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What Is A Good Estimated Average Glucose Level?

Eag: Estimated Average Glucose Levels

Eag: Estimated Average Glucose Levels

The American Diabetes Association (ADA) is now recommending the use of a new term in the management of diabetes called an eAG or, estimated average glucose. This new term was introduced so that healthcare providers could give their patients their A1c data in the same units used when self-monitoring blood sugar, which is either mg/dL in the USA or mmol/L in most of the rest of the world. Your A1c test result is expressed in percentage values, such as a 7%. That 7% A1c test result correlates to a 154 mg/dL (or 8.6mmol/L), which is the measurement used when you test your blood sugar with your meter. To understand your A1c, be sure to read HbA1c: Everything You Need to Know.. So if you got an A1c test result of 7% then your eAG is 154 mg/dL (8.6mmol/L). This means your average blood sugar level over the past 2-3 months comes to 154 mg/dL (8.6mmol/L). The below chart shows the correlating eAG level for different A1c results. A1C% eAG mg/dL eAG mmol/L 6 126 7.0 6.5 140 7.8 7 154 8.6 7.5 169 9.4 8 183 10.1 8.5 197 10.9 9 212 11.8 9.5 226 12.6 10 240 13.4 10.5 255 14.1 11 269 14.9 11.5 283 15.7 12 298 16.5 12.5 312 17.3 13 326 18.1 13.5 341 18.9 14 355 19.7 14.5 369 20.5 15 384 21.3 What Does an eAG Mean? Now if your A1c is 7% this doesn’t necessarily mean that at any point during the past 2-3 months your blood sugar was 154 mg/dL (8.6 mmol/L). Hypothetically speaking, let’s say you tested your blood sugar every minute of every day and night for 2-3 months. If you then averaged together every single one of those readings, then that would be your eAG. The important thing to note about your eAG and A1c is that while this information is very useful to gain an overall idea of your diabetes management, it is one piece of the puzzle regarding your blood sugar levels. It is entire Continue reading >>

Translating The A1c Assay Into Estimated Average Glucose Values

Translating The A1c Assay Into Estimated Average Glucose Values

Response to Nathan et al. Certainty in science went out of fashion early last century following Heisenberg's postulates. We now see ranges and confidence intervals around any given mode, mean, or median. Truth, in short, is a dependent variable. Yet the American Diabetes Association (ADA) seems to be set on recommending the introduction of an estimated average glucose (eAG) value based on A1C levels, as an ADA Web site carries the formula for conversion of A1C to eAG. However, three factors have led representatives of 18 professional organizations in the U.K. to reject the introduction of this same eAG conversion based on current evidence (1). These representatives, including the current two authors, are concerned with the validity of the basic observation, its lack of validation, and the level of uncertainty associated with this conversion formula. First, the critical conversion formula, proposed by Nathan et al. (2), is probably flawed because the patients who comprised their study group had been nonrandomly selected (and included individuals without diabetes), so there is, therefore, no way of knowing whether this conversion would apply to the full breadth of patients that clinicians treat. Second, validation within fields of biochemistry requires that findings from one study population be validated by a second phase that uses different and unselected patient groups. This validation step has not been done, in either a separate group of Caucasian adults or other patient groups, such as children or patients of Afro-Caribbean descent. Further, other studies have shown that A1C can vary with hemoglobinopathy, race, age, pregnancy, and renal dysfunction (3). Third, there is uncertainty associated with the eAG value itself, acknowledged by the authors but not evident in th 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 >>

Estimated Average Glucose (eag)

Estimated Average Glucose (eag)

An average blood glucose level, expressed in milligrams per deciliter (mg/dl), based on a person’s glycosylated hemoglobin (HbA1c) level. Estimated average glucose (eAG) is considered easier for people with diabetes and their doctors to work with than HbA1c, since it is given in the same units as everyday blood glucose readings. The HbA1c test is currently considered the best measure of overall blood glucose control and of the risk of developing diabetic complications in the future. The test measures the percentage of hemoglobin molecules in the blood that have glucose attached to them. People without diabetes typically have an HbA1c level under 6%, and the American Diabetes Association recommends that people with diabetes strive for an HbA1c level below 7% (below 6% in certain individuals). In a study recently published in the journal Diabetes Care, researchers sought to define the relationship between HbA1c and average blood glucose level. Over a period of three months, they recorded continuous glucose monitor readings and seven-times-daily blood glucose meter readings in 268 people with Type 1 diabetes, 159 with Type 2 diabetes, and 80 without diabetes. The researchers compared these data with the HbA1c levels of the participants at the end of the three-month period. Based on the relationship between the two, they designed a mathematical formula for translating HbA1c into eAG. Someday, eAG may be printed alongside HbA1c in laboratory reports. Until then, there are a few ways to calculate eAG yourself: You can log on to the American Diabetes Association’s Web site at www.diabetes.org/ag, where you’ll find a conversion calculator as well as a chart showing equivalent values of HbA1c and eAG. You can also use the formula directly, using a calculator: 28.7 x HbA1c 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 >>

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 >>

Eag (estimated Average Glucose) = Glucose Standards War

Eag (estimated Average Glucose) = Glucose Standards War

For at least three consecutive years now at the annual ADA Conference, we keep hearing about a rumored switchover from the A1c as the gold standard average glucose measurement. Instead, we'll get something new and supposedly easier to understand: a new measure that more closely reflects the mg/dL (and international mmol/l)numbers we all get on our home glucose meters. This new test is now dubbed the eAG (estimated average glucose). One of the big news announcements Scientific Sessions this week was the results of a large international study that supposedly underscores the accuracy of the eAG. In this 10-center study, 507 volunteers with diabetes had their A1c translated into eAG readings and compared with their running daily BG results, if I understood the press materials correctly. "Study investigators found a simple linear relationship," the ADA press release states. Also stated: "Patients find it difficult to relate the A1c's percentage of hemoglobin that is glycated (and a goal of under 7%) to the self-monitoring of blood glucose they do at home... To reduce confusion, researchers have conducted a major international study to demonstrate how A1c correlates with self-monitoring." The ADA is clearly pushing hard for a massive migration to the eAG, which I find incredibly odd. They've even created little red handheld calculators (shown here) that they plan to sell to physicians off their website for easier conversion of A1c values into the "simpler" eAG. You can try their online calculator HERE. One reason I find this so odd is that just last September, the Diabetes Care Coalition, a consortium backed by the ADA, JDRF and AADE, along with a half-dozen major pharma companies, launched a sweeping "Know Your A1C" public service campaign to get people aware of their A1c an 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 >>

A New Number

A New Number "average Glucose" Will Soon Be A Key Part Of Your Diabetes Tool Kit

From the Editor: The following article first appeared in the November 2008 issue of Diabetes Forecast. It will be of interest to anyone who keeps track of blood sugar. Here it is: So how’s your diabetes? One way to tell is by monitoring your blood glucose with a meter. By testing yourself when you wake up in the morning and before and after meals, you can get a quick look at whether your current regimen is keeping your glucose levels in the range you and your doctor have agreed is best for you. Depending on your particular situation, you may be doing this several times a day, a couple of times a week, or less frequently. The other main way your health care provider can see how you’re doing is by ordering a lab test called an A1C. Most people with diabetes get this test—which gives a rough average of your blood glucose levels for the past 2 to 3 months—two to four times a year. It’s reported as a percentage, with normal levels between 4 and 6 for people who don’t have diabetes. Pretty soon, however, another number may show up on your lab chart: the estimated average glucose, or eAG. Sound like the same thing as the A1C? It is, in a way, but the eAG will look a lot more familiar. Why another number? The new number comes in part from new research. A large international study, called the A1C-Derived Average Glucose (ADAG) study, published in Diabetes Care in August, established that the A1C does, in fact, do what scientists have long believed it does: provide an accurate test of average blood glucose. “The results of the ADAG study should give people with diabetes increased confidence that the A1C…is, indeed, a valid measurement of their average blood glucose,” says Susan McLaughlin, BS, RD, CDE, CPT. McLaughlin, who is president-elect of health care and e Continue reading >>

Convert Hba1c To Average Blood Sugar Level

Convert Hba1c To Average Blood Sugar Level

Tweet Use this calculator to convert HbA1c to Average Blood Sugar Level. The HbA1c level in your blood indicates what your average blood glucose level has been in the past 2 to 3 months. Everyone, whether non-diabetic, pre-diabetic, type 1 diabetic or type 2 diabetic has some degree of sugar in their blood. To convert between mg/dl and mmol/L, use our blood sugar converter. You can then convert average blood glucose levels back to HbA1c units with the calculator below. mmol/L Recommended HbA1c ranges The recommended HbA1c range for most with diabetes is to keep the value under 48 mmols/mol (under 6.5% in the old percentage units). People at risk of hypoglycemia, or for whom such tight blood glucose regulation is not advised, may be advised to keep their HbA1c below 59 mmols/mol (under 7.5% in the old percentage units). Because the two tests measure two different things, the calculator can only give an estimate and therefore there will always be some discrepancy between the value provided by the calculator and actual lab test results. How accurate are the results? The calculator looks to provide an estimate of what your HbA1c value may be based upon your average blood glucose results and vice versa. It’s important to note that HbA1c and blood glucose tests measure different things. Blood glucose tests measure the concentration of glucose molecules in the blood at a single point in time. The HbA1c test measures the proportion of haemoglobin molecules in the blood that have become chemically bonded with glucose over a period of up to 3 months. However, the calculator serves as a useful guide which can give you a close indication of what your HbA1c result might be based on your blood glucose results? What can I learn from converting my average blood glucose level to HbA1c 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 >>

Estimated Average Glucose (eag) From Hba1c

Estimated Average Glucose (eag) From Hba1c

Knowing an estimated average glucose can allow clinicians to set a goal and target for glucose levels, especially in non-compliant patients who do not check their glucose levels frequently or do not record them. Continue reading >>

What The A1c And Eag Blood Tests Tell About Your Hemoglobin

What The A1c And Eag Blood Tests Tell About Your Hemoglobin

What is "estimated Average Glucose" (eAG)? eAG stands for Estimated Average Glucose. This term is a measurement that directly relates to A1c blood test. The A1c has been the standard measure of diabetes control for many years. The chart below shows how the A1c directly relates to the eAG: What does a1c stand for A1c is a blood test that shows you what your diabetes control has been for 2-3 months. The A1c and your daily blood sugar levels let your doctor see how well you are managing your diabetes. There is now a new term known as eAG. The eAG is a better way to explain the A1c. How the A1c Test Works Hemoglobin is one part of the red blood cell. It carries oxygen through the body. The sugar in your blood attaches to the hemoglobin and stays there for the life of that red blood cell. The glucose-hemoglobin part of the red blood cell is called the A1c. The A1c measures the percent of hemoglobin that has sugar attached to it. Since red blood cells live for approximately 90 days, they carry the memory of all your blood sugar levels. The A1c shows what your diabetes control has been for the past 3 months. A blood sample using your glucose monitor shows you what your blood sugar is at that moment. How the A1c Test Administered The process for this test is easier than getting the actual results. Since little blood is actually needed the doctor will painlessly draw a small sample of blood. If their office is equipped for it, they can provide you instant results otherwise it may take a few days to get your results back. The entire process takes only a moment and is virtually painless. No fasting is required for this process unlike a standard glucose test. What is a good a1c level? For people without diabetes, the normal A1c range is between 4-6%. When the results of your A1c fa Continue reading >>

An Overview Of Estimated Average Glucose (eag)

An Overview Of Estimated Average Glucose (eag)

Estimated average glucose (eAG) or "average glucose" is a newer term you may see reported by your doctor. The American Diabetes Association (ADA) introduced this term to help us translate our A1c tests into numbers that would more closely represent our daily glucose meter readings. Making Sense of eAG: Estimated Average Glucose To understand eAG, we have to begin with the A1c test (also known as glycated hemoglobin or HbA1c). The A1c test measures the amount of hemoglobin in your blood that has glucose attached to it in the red blood cells (glycated hemoglobin). It tells you what your average blood glucose control has been for the past two to three months. The problem is that the A1c test reports a percentage of total hemoglobin that is glycated hemoglobin. In other words, an A1c of 7 percent means that 7 percent of the total hemoglobin has glucose attached to it. But your glucose meter measure glucose directly in the blood in milligrams per deciliter (for example, 150 mg/dl). The two types of numbers are confusing and few of us would be able to easily translate one into the other. Researchers discovered an accurate way to calculate estimated glucose levels from the A1c results. This way we can use the same numbers we are accustomed to seeing on our daily glucose meters. Quick Reference Chart for Hemoglobin A1c to eAG Below is a quick reference guide that will help you calculate your estimated average blood glucose level from your A1c result. A1c (%) to eAG (mg/dl) 6.0% = 126 mg/dl 6.5% = 140 mg/dl 7.0% = 154 mg/dl 7.5% = 169 mg/dl 8.0% = 183 mg/dl 8.5% = 197 mg/dl 9.0% = 212 mg/dl 9.5% = 226 mg/dl 10.0% = 240 mg/dl A1c Versus Daily Monitoring While the A1c test is important for measuring your long-term blood glucose management, it can’t replace daily blood glucose te Continue reading >>

What Is The Average Blood Sugar Level?

What Is The Average Blood Sugar Level?

Blood sugar, or glucose, serves as the fuel your body uses to generate energy. The level of glucose in your blood remains fairly stable, slightly rising after eating and declining a small amount between meals or after exercising. Blood glucose can be measured in many ways. Some tests measure glucose directly, while others measure the amount of glucose attached to a specific protein. Video of the Day Fasting and Premeal Blood Glucose Levels The amount of glucose in the blood varies, depending on when you last ate. A fasting blood glucose level after at least 8 hours without caloric intake in a healthy, nondiabetic adult typically ranges from 70 to 99 mg/dL, according to the American Diabetes Association (ADA). People with a fasting blood glucose of 100 to 125 mg/dL are considered prediabetic, meaning the body's handling of glucose is impaired but not yet to the point of warranting a diagnosis of diabetes. A fasting blood glucose of 126 mg/dL or greater typically indicates diabetes, according to ADA criteria. Among people diagnosed with diabetes who are not pregnant, the ADA recommends a target fasting or premeal blood sugar level of 80 to 130 mg/dL. Postprandial and Oral Glucose Tolerance Levels As the blood glucose level typically increases after eating, testing after a meal -- known as a postprandial glucose level -- provides information about the body's capacity to maintain a healthy blood sugar level when challenged with a caloric load. Blood glucose levels usually peak 1 to 2 hours after beginning a meal, depending largely on the amount of carbohydrates, proteins and fat in the meal. Among healthy, nondiabetic adults a normal postprandial glucose level 2 hours after a meal is less than 140 mg/dL. For people with diabetes, the ADA generally recommends a peak postpran Continue reading >>

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