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What Does An A1c Of 12 Mean

Blood Levels Of Insulin And Hemoglobin A1c In Foundation Members

Blood Levels Of Insulin And Hemoglobin A1c In Foundation Members

Life Extension® has an advantage in identifying modern causes of premature aging and death. That’s because we have direct access to tens of thousands of our members’ blood test results. Our review of this real-world data enables us to uncover disease risk factors that are overlooked by the mainstream media. We then alert members about simple steps they can take to mitigate these hazards. Earlier this year, we analyzed fasting insulin and hemoglobin A1c blood levels in over 10,000 members. A startling 66% had higher than desired fasting insulin. Twenty-two percent had hemoglobin A1c levels that placed them in a pre-diabetic state. Hemoglobin A1c measures the percentage of glycated hemoglobin in one’s blood. Hemoglobin A1c levels should be below 5.6%,1 yet more than one in five people we tested had a reading over 6%. Gaining early access to this kind of data can spare aging humans the ravages of degenerative illness. Armed with this knowledge, Foundation members can slash their risk of cancer, vascular occlusion, and other complications before frank diabetes is diagnosed. This article will describe the dangers of elevated fasting insulin and hemoglobin A1c, our recent analysis of member blood tests, and a novel way to protect against glycemic overload. What Is Insulin Supposed to Do? Insulin is a hormone that regulates carbohydrate and fat metabolism.2 Insulin enables liver and muscle cells to take up blood sugar (glucose) for energy production or storage.2 Insulin also facilitates the packing of glucose into fat cells as triglycerides.2 A burst of insulin is released in response to food ingestion. Once glucose has been safely shuttled into energy producing cells or stored, insulin levels should drop below 5 µIU/mL.3 Only a tiny amount of residual insulin should b Continue reading >>

A1c %

A1c %

The eAG test is your estimated Average Glucose. The estimated Average Glucose, is reported in the same units as you see on a lab report or on your glucose meter at home, for example, 140 or 154 mg/dl. “Both the A1c and the newer eAG can help you find out how your diabetes has been managed each and every day, for the last 2- 3 months.†• Compare your results to your previous tests. • If your A1c or eAG number is higher than recommended, talk to your doctor or diabetes educator about what changes could help you lower your blood glucose levels. • Setting a target with your doctor or diabetes educator and working towards it, will help you to feel better, and reduce your risk of diabetes complications. • Diabetes complications don’t have to happen! To help prevent them you need to keep your average glucose levels as close to normal as possible. Remember to always discuss the results of your tests with your doctor, or diabetes educator. Name: Test Date Goal Results Goal Results % % mgdl mgdl % % mgdl mgdl % % mgdl mgdl % % mgdl mgdl % % mgdl mgdl % % mgdl mgdl % % mgdl mgdl 1 Becton Drive Franklin Lakes, New Jersey 07417 BD and BD Logo are trademarks of Becton, Dickinson and Company. © 2010 BD BD wants you to know about the latest advances in diabetes care. BD is working to improve the quality of life for people with diabetes. For more information call us toll free at: 1.888.BD CARES (232.2737) NOT FOR MEDICAL OR EMERGENCY INFORMATION or visit our web site at: www.bd.com/us/diabetes 10D05912331A1CBRO 151198 BD Getting Started™ A1c/eAG Educational Information from BD Consumer Healthcare What Are Your Numbers, and What Do They Mean? “My Doctor says these tests tell you the average of your blood glucose over the last 2-3 mo Continue reading >>

What Is Normal Blood Sugar?

What Is Normal Blood Sugar?

Thank you for visiting my website! If you need help lowering your blood sugar level, check out my books at Amazon or Smashwords. If you’re outside of the U.S., Smashwords may be the best source. —Steve Parker, M.D. * * * Physicians focus so much on disease that we sometimes lose sight of what’s healthy and normal. For instance, the American Diabetes Association defines “tight” control of diabetes to include sugar levels as high as 179 mg/dl (9.94 mmol/l) when measured two hours after a meal. In contrast, young adults without diabetes two hours after a meal are usually in the range of 90 to 110 mg/dl (5.00–6.11 mmol/l). What Is a Normal Blood Sugar Level? The following numbers refer to average blood sugar (glucose) levels in venous plasma, as measured in a lab. Portable home glucose meters measure sugar in capillary whole blood. Many, but not all, meters in 2010 are calibrated to compare directly to venous plasma levels. Fasting blood sugar after a night of sleep and before breakfast: 85 mg/dl (4.72 mmol/l) One hour after a meal: 110 mg/dl (6.11 mmol/l) Two hours after a meal: 95 mg/dl (5.28 mmol/l) Five hours after a meal: 85 mg/dl (4.72 mmol/l) (The aforementioned meal derives 50–55% of its energy from carbohydrate) ♦ ♦ ♦ Ranges of blood sugar for young healthy non-diabetic adults: Fasting blood sugar: 70–90 mg/dl (3.89–5.00 mmol/l) One hour after a typical meal: 90–125 mg/dl (5.00–6.94 mmol/l) Two hours after a typical meal: 90–110 mg/dl (5.00–6.11 mmol/l) Five hours after a typical meal: 70–90 mg/dl (3.89–5.00 mmol/l) Blood sugars tend to be a bit lower in pregnant women. ♦ ♦ ♦ What Level of Blood Sugar Defines Diabetes and Prediabetes? According to the 2007 guidelines issued by the American Association of Clinical Endocrinol Continue reading >>

Translating A1c To A Blood Sugar Level

Translating A1c To A Blood Sugar Level

In the USA, doctors recommend that you have your Hemoglobin A1c measured at least twice per year. This simple blood test will tell you an approximation of your blood sugar control for the past 3 months based on the amount of Advanced Glycogenated End-Products (AGEs) that have accumulated in your blood. The higher your blood sugar levels are, the more AGEs are present. AGEs are also responsible for the development of complications such as retinopathy and neuropathy, because that accumulation will build and irritate crucial nerve-endings. Now, let’s get back to your A1C: To help people with diabetes understanding their A1C in real day-to-day terms, the medical world has developed the “eAG” measurement. Estimated Average Glucose. Your eAG will give your A1C reading in a blood sugar level of milligrams per deciliter (mg/dL) just like you’re used to seeing on your glucose meter. The American Diabetes Association has this easy calculator, allowing you to enter and translate your latest A1C to your eAG. 12% = 298 mg/dL (240 – 347) 11% = 269 mg/dL (217 – 314) 10% = 240 mg/dL (193 – 282) 9% = 212 mg/dL (170 –249) 8% = 183 mg/dL (147 – 217) 7% = 154 mg/dL (123 – 185) 6% = 126 mg/dL (100 – 152) What can you do with that information? It is recommended that people with type 1 and type 2 diabetes achieve an A1C of 7.0 percent or lower for optimal health, and the prevention of complications. This translates to an average blood sugar before and between meals around 70 to 130 mg/dL. And after meals, under 180 mg/dL. For pregnancy with diabetes, an A1C lower than 6.5 percent is imperative for the healthy development of your baby, and your own health and safety. Post-meal blood sugars for pregnant women is suggested at lower than 120 mg/dL. A non-diabetic’s A1C is Continue reading >>

What's A

What's A "normal" A1c? When Is It Misleading?

By Adithi Gandhi and Jeemin Kwon Why we use A1c, what values are recommended, and what impacts A1c – everything from anemia to vitamins Want more information just like this? Hemoglobin A1c (“HbA1c” or just “A1c”) is the standard for measuring blood sugar management in people with diabetes. A1c reflects average blood sugars over 2 to 3 months, and through studies like DCCT and UKPDS, higher A1c levels have been shown to be associated with the risk of certain diabetes complications (eye, kidney, and nerve disease). For every 1% decrease in A1c, there is significant pretection against those complications. However, as an average over a period of months, A1c cannot capture critical information such as time spent in a target range (70-180 mg/dl) and hypoglycemia (less than 70 mg/dl). This article describes why A1c is used in the first place, as well as factors that can lead to misleadingly high or low values. In a follow-up piece, we will discuss time-in-range, hypoglycemia, hyperglycemia, blood sugar variability, and how to measure and interpret them. Click to jump down to a section: What tools are available if an A1c test is not accurate or sufficient? What is A1c and why is it used? A1c estimates a person’s average blood sugar levels over a 2 to 3-month span. It is the best measure we have of how well blood glucose is controlled and an indicator of diabetes management. Though A1c doesn’t provide day-to-day information, keeping A1c low has been proven to lower the risk of “microvascular” complications like kidney disease (nephropathy), vision loss (retinopathy), and nerve damage (neuropathy). The relationship between A1c and “macrovascular” complications like heart disease is harder to show in clinical trials, but having high blood sugar is a major ris Continue reading >>

Understanding Markers Of Blood Sugar Control | Empoweryourhealth.org

Understanding Markers Of Blood Sugar Control | Empoweryourhealth.org

IS THIS FOR YOU? You’re doing everything right. You’ve decided to finally take control and to pay more attention to your diabetes. You’re checking your blood sugar often at home and at different times of the day. You’re paying close attention to your food choices and being careful on portion sizes. In fact, you’ve been doing so well you can’t wait to see your doctor to prove that your efforts have paid off! Your glucose levels are way down but, when you do see your doctor, you’re surprised (and a little shocked) to discover that your average control is not as good as you thought it was. Your doctor checked your hemoglobin A1c and is concerned that your average blood sugar may be running too high (or too low). How can that be? Your blood sugars at home have been on target for the last several months. You and your doctor confirm your glucose meter is working properly. What can be a possible explanation for this? It’s time to learn about some markers of blood sugar control! HEMOGLOBIN A1C When sugar (glucose) is higher than it should be in blood, it attaches to proteins in the body. This is used as a marker or indicator of blood sugar control. HERES' HOW IT WORKS : Many different types of cells are found in blood, among them are the red blood cells. They are named “red” blood cells because they contain a protein named hemoglobin [HEE-mo-glo-bin], which gives them the color red. Hemoglobin is the protein responsible for getting oxygen to the body’s tissues. Because glucose/sugar can easily enter the red blood cells, when blood sugar levels increase, sugar molecules enter the red blood cells and attach to hemoglobin. The higher your blood sugar, the more sugar will enter the red blood cells and will attach to the hemoglobin. Glucose attaches to hemoglob Continue reading >>

Hba1c And Estimated Average Glucose (eag)

Hba1c And Estimated Average Glucose (eag)

Why is relating HbA1c to glucose important? We are frequently asked about the relationship between HbA1c and plasma glucose levels. Many patients with diabetes mellitus now perform self-monitoring of blood glucose (SMBG) in the home setting, and understanding the relationship between HbA1c and glucose can be useful in setting goals for day-to-day testing. HbA1c: A "Weighted" Average Many studies have shown that HbA1c is an index of average glucose (AG) over the preceding weeks-to-months. Erythrocyte (red blood cell) life-span averages about 120 days. The level of HbA1c at any point in time is contributed to by all circulating erythrocytes, from the oldest (120 days old) to the youngest. However, HbA1c is a "weighted" average of blood glucose levels during the preceding 120 days, meaning that glucose levels in the preceding 30 days contribute substantially more to the level of HbA1c than do glucose levels 90-120 days earlier. This explains why the level of HbA1c can increase or decrease relatively quickly with large changes in glucose; it does not take 120 days to detect a clinically meaningful change in HbA1c following a clinically significant change in AG. How does HbA1c relate to average glucose (AG)? In the Diabetes Control and Complications Trial or DCCT (New Engl J Med 1993;329:977-986) study of patients with Type 1 diabetes, quarterly HbA1c determinations were the principal measure of glycemic control; study subjects also performed quarterly 24-hour, 7-point capillary-blood glucose profiles. Blood specimens were obtained by subjects in the home setting, pre-meal, 90 minutes post-meal, and at bed-time. In an analysis of the DCCT glucose profile data (Diabetes Care 25:275-278, 2002), mean HbA1c and AG were calculated for each study subject (n= 1439). Results showed Continue reading >>

Hba1c Test Results Don't Tell The Full Story

Hba1c Test Results Don't Tell The Full Story

back to Overview When I was a teenager, the HbA1c test results cut straight through my lies and made-up paper logbook. It’s often viewed as the number to rule all numbers. But hemoglobin A1c (HbA1c) test results can be misleading and don’t tell the full story. As I learned in my teens, the HbA1c test shines a light on things I was trying to hide. Overall, It’s not good at getting to the details of blood sugars, but when used with other pieces of information it can draw attention to (sometimes unseen) problem areas in our diabetes management, and that’s a good thing. How do HbA1c test results work? Let’s take a quick look at the basics of the HbA1c test. A certain amount of sugar in your blood sticks to your red blood cells and can’t be unstuck. It’s there for the life of the cell, which is, on average, about 8-12 weeks. Those red blood cells in your body are constantly recycled, and by checking your HbA1c value every 8-12 weeks (or as often as recommended by your doctor – the ADA recommends at least twice a year), you get to see a fresh new grouping of them. So – A higher blood sugar for a longer time means more sugar on more cells – which means a higher HbA1c. Get it? Ideal HbA1c range HbA1c goals are very individual, which makes sense. We’re all different, right? Of course, there are reference values as a guide, and that’s a good place to start. The ADA suggests an HbA1c of 7%, but also say that “more or less stringent glycemic goals may be appropriate for each individual.” Why have different goals? Because, as you know, there’s a lot to consider with diabetes. Avoiding lows (hypoglycemia) while pushing for lower A1c’s is really important because low blood sugars are immediately dangerous. It’s simply not safe to push for a very low H 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 >>

A1c Is Changing To Average Mean Blood Glucose

A1c Is Changing To Average Mean Blood Glucose

A1C Translation to Estimated Average Glucose (eAG) Units Will Yield Easier Patient Education. New more accurate formula used to convert A1c to average blood glucose. A mathematical relationship between the average glucose level over the preceding three months and levels of the A1C test, thus yielding translation of the A1C for reporting as estimated average glucose (eAG), was proven in an international study published online in the August issue of Diabetes Care. A1C has been used for more than 25 years as the major measure of glucose control and to establish targets for diabetes therapy. “The findings of this large study have confirmed what smaller studies have shown and will give us confidence that A1C really does represent an average glucose because we now have a reliable formula to convert A1C into average glucose,” said David M. Nathan, MD, Professor of Medicine, Harvard Medical School, and cochair of the International A1C-Derived Average Glucose (ADAG) Study, in a recent interview. “While eAG will not replace A1C, physicians will be able to obtain reports both in A1C units of glycated hemoglobin and eAG units of milligrams per deciliter or millimols per liter, depending on the country, and choose which to use in clinical situations.” The implications of using eAG in mg/dl or mmol/L – the same units that patients use for self-monitoring of blood glucose (SMBG) at home – were discussed recently by his co-chair, Robert J. Heine, MD, PhD, Professor of Diabetology in the Department of Endocrinology at the VU University Medical Center in Amsterdam, and Executive Medical Director of the Diabetes and Endocrine Division of Eli Lilly and Company. “It is extremely helpful for health care professionals and patients to be using the same language to discuss glucose Continue reading >>

In Search Of: The Highest Diabetes A1c In History

In Search Of: The Highest Diabetes A1c In History

My most recent A1C was nothing to be proud of, but I consoled myself with the thought that it was hardly the worst in history. That got me wondering: What was the all-time worst A1C? Who holds this dubious record, and how high is it possible to go? I decided to pound the pavement and try to find out. So where to start when looking for a diabetes record? Well, with the Guinness Book of World Records, of course. But oddly, the Guinness people don’t seem to have any listings related to A1Cs. They do, however, report that Michael Patrick Buonocore survived a blood sugar of 2,656 mg/dL upon admittance to the ER in East Stroudsburg, PA, on March 23, 2008. Michael was a T1 kiddo at the time, and that record-high sugar level was part of his diagnosis experience. So does Michael also hold the record for top A1C? No. Because while he’s living (thankfully) proof that stratospheric blood sugar levels are possible, a sky-scraping A1C requires both altitude and time. Remember that A1Cs provide a three-month average of our blood sugars. Individual high BG readings, even crazy-high ones, don’t alter the test as much as you’d think if they last only a short time. Because type 1 in kids Michael's age hit so quickly, I figured his A1C would have been rather middle of the road. It takes a slow burn to make an A1C boil. But just to be sure, I reached out to his parents, who tell me his A1C was 11.9 at diagnosis. Higher than I expected, but not too high given the four-digit BG reading. (If his 2,656 had been his average blood sugar for three months, his A1C would have been roughly 95! Yes, that’s 95.0, not 9.5). The highest A1C turns out to be a tricky piece of data to ferret out. If you try Google, you find a gazillion people talking about their own personal highest A1Cs, and comp Continue reading >>

A1c And Complications

A1c And Complications

The Diabetes Control and Complications Trial (DCCT) was the pivotal trial that provided the link between A1c levels and the risk of diabetes-associated complications. The results of the DCCT shown below are considered definitive for patients with type 1 diabetes. Relative risk increased with A1c for retinopathy, nephropathy, and microalbuminuria, and the risk of retinopathy and nephropathy accelerated at the highest levels of A1c. In this study, improved glycemic control following intensive diabetes therapy delayed the onset and slowed the progression of diabetic retinopathy, nephropathy and neuropathy in patients with type 1 diabetes. [1] DCCT A1c levels and the risk of complications in type 1 diabetes The United Kingdom Prospective Diabetes Study (UKPDS) was a large-scale trial that investigated the effect of intensive blood glucose control versus conventional treatment in patients with type 2 diabetes, with a median follow-up of 10 years. This observational analysis of data from the UKPDS demonstrated a direct relationship between the risk of diabetic complications and glycemia over time. Each 1% absolute reduction in mean A1c levels was associated with a 37% decrease in the risk of microvascular complications and a 21% reduction in the risk of any diabetes-related complication or death. Therefore, any improvement in A1c levels is likely to reduce the risk of diabetic complications. [2] Lowering A1c levels reduces the risk of diabetes complications in people with type 2 diabetes UKPDS: 21% risk reduction per 1% absolute decrease in A1c levels (p<0.0001) Continue reading >>

Why The A1c Test Is Important

Why The A1c Test Is Important

The A1c is a blood test, done in a lab, that shows what your average blood sugar has been for the past 3 months. Other names for this test are glycosylated hemoglobin, glycohemoglobin, hemoglobin A1c, and HbA1c. How the A1c Test Works The glucose that the body doesn't store or use for energy stays in the blood and attaches to red blood cells, which live in the bloodstream for about 4 months. The lab test measures the amount of glucose attached to the red blood cells. The amount is the A1c and is shown as a percentage. Your A1c number can give you and your health care team a good idea of how well you've controlled your blood sugar over the previous 2 to 3 months. When you get your A1c result from a Kaiser Permanente lab, you'll also see another number called the estimated Average Glucose, or eAG. Understanding the eAG Your estimated Average Glucose (eAG) number is calculated from the result of your A1c test. Like the A1c, the eAG shows what your average blood sugars have been over the previous 2 to 3 months. Instead of a percentage, the eAG is in the same units (mg/dl) as your blood glucose meter. The chart shows the relationship between the A1c percentage and the eAG. If A1c % is: Your eAG is: 6 126 6.5 140 7 154 7.5 169 8 183 8.5 197 9 212 9.5 226 10 240 10.5 255 11 269 11.5 283 12 298 What the Numbers Mean The A1c and eAG reflect your average blood sugar over a period of time. These numbers help you and your doctor see how well your treatment plan is working. The higher your A1c and eAG numbers are, the higher your chances for having long-term health problems caused by consistently high blood sugar levels. These problems include heart attacks, strokes, kidney failure, vision problems, and numbness in your legs or feet. The lower your A1c and eAG numbers, the lower you Continue reading >>

Boston, Usa

Boston, Usa

8/7/2015 1 ADA Type 1 Diabetes Guidelines Pediatric and Adult Patients with T1D: Glycemic Targets and more Lori Laffel MD MPH Chief, Pediatric, Adolescent & Young Adult Section Senior Investigator, Genetics and Epidemiology Section Professor of Pediatrics Boston, USA AADE New Orleans, LA Disclosures Consultant • Johnson & Johnson, Eli Lilly, Sanofi-Aventis, NovoNordisk, Bristol Myers Squibb, Menarini, Bayer Healthcare (grant support), LifeScan/Animas, Roche Diagnostics, Oshadi, Dexcom, Boehringer Ingelheim Content of lecture unrelated to above 2014 CDC June Report • Prevalence estimates of T1D in youth 0-19 and T2D in youth 10-19 in 2001 and 2009 in 5 representative US areas in the SEARCH Study • T1D prevalence: 1.48/1000 in 2001 (1/676) 1.93/1000 in 2009 (1/518) • T2D prevalence: 0.34/1000 in 2001 (1/2941) 0.46/1000 in 2009 (1/2174) • T1D increased 21.1% (95% CI, 15.6-27.0%)* • T2D increased 30.5% (95% CI, 17.3-45.1%)* * After adjustment for case ascertainment T1D in Adults • No precise estimates of T1D in adults >20 y/o • Greatest number of patients with T1D are adults: – Increasing numbers of patients diagnosed with T1D at all ages – Patients w/ childhood onset T1D survive to adulthood • Estimated that 50-75% of T1D diagnosed in childhood (25-50% diagnosed in adulthood) • LADA: latent autoimmune diabetes in adults – ~9% of adults with diabetes ages 30-70 have +GAD ab – Prolonged period of residual beta cell function (T1DX) – Additional peak age of onset of T1D in 6th to 7th decades of life • Diabetes Care. 2015 Mar;38(3):476-81. Diabetes Care. 2015 Mar;38(3):476-81. Residual C-peptide present in 1/3 persons with T1D of 3+ years duration 8/7/2015 2 • Glycemic tar Continue reading >>

Study Reveals Poor Disease Control Among Adolescents And Young Adults With Type 1 Diabetes

Study Reveals Poor Disease Control Among Adolescents And Young Adults With Type 1 Diabetes

T1D Exchange Clinic Registry data find a stagnant situation as little has changed in 25 years; underscores need for new technologies to help teens manage their disease BOSTON, May 22, 2015 – In a sweeping analysis assessing the current state of diabetes treatment in the U.S., T1D Exchange researchers conclude that there remains considerable room for improving treatment outcomes in type 1 diabetes across all age groups, but especially for adolescents and young adults. The analysis provides the most up-to-date picture of diabetes treatment, underscoring the need to address barriers to care and implement new therapies and technologies that can help type 1 patients achieve optimal metabolic control. The findings, published today in a special issue of Diabetes Care, come from data collected by the T1D Exchange Clinic Registry. Researchers from the Exchange evaluated data from more than 16,000 patients ages two to 95. Data were collected twice: between September 2010 to August 2012 and again, from September 2013 to December 2014. A key area of study was glycemic control across the age spectrum, determined by examining Hemoglobin A1c (HbA1c) levels, a standard test of average blood sugar levels over two to three months. According to the American Diabetes Association, the recommended target A1c level is less than 7 percent for adults with type 1 diabetes and less than 7.5 percent for youth under the age of 19. Researchers found that while 8.4 percent remains the average A1c level across the Registry, A1c levels are notably worse among 13 to 25-year olds. In fact, A1c levels for 13 to 17-year olds have barely changed since the initial Diabetes Control and Complications Trial (DCCT) results published in 1992. Specifically: Adolescents in the Registry averaged a 9.0 percent A1c Continue reading >>

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