OBJECTIVE Hemoglobin A1c (A1C) has emerged as a recommended diagnostic tool for identifying diabetes and subjects at risk for the disease. This recommendation is based on data in adults showing the relationship between A1C with future development of diabetes and microvascular complications. However, studies in the pediatric population are lacking. RESEARCH DESIGN AND METHODS We studied a multiethnic cohort of 1,156 obese children and adolescents without a diagnosis of diabetes (male, 40%/female, 60%). All subjects underwent an oral glucose tolerance test (OGTT) and A1C measurement. These tests were repeated after a follow-up time of ∼2 years in 218 subjects. RESULTS At baseline, subjects were stratified according to A1C categories: 77% with normal glucose tolerance (A1C <5.7%), 21% at risk for diabetes (A1C 5.7–6.4%), and 1% with diabetes (A1C >6.5%). In the at risk for diabetes category, 47% were classified with prediabetes or diabetes, and in the diabetes category, 62% were classified with type 2 diabetes by the OGTT. The area under the curve receiver operating characteristic for A1C was 0.81 (95% CI 0.70–0.92). The threshold for identifying type 2 diabetes was 5.8%, with 78% specificity and 68% sensitivity. In the subgroup with repeated measures, a multivariate analysis showed that the strongest predictors of 2-h glucose at follow-up were baseline A1C and 2-h glucose, independently of age, ethnicity, sex, fasting glucose, and follow-up time. CONCLUSIONS The American Diabetes Association suggested that an A1C of 6.5% underestimates the prevalence of prediabetes and diabetes in obese children and adolescents. Given the low sensitivity and specificity, the use of A1C by itself represents a poor diagnostic tool for prediabetes and type 2 diabetes in obese children Continue reading >>

One-third Of Slim American Adults Have Pre-diabetes

One-third Of Slim American Adults Have Pre-diabetes

Among normal-weight individuals, those who were inactive were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic Among all the normal-weight inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent Inactivity increases your risk of pre-diabetes even if you’re not overweight or obese By Dr. Mercola It's often assumed that in order to develop type 2 diabetes, you have to be overweight. While it's true that excess weight is clearly associated with insulin resistance and diabetes, it's the insulin resistance — not necessarily the weight gain — that drives the disease. As such, many people with a healthy weight are not metabolically healthy, putting them at risk of diseases like type 2 diabetes — even without being overweight or obese. One of the greatest risk factors, according to University of Florida researchers, is actually inactivity, which drives up your risk of pre-diabetes regardless of your weight. Inactivity Is Associated With Pre-Diabetes, Even if You're a Healthy Weight If you were looking for motivation to get moving, this study, published in the American Journal of Preventive Medicine, is as good as it gets.1 In a survey of more than 1,100 healthy-weight individuals, those who were inactive (physically active for less than 30 minutes per week) were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic. Among all the inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic. When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent. The researchers suggested that peop Continue reading >>

Do I Have Prediabetes Or Diabetes? Guide To The A1c, Fpg, And Ogtt Tests, Plus Tips For Prevention

Do I Have Prediabetes Or Diabetes? Guide To The A1c, Fpg, And Ogtt Tests, Plus Tips For Prevention

If you’ve been diagnosed with prediabetes, you may wonder what that means. It’s a condition where your blood glucose levels are above normal, but not high enough for you to be diagnosed with diabetes. Many doctors consider prediabetes to be the first stage of type 2 diabetes. Studies show that 15 to 30 percent of people with prediabetes will develop diabetes in as little as five years without intervention, such as weight loss or increased physical activity. In fact, most people who get type 2 diabetes had prediabetes first. Prediabetes is serious in and of itself. People with this condition have a greater risk of developing cardiovascular disease than those without it. There are three tests that doctors can do in order to determine whether you have high blood sugar. A1C This blood test, which is also called hemoglobin A1c, HbA1c, or glycosylated hemoglobin, measures the percentage of sugar that is attached to your hemoglobin. Hemoglobin is a protein in your red blood cells. The higher the A1C, the higher your average blood sugar levels have been running over the past two or three months. A normal A1C is below 5.7 percent. An A1C between 5.7 percent and 6.4 percent suggests prediabetes. An A1C of 6.5 or more indicates type 2 diabetes if the test is confirmed. If your results are questionable, your doctor will retest your A1C on another day to confirm the diagnosis. Fasting plasma glucose The fasting plasma glucose (FPG) test is a blood test that’s done after you’ve been fasting overnight. It measures the sugar in your blood. A normal fasting glucose test is lower than 100 milligrams per deciliter (mg/dL). A result between 100 and 125 mg/dL is diagnostic for prediabetes. One that is 126 mg/dL or above is indicative of diabetes. It’s recommended to retest this an Continue reading >>

What Is Prediabetes?

What Is Prediabetes?

Prediabetes is a wake-up call that you’re on the path to diabetes. But it’s not too late to turn things around. If you have it (like 86 million other Americans), your blood sugar (glucose) level is higher than it should be, but not in the diabetes range. People used to call it "borderline" diabetes. Normally, your body makes a hormone called insulin to help control your blood sugar. When you have prediabetes, that system doesn't work as well as it should. You might not be able to make enough insulin after eating, or your body might not respond to insulin properly. Prediabetes makes you more likely to get heart disease or have a stroke. But you can take action to lower those risks. Your doctor will give you one of three simple blood tests: Fasting plasma glucose test. You won't eat for 8 hours before taking this blood test. The results are: Normal if your blood sugar is less than 100 Prediabetes if your blood sugar is 100-125 Diabetes if your blood sugar is 126 or higher Oral glucose tolerance test. First, you'll take the fasting glucose test. Then you'll drink a sugary solution. Two hours after that, you'll take another blood test. The results are: Normal if your blood sugar is less than 140 after the second test Prediabetes if your blood sugar is 140-199 after the second test Diabetes if your blood sugar is 200 or higher after the second test Hemoglobin A1C (or average blood sugar) test. This blood test shows your average blood sugar level for the past 2 to 3 months. Doctors can use it to diagnose prediabetes or diabetes or, if you already know you have diabetes, it helps show whether it's under control. The results are: Normal: 5.6% or less Prediabetes: 5.7 to 6.4% Diabetes: 6.5% or above You may need to take the test again to confirm the results. Lifestyle change Continue reading >>

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