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What Does It Mean When Your A1c Is High?

What Your Doctor Doesn't Know About Glucose Testing.

What Your Doctor Doesn't Know About Glucose Testing.

Blood sugar management is important for preventing everything from hypoglycemia to full blown diabetes. However, monitoring blood glucose is rarely as straightforward as it seems. In this article we’ll discuss the current gold standard for measuring a person’s blood sugar. We’ll share some problems with the most popular tests. And we’ll review the best ways to interpret your results. (Even if your doctor doesn’t know how). [Note: We’ve also prepared an audio recording of this article for you to listen to. So, if you’d rather listen to the piece, click here.] ++ Homeostasis is a fancy scientific word for “body balance”. Essentially, our bodies must keep internal levels of thousands of chemicals in check. Or else health can go awry. One of the most important homeostatic systems in our body is our blood sugar management system. When blood sugar is kept at a healthy range, we feel healthy, strong, energetic. On the other hand, unbalanced blood sugars put us at risk for problems ranging from reactive hypoglycemia to insulin resistance to full blown diabetes. But estimating blood sugar levels can be tricky. First, these levels change throughout the day, and with meals and exercise. So, unless you’re monitoring blood sugar levels continuously, every second of every day, it’s hard to get a complete picture of your glucose health. Second, the convenient glucose meters that many Type 1 diabetics use only give us a snapshot instead of a movie. They don’t show us how patients regulate blood sugars over time. And that may be the most important information of all when it comes to disease prevention. That’s why doctors and scientists have become obsessed with finding a test that measures blood glucose balance across days, weeks, or months. In other words, a t Continue reading >>

Resources - Conditions - A1c Test For Diabetes

Resources - Conditions - A1c Test For Diabetes

_______________________________________________________________________ The A1C blood test checks your average blood glucose (sugar) over the past 3 months. The test is done to diagnose prediabetes or diabetes, or to see how well you are controlling your blood glucose if you have been diagnosed with diabetes. You dont need to fast before you have the test and it can be done any time of the day. A small amount of blood is taken with a prick of the finger or from a vein in your arm with a needle. Talk to your healthcare provider about what the test results mean and ask any questions you have. ________________________________________________________________________ The A1C ("A-one-C") is a blood test that checks your average blood glucose (sugar) over the past 3 months. Glucose absorbed from the foods you eat and drink goes into your bloodstream. The glucose sticks to the hemoglobin protein, which is the part of red blood cells that carry oxygen to the cells in your body. When glucose sticks to the hemoglobin, it forms hemoglobin A1C. The A1C stays in the blood for the life of the red blood cell, which is 90 to 120 days. This means that the amount of A1C in your blood reflects the average level of your blood glucose over the past 3 months. Another name for this test is hemoglobin A1C test. It is different from a regular blood glucose lab test or a finger stick blood glucose test. Daily checks of blood glucose show how well treatment is working throughout the day. To diagnose prediabetes (blood glucose that is higher than normal, but not quite high enough to be called diabetes) To see how well you are controlling your blood glucose if you have been diagnosed with diabetes If you have diabetes, you should have an A1C test every 3 to 6 months. A1C tests are important because Continue reading >>

Ask The Doctor: What's The Difference Between Blood Sugar And Hemoglobin A1c?

Ask The Doctor: What's The Difference Between Blood Sugar And Hemoglobin A1c?

Ask the doctor Q. In your article on blood sugar control, you kept talking about hemoglobin A1c. I measure my blood sugar all the time, but my meter doesn't have a setting for a percentage reading. Is there a simple connection between blood sugar and hemoglobin A1c? A. I'm sorry we confused you. Blood sugar and hemoglobin A1c are connected, but they are different, too. Your blood sugar meter measures the concentration of glucose in the bloodstream at the instant you prick your finger. The reading is in milligrams of glucose per deciliter (a tenth of a liter) of blood, abbreviated as mg/dL. Blood sugar levels vary throughout the day. In people with diabetes, they can range from below 70 mg/dL to above 200. Continue reading >>

When “normal” Blood Sugar Isn’t Normal (part 2)

When “normal” Blood Sugar Isn’t Normal (part 2)

In the last article I explained the three primary markers we use to track blood sugar: fasting blood glucose (FBG), oral glucose tolerance test (OGTT) and hemoglobin A1c (A1c). We also looked at what the medical establishment considers as normal for these markers. The table below summarizes those values. In this article, we’re going to look at just how “normal” those normal levels are — according to the scientific literature. We’ll also consider which of these three markers is most important in preventing diabetes and cardiovascular disease. Marker Normal Pre-diabetes Diabetes Fasting blood glucose (mg/dL) <99 100-125 >126 OGGT / post-meal (mg/dL after 2 hours) <140 140-199 >200 Hemoglobin A1c (%) <6 6-6.4 >6.4 But before we do that, I’d like to make an important point: context is everything. In my work with patients, I never use any single marker alone to determine whether someone has a blood sugar issue. I run a full blood panel that includes fasting glucose, A1c, fructosamine, uric acid and triglycerides (along with other lipids), and I also have them do post-meal testing at home over a period of 3 days with a range of foods. If they have a few post-meal spikes and all other markers or normal, I’m not concerned. If their fasting BG, A1c and fructosamine are all elevated, and they’re having spikes, then I’m concerned and I will investigate further. On a similar note, I’ve written that A1c is not a reliable marker for individuals because of context: there are many non-blood sugar-related conditions that can make A1c appear high or low. So if someone is normal on all of the other blood sugar markers, but has high A1c, I’m usually not concerned. With all of that said, let’s take a look at some of the research. Fasting blood sugar According to cont 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 >>

Diabetes: Your A1c Test

Diabetes: Your A1c Test

www.CardioSmart.org The hemoglobin A1c test is a simple blood test that checks howmuch sugar, or glucose, is stuck to your red blood cells. This test also is called the glycohemoglobin test or the A1c test. Most doctors think the A1c test is the best way to monitor your diabetes over the long term. What does your A1c result mean? Your test results tell you how well you have controlled your diabetes over the last 3 months. With this information, your doctor can adjust your medicine and diabetes treatment, if necessary. This test also gives you an idea of how likely you are to develop problems such as kidney failure, vision trouble, or numbness in your leg or foot. Keeping your A1c level in your target range can lower your chance for problems. The test result is usually given as a percentage. The American Diabetes Association (ADA) recommends that most non-pregnant adults with diabetes have an A1c level less than 7%. If your A1c level is higher than your target A1c level, the ADA recommends that your doctor look at making changes in your diabetes treatment. To lower your A1c level, your blood sugar needs to be lower. In some people with diabetes, having blood sugar that is too low may cause problems. Your doctor can help you decide the best and safest A1c level. How often should you have your A1c tested? If you have diabetes, your doctor may order a test every 3 to 6months, depending on your type of diabetes and how well you control it. Generally, A1c is checked 2 to 4 times a year. Talk with your doctor about how often you should expect to have this test. If your levels have been good for several tests, you may not need the test as often. Do you need to fast before your A1c test? You do not need to fast before this test. You can have this test at any time during the day, Continue reading >>

Understanding Your A1c

Understanding Your A1c

The A1C is a blood test that helps determine if your diabetes management plan is working well. (Both Type 1 and Type 2 take this test.) It’s done every 2-3 months to find out what your average blood sugar has been. (You may also hear this test called glycosylated hemoglobin, glycohemoglobin, hemoglobin A1c, and HbA1c.) A1c is the most common name for it though. How the test works Essentially, the test can tell how much sugar is in the blood stream by looking for proteins (hemoglobins). When glucose (sugar) enters the blood, it binds to the protein in the red blood cells. This binding creates “glycated hemoglobin”. The more sugar in the blood, the more glycated hemoglobin. It’s important to test your blood sugar levels (BGLs) throughout the day; however, an A1C test gives you a bigger picture with a long-term average of those blood sugar levels. What do these numbers mean? The A1c is an average of what your blood sugar levels have been over the 3-month period. In general, the higher your A1C number, the higher your likelihood of diabetes complications. (You don’t want a high A1C; it means there is too much sugar in your blood and your body isn’t absorbing it.) A1C number 4.6 – 6.0 Normal (does not have diabetes) 5.7 – 6.4 Pre-diabetes (warning that someone may develop Type 2 or have the beginning onset of Type 1) 6.7+ Diabetes (someone diagnosed with diabetes) <7.0 – 7.5 Target range (for adults diagnosed with diabetes – children diagnosed with diabetes) This target range varies between individuals, some people naturally run a little higher, some lower. It is important to note that especially in children a higher A1C (of 7.5) is recommended. The A1C number will help you and your doctor determine though if your diabetes management plan is working well. Continue reading >>

Why Is Blood Sugar High In The Morning?

Why Is Blood Sugar High In The Morning?

Here you'll find info about why blood sugar is high in the morning, along with tips and resources to lower those numbers! A while back I had a client sending me her blood sugar charts every few days and on those charts she always made some notes if she had questions. Every time she sent them through, I noticed she had 3 big question marks (???) against her morning blood sugar results. And on another morning when her morning blood sugar levels were high at 160 mg/dl (or 8.9 mmol/l). She had written: I don't understand. 97 mg/dl (or 5.5mmol/l) last night when I went to sleep. I didn't eat anything because I didn't feel well. Humm… I was also over in one of the online diabetes groups I'm involved in today and this message popped up. I'm struggling with my morning BS number. When I went to bed around 11PM my BS was 107. I'm waking up with my BS between 120 – 135. I did put two pieces of string cheese next to my bed and when I woke up around 3am, I ate one. Since I was told to eat protein at night. When I woke up 3 hours later my BS was 130. I didn't want to eat anything large since it's so close to 140 (my goal is to keep it below 140). So I had 1 piece of toast (sugar free wheat bread) and just a tiny bit of peanut butter. I checked it an hour later and it was 161! What am I doing wrong? Do these morning situations sound familiar to you? Are you constantly questioning: Why is blood sugar high in the morning? I mean, logically we'd think that it should be at it's lowest in the morning right? Well don't panic, there is a reason for it, so let's explore why morning blood sugar is often higher. And at the end, I'll also point you toward some resources to help you lower those levels. Why Is Blood Sugar High In The Morning? Although it would seem logical that your body would Continue reading >>

Blood Glucose Readings: What They Mean

Blood Glucose Readings: What They Mean

Source: Web exclusive: June 2011 When you have diabetes, perhaps the most important thing you need to know is the level of your blood glucose, also known as your blood sugar. Since many factors can raise or lower your blood glucose, you may have to check it several times a day. But once you obtain a blood glucose reading, what exactly does it mean? Crunch those numbers When you test a drop of your blood with a glucose meter, the big number that pops onto the screen refers to the number of millimoles (mmol) of glucose per litre (L) of your blood. A millimole (mmol) is one-thousandth of a mole, which is a standard unit for measuring the mass of molecules. And if that’s not already confusing enough, the United States uses a completely different system than Canadians for measuring blood glucose. South of the border, blood glucose is measured in milligrams per decilitre (mg/dL). This can sometimes be rather bewildering, especially if you’re brand new to diabetes and researching your disease on the Internet. “I tell people to go to a Canadian site first,” says Tabitha Palmer, a certified diabetes educator at the Centre for Clinical Research in Halifax. Know your targets So what numbers should you be looking for? Your target reading before meals should be between 4 and 7. Your blood sugar normally spikes two hours after a meal, so between 5 and 10 is a good range after you eat. Besides food, other factors that can cause your blood sugar to go up or down include exercise, illness, medications and stress. Your blood glucose readings are hands-down the best way to monitor whether or not your diabetes is generally well managed. "They really help the physicians and educators if we’re trying to look at whether you need to have your medication, insulin or mealtime adjusted, 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 >>

High Blood Sugar Basics

High Blood Sugar Basics

High blood sugar, called hyperglycemia, is one of the defining characteristics of diabetes. When people are diagnosed with diabetes, it means their blood sugar has been high, usually for a long period of time. There are two ways high blood sugar can be monitored: Self-tests using a glucose meter that measures your blood sugar at a specific moment The A1C test performed by your doctor, which shows your average blood sugar level over the past 2-3 months Over time, high blood sugar can lead to serious long-term health problems. The good news is that scientific studies have proven that control of blood sugar may help delay or even prevent diabetes complications – get started by learning more about the signs and causes of high blood sugar and tips to help prevent its development. Click here to test your knowledge about blood sugar. What happens when you have high blood sugar? Insulin is a hormone needed for proper control of blood sugar. Specifically, insulin helps move sugar from your blood into most of your body’s cells, where sugar is used for energy. In patients with type 2 diabetes, the pancreas does not make enough insulin, and/or the insulin that the pancreas makes does not work the way that it should. As a result, sugar in the blood cannot enter most cells and the cells are unable to use this sugar for energy, while the liver makes too much sugar. This in turn, causes blood sugar levels to get too high, which can cause serious long-term health problems. High blood sugar symptoms When sugar levels become high, you may experience: Dry mouth, unusual thirst Frequent urination Fatigue Blurred vision Headaches Unintentional weight loss However, some patients with type 2 diabetes may have no symptoms. What should I do if I have symptoms? If you haven’t al Continue reading >>

A1c Test

A1c Test

Print Overview The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c. The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Why it's done An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation, recommend that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes. After a diabetes diagnosis, the A1C test is used to monitor your diabetes treatment plan. Since the A1C test measures your average blood sugar level for the past two to three months instead of your blood sugar level at a specific point in time, it is a better reflection of how well your diabetes treatment plan is working overall. Your doctor will likely use the A1C test when you're first diagnosed with diabetes. This also helps establish a baseline A1C level. The test may then need to be repeated while you're learning to control your blood sugar. Later, how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you're managing your blood sugar. For example, the A1C test may be recommended: Once every year if you have prediabetes, which indicates a high risk of developing diabetes Twice a year if Continue reading >>

Understanding Your Average Blood Sugar

Understanding Your Average Blood Sugar

A1c is an average of all your blood sugars. It does not tell you your blood sugar patterns. Use it only as yet another indicator of how well you’re doing. Glysolated Hemoglobin (or A1c) is a measure of your average blood glucose control over the previous three months. Glucose attaches to hemoglobin the oxygen carrying molecule in red blood cells. The glucose-hemoglobin unit is called glycosolated hemoglobin. As red blood cells live an average of three months, the glycosolated hemoglobin reflects the sugar exposure to the cells over that time. The higher the amount of glucose in the blood, the higher the percentage of hemoglobin molecules that will have glucose attached. Think of the A1c as a long-term blood glucose measure that changes very gradually as red blood cells die and are replaced by new cells. The A1c doesn’t replace self blood-glucose monitoring. Because the A1c is an average of all your blood sugars, it does not tell you your blood sugar patterns. For example, one person with frequent highs and lows can have the same A1c as another person with very stable blood sugars that don’t vary too much. So what’s the point? A1c is yet another indicator of how well you’re doing. An A1c measurement between 4-6% is considered the range that someone without diabetes will have. The American Diabetes Association goal is an A1c less than 7%. Research has shown that an A1c less than 7% lowers risk for complications. The American College of Endocrinology goal is an A1c less than 6.5%. For some people with diabetes an A1c goal of less than 6% is appropriate. Talk with your doctor about your A1c goal. Use this chart to view A1c values and comparable blood glucose values: A1c Estimated Average Glucose mg/dL 5% 97 6% 126 7% 154 8% 183 9% 212 10% 240 11% 269 12% 298 A not Continue reading >>

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin (a blood pigment that carries oxygen) that is bound to glucose. The blood test for HbA1c level is routinely performed in people with type 1 and type 2 diabetes mellitus. Blood HbA1c levels are reflective of how well diabetes is controlled. The normal range for level for hemoglobin A1c is less than 6%. HbA1c also is known as glycosylated, or glycated hemoglobin. HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose. High HbA1c levels indicate poorer control of diabetes than levels in the normal range. HbA1c is typically measured to determine how well a type 1 or type 2 diabetes treatment plan (including medications, exercise, or dietary changes) is working. How Is Hemoglobin A1c Measured? The test for hemoglobin A1c depends on the chemical (electrical) charge on the molecule of HbA1c, which differs from the charges on the other components of hemoglobin. The molecule of HbA1c also differs in size from the other components. HbA1c may be separated by charge and size from the other hemoglobin A components in blood by a procedure called high pressure (or performance) liquid chromatography (HPLC). HPLC separates mixtures (for example, blood) into its various components by adding the mixtures to special liquids and passing them under pressure through columns filled with a material that separates the mixture into its different component molecules. HbA1c testing is done on a blood sample. Because HbA1c is not affected by short-term fluctuations in blood glucose concentrations, for example, due to meals, blood can be drawn for HbA1c testing without regard to when food was eaten. Fasting for the blood test is not necessary. What Are Continue reading >>

Your Average Blood Sugar: Why It Really Matters

Your Average Blood Sugar: Why It Really Matters

If there was a blood test that could give you valuable information about a major, yet reversible risk factor for Alzheimer’s disease and age related dementia, would you want to take it? What if that same blood test could also give you information about your risk of heart disease, high blood pressure, diabetes, vision loss, cancer and how fast you can expect your body to age? What if the test was really cheap? Now, what if you knew that what you were going to have to do to reverse your risk of all these conditions was going to be personally challenging, maybe even really hard, would you still want to take the test? Something to think about, isn’t it? The test I’m talking about does exist. It’s a simple little test that’s run all the time. It’s full implications are rarely considered, however. The test It’s called “hemoglobin A1c” and is sometimes referred to simply as the “A1c” test. In essence, it measures the amount of sugar that has become stuck to the hemoglobin in your red blood cells (hemoglobin is the component in blood that carries oxygen). Because red blood cells live for about 3 to 4 months, the test is usually used to estimate an “average blood sugar” for the previous 3 months. The more sugar floating around in your blood on a daily basis, the higher you A1c value will be. In conventional medicine the test is used to diagnose and monitor treatment goals for diabetics. The implications of a person’s A1c value run much deeper, however. Sugar within the body doesn’t just stick to hemoglobin. It sticks to many tissues that are made of proteins and fats (this accounts for most tissues in your body by the way) and can bind directly to DNA. The compounds formed by this process are called advanced glycation end products or “AGEs” for Continue reading >>

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