diabetestalk.net

What Is A Good Score For A1c?

Overtreatment Of Elderly Diabetics

Overtreatment Of Elderly Diabetics

The last time I was directly responsible for treating diabetes was fifty years ago, when I was an intern in medicine at UCLA. In my subsequent career as a psychiatrist I was not directly responsible for diabetes care, and as an individual, I don’t have the condition. As a result, I haven’t kept up on diabetes treatment, so a June 11 article on “Diabetes Overtreatment in Elderly Individuals: Risky Business in Need of Better Management” was news to me. The opening two sentences of the American Diabetes Association’s article on “Tight Diabetes Control” make it sound as if “tight control” should be the goal of treatment: “Keeping your blood glucose levels as close to normal as possible can be a lifesaver. Tight control can prevent or slow the progress of many complications of diabetes, giving you extra years of healthy, active life.” In my uninformed state, that’s how I understood how diabetes should be managed, even for over 65ers. But I was wrong. Several paragraphs later there’s a very clear statement that elderly people with diabetes should be treated differently: “Elderly people probably should not go on tight control. Hypoglycemia [overly low blood sugar] can cause strokes and heart attacks in older people. Also, the major goal of tight control is to prevent complications many years later. Tight control is most worthwhile for healthy people who can expect to live at least 10 more years.” The American Geriatrics Society gives precise guidelines for the goal of diabetes treatment in over 65ers. The key measure of diabetes control is hemoglobin A1c. For healthy over 65ers with long life expectancy, the target should be 7.0 – 7.5%. For those with “moderate comorbidity” (so-so health) and a life expectancy of less than 10 years the targe 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 >>

How To Lower A1c In Just A Few Months? Reduce A1c Levels In Months

How To Lower A1c In Just A Few Months? Reduce A1c Levels In Months

Lower A1C levels with tips provided by us. Individuals who have diabetes are not familiar with the aspects of an A1C test. They just have a general idea that the A1C test is done for understanding and checking their A1C levels. You have to understand that the solution also lies in the test itself. The test results will indicate all the reasons which cause fluctuations in the sugar levels and hemoglobin. Most people know about the A1C test, but they are not aware of the reasons behind it. Reasons why the Diet Plans don’t work You have to make efforts to lower your a1c hemoglobin as it has a bigger effect than just reducing your a1c levels. Having low scores in the A1C levels is not helpful, and it also affects your overall health. It’s not necessary to just eat broccoli or some other veggies throughout the whole month and just wait for the A1C levels to come down. One should exercise regularly and have a good diet as this is going to help lower A1C levels. Some people think that they eat some healthy food and it’s going to help you to become healthy miraculously. You have to make maximum efforts to get its benefits. When you decide to live a healthy life, then it becomes easy for you to do it. Human life is complicated, and you can make it easy by focusing on more important things. All diabetic patients are different and have various problems. Reduce A1C Levels In Months Some people manage their problems properly without having any issues, But some of them struggle a lot. You have to focus on a few different things to lower your A1C levels. Such as Diet, Exercise, Stress control, etc. It would be better if you handle all these things equally to have better control over your sugar levels. First, try to understand your A1C results. One common mistake made by some dia Continue reading >>

If I Am Diabetic, My A1c Is 6.0-6.7, Is My Current Diet Enough? If My A1c Is In The Target Range, Is Any Further Reduction In My Diet Called For? Do I Have To Cut Out All Desserts And Candy?

If I Am Diabetic, My A1c Is 6.0-6.7, Is My Current Diet Enough? If My A1c Is In The Target Range, Is Any Further Reduction In My Diet Called For? Do I Have To Cut Out All Desserts And Candy?

It seems you are good. Try to have a HBA1c of <7% if you're otherwise healthy and not on insulin. Cutting deserts, candy etc., calories in general and carbs especially is useful especially if you are overweight, or tend to gain weight, most type 2 diabetic are overweight, and being overweight will up your insulin resistance, so making you need meds sooner or more some of which the sulfonylureas (see Sulfonylureas Increase Mortality by 50 Percent) are correlated with a higher mortality (metformin is the only antidiabetic drug which correlates with a lower mortality see Can people with type 2 diabetes live longer than those without? A comparison of mortality in people initiated with metformin or sulphonylurea monot... - PubMed - NCBI) We now know that in type 2 diabetics on insulin, the addition of metformin lowers one’s risk of dying Association between Insulin Monotherapy versus Insulin plus Metformin and the Risk of All-Cause Mortality and Other Serious Outcomes: A Retrospecti... - PubMed - NCBI Besides not growing fat physical exercise is the only other way one can lower one's insulin resistance which is part of being a type 2 diabetic. The idea that a diabetic isn't allowed to have any sugar is obsolete and based on a wrongly interpreted 1903 experiment in which dogs in whom the pancreas had been surgically removed were fed either a sugar rich or a fat rich diet. Those on a fat rich diet weren't able to digest all this fat, since the pancreas also produces the digestive enzyme lipase needed to digest fat, causing enormous fatty diarrhea (steathorrhea) so losing all the food in the process, thus having lower blood sugar levels, while those fed a high sugar feed didn't suffer this fatty diarrhea, took up the sugars and had very high blood sugar levels because they la Continue reading >>

From Wikipedia, The Free Encyclopedia

From Wikipedia, The Free Encyclopedia

A1C may refer to: Airman First Class, the third enlisted rank in the United States Air Force Glycated hemoglobin (hemoglobin A1c or HbA1c), a surrogate marker for blood glucose levels Continue reading >>

Epw02 - Depression 1 Epa-0023 – Diabetes And Major Depressive Disorder Interaction: No Effect Of Baseline Diabetic Control On Six Month Depression Outcomes

Epw02 - Depression 1 Epa-0023 – Diabetes And Major Depressive Disorder Interaction: No Effect Of Baseline Diabetic Control On Six Month Depression Outcomes

Prior studies have demonstrated an inter-relationship between the diagnosis of diabetes, obesity and depression. Our prior studies have shown that the diagnosis of diabetes or baseline body mass index (BMI) did not impact six month depression remission rates. Our hypothesis was that level of control of diabetes (hemoglobulin A1c < 8.0%) in depressed diabetic patients would have no effect on depression remission rates six months after diagnosis. This study was retrospective analysis of 451 diabetic primary care patients diagnosed with Major Depressive Disorder or Dysthymia with a PHQ-9 score of 10 or greater. ▪ Outcome variable was clinical remission (PHQ-9 < 5) at six months. ▪ Logistic regression modeling included the demographic variables of age, gender, marital status, the clinical variables of BMI, baseline PHQ-9 score, hemoglobin A1c level (at date of diagnosis of depression) and clinical diagnosis (recurrent or first episode of depression, or dysthymia). 78.5% (354) of depressed diabetics were in good control of diabetes (hemoglobin A1c< 8%) at enrollment. Obesity (BMI≥ 30) at baseline was not different between the controlled and uncontrolled diabetic patients at baseline (approximately 70%), p=0.36. Figure 1. Odds ratio for clinical remission (PHQ-9<5) at six months in diabetic primary care patients, by variable (N=451). Controlling for age, gender, marital status, race, clinical diagnosis and clinical site. ▪ Baseline control of diabetes was not an independent predictor for depression outcome at six months. This data suggests that poor diabetic control was not associated worsening clinical outcomes in depression management. Continue reading >>

Diabetes Control Tied To Heart Stent Outcomes

Diabetes Control Tied To Heart Stent Outcomes

(Reuters Health) - For people with type 2 diabetes, maintaining good blood sugar control in the years after receiving a coronary artery stent is associated with a lower risk of heart attack and stroke, according to a recent study. “Although intensive glucose control had no benefit on the rate of major cardiovascular events in previous studies, our data suggest that strict glucose control after PCI (heart catheterization) can improve long-term clinical outcomes in diabetic patients,” Dr. Joo-Yong Hahn from Samsung Medical Center in Seoul told Reuters Health. Heart disease is the major cause of death among people with type 2 diabetes, Hahn’s team writes in Circulation: Cardiovascular Interventions. Although intensive blood sugar control is known to reduce damage to tiny blood vessels that are involved in many of the nerve and circulatory effects of diabetes, it’s not clear if the same is true for major arteries such as the ones that carry blood to the heart. The researchers studied 980 patients with type 2 diabetes who had undergone percutaneous cardiac intervention (PCI) to clear a blocked coronary artery and place a supportive mesh tube known as a stent. Hahn’s team followed the patients’ health for up to seven years. They looked at long-term blood sugar control using a measurement known as hemoglobin A1c (HbA1c or A1C), and used it to compare the patients’ risks of death, heart attack, repeat catheterizations and stroke over the study period. The researchers defined good control as an A1C score below 7.0 and poor control as A1C of 7.0 or higher. Then they matched patients according to other risk factors and ended up with 322 pairs of patients for comparison. In the overall group of 980 patients, the risk of all bad outcomes was 25 percent lower with good Continue reading >>

Ada Tightens A1c Goals For Children

Ada Tightens A1c Goals For Children

The ADA calls for better blood glucose control in its first-ever Type 1 diabetes position paper. Scientists from the American Diabetes Association (ADA) held an open Twitter chat to discuss new guidelines for children with Type 1 diabetes, as part of the rollout of the association’s first Type 1-only position paper. Endocrinologists Dr. Jane Chiang and Dr. Sue Kirkman fielded questions for the ADA. In a move that stirred up online chatter, the ADA tightened its A1C goals for children. Previously, ADA guidelines called for A1C goals of 8.5 or lower for children under 6 years old, 8.0 or lower for children ages 6 to 12, and then 7.5 or lower for teens. The new guidelines now call for an A1C score of 7.5 or lower for all children, regardless of age. The recently-released position paper is the first from the ADA to discuss Type 1 diabetes exclusively. In the past, Type 1 and Type 2 guidelines were lumped together. Issuing Type 1-only position papers will help physicians focus on the unique characteristics and treatment options for Type 1, Dr. Chiang said. “Diabetes is not a one-size-fits-all disease, and it’s important that we recognize that,” Dr. Chiang said A1C goals for children were tightened because new research shows that children with high blood glucose levels before puberty are at greater risk for heart and kidney problems later on in life, according to Dr. Chiang. A1C guidelines always must balance the long-term health impact of high blood glucose levels with the short-term danger of hypoglycemia. In the past, an A1C goal of 7.5 or lower for children seemed too difficult to reach without risking increased hypoglycemia. Dr. Kirkman believes that pumps and other advances in diabetes home care technology will now make such a goal more attainable without dire r 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 >>

Why The A1c (glycated Hemoglobin) Test For Diabetics Does Not Give Us The Whole Picture

Why The A1c (glycated Hemoglobin) Test For Diabetics Does Not Give Us The Whole Picture

Diabetics are familiar with the A1C test. It is performed to assess roughly a 90 day period of sugar that is attached to your hemoglobin. It is supposed to tell us if we are taking good care of ourselves. The test is performed every 3 months because the average life of a red blood cell is 90 days. Diabetics are told that the A1C is the ‘holy grail’ of knowing if you are in good health or not. It’s the aim of most every diabetic to get that number lower! I’ve been diabetic for over 35 years and it’s great to learn new things. What have I learned? I now know that the A1C, although a great test to determine the ‘average’ blood sugar reading over 3 months, does really nothing more than that. It does NOT accurately tell us all we need to know about our diabetic health. The A1C for a non-diabetic person is about 5.7%. A ‘well-controlled’ diabetic will have an A1C at 6.5% or lower. If someone’s A1C is 8.0% or higher, then they are generally in trouble! Long-term high blood sugar levels lead to high levels of oxidative stress (free radical damage). This damage is mostly what is responsible for killing diabetics. Afterall, 65% of diabetics will die from heart disease/stroke and this damage is caused by, you guessed it, poor blood sugar control. The formula for determining your A1C is as follows: Take an average of your blood sugars over a period of time. The longer the time, the better. When you get blood work done, they are using a decent quantity of blood and again, can read the amount of glucose attached to the hemoglobin in your blood (over about 90 days)…this gives a result that is far more accurate than you can determine at home…but for the sake of this blog, follow along. Add the number 46.7 to your final average that you have determined. Now divid Continue reading >>

Blood Test That Provides Prior Blood Sugar Average Now Recommended For Diabetes Screening, Diagnosis

Blood Test That Provides Prior Blood Sugar Average Now Recommended For Diabetes Screening, Diagnosis

New official guidelines for diabetes screening and diagnosis now include a blood test that gives a person’s average blood glucose level over the previous 2-3 months. The A1C test is not new. It has been used since the late 1970s as a way to get a snapshot of how well glucose control is going in people with diabetes. But only in the last 15 years has its use and scoring become more standardized and reproducible from place to place and time to time than other diabetes blood glucose tests. Now, in an annual supplement to the journal Diabetes Care, published Dec. 29 by the American Diabetes Association, the A1C test is given a prominent role in the 2010 guidelines for diabetes screening, diagnosis and prevention. In particular, the section “Revisions to the Standards of Medical Care in Diabetes,” recommends that the A1C be used to identify people with “pre-diabetes,” those at increased risk for developing the type 2 form of disease. Unlike type 1 diabetes with its sudden onset, type 2 develops gradually and without symptoms. But its damage to health and longevity can be equally severe. At least 50 million adults and children in the U.S. may be well on their way to developing type 2 diabetes, according to John Buse, M.D., Ph.D., professor of medicine and endocrinology chief at the University of North Carolina at Chapel Hill. Buse is former ADA president for medicine and science and a member of the International Expert Committee whose report in July 2009 strongly recommended the A1C assay for diabetes diagnosis and for identifying people at high risk for diabetes. “One big advantage of the A1C test is that it doesn’t require fasting. The patient can come in any day, at any time. It’s also not as skittish as the older blood sugar test which can be increased by Continue reading >>

Hemoglobin A1c (hba1c) Test For Diabetes

Hemoglobin A1c (hba1c) Test For Diabetes

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes. Hemoglobin is a protein found in red blood cells. It gives blood its red color, and it’s job is to carry oxygen throughout your body. The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher change of getting of diabetes. Levels of 6.5% or higher mean you have diabetes. The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. A combination of diet, exercise, and medication can bring your levels down. People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year. People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can Continue reading >>

A1c Calculator*

A1c Calculator*

Average blood glucose and the A1C test Your A1C test result (also known as HbA1c or glycated hemoglobin) can be a good general gauge of your diabetes control, because it provides an average blood glucose level over the past few months. Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you check blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target of 7% or lower recommended by the American Diabetes Association (ADA) for many adults who are not pregnant. For some people, a tighter goal of 6.5% may be appropriate, and for others, a less stringent goal such as 8% may be better.1 Talk to your doctor about the right goal for you. GET YOURS FREE The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management. See how average daily blood sugar may correlate to A1C levels.2 Enter your average blood sugar reading and click Calculate. *Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes. What is A1C? Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a Continue reading >>

Why Hemoglobin A1c Is Not A Reliable Marker

Why Hemoglobin A1c Is Not A Reliable Marker

i was recently tested for Hemoglobin A1c because i presented to an endocrinologist with extremely low blood glucose on lab test and some scary symptoms, not the ordinary hypoglycemia symptoms. My A1c was 4.7 which registered as low (L) on the lab print out–it was only slightly low. Does a low score on this suggest a possibility of short-lived RBCs? Does it have any relationship with extremely low blood glucose? my result at the lab, fasting, was 32mg/dL. Not long after that i got a home glucometer and i get the same kind of results on that as the lab got, in the 20s and 30s first thing in the morning, every day. did not know i had hypoglycemia until i had that lab test, though i had had one episode where i woke up with ataxia, i fell while walking to the bathroom first thing in the morning, i got up and immediately fell again. I soon found that i had very impaired coordination. i did not know why and i was very worried. Eventually i wanted to have breakfast but had great difficulty holding the measuring cup under the faucet, to get some water to heat, to make instant oatmeal, i lacked the coordination to get the water into the cup. I persisted and did make the instant oatmeal (pour hot water onto flakes and it’s done), and i got my lap top and was eating the oatmeal and i suddenly was aware that the symptoms were going away. Previously i had been unable to type. While eating the small amount of oatmeal, i realized i could type. That was about a month before the lab test. Since it only happened that once, i put it out of my mind. About 5 days after the lab test, i had the second episode, worse than the first, i woke falling out of bed to the floor, couldn’t use my arm to break the fall, i didn’t have the coordination. i sat on the floor, i could not get up and wa Continue reading >>

Understanding Your A1c Reading With Your Eag: Estimated Average Glucose

Understanding Your A1c Reading With Your Eag: Estimated Average Glucose

Every three to six months we have our A1C measured"but what does that number really mean? You know it’s a measure of your average blood sugar reading, but when was the last time your blood glucose monitor gave you a percentage? Your A1C is essentially a measurement of the Advanced Glycogenated End-products that have accumulated in your blood from blood sugar levels"the higher our blood sugars are, the more AGEs are present in our blood. These AGEs are also what lead to various complications we’re warned about: nerve damage, retinopathy, etc. So, as usual, our goal is to reduce our A1C which will reduce our AGEs, and we do this by controlling our blood sugars better. The Joslin Diabetes Center recently published an article about a new way to report your A1C so you can translate that number to the numbers you see on your monitor. This is your eAG= Estimated Average Glucose. So what does it mean to you when your doctor says your A1C is 8%? According to the Joslin article an A1C of 8% means your eAG is 183, which means your blood sugars run usually between 147 to 217. My last A1C was 7.6%. This means my blood sugars run between 140 to 200 on average through the day. The lowest A1C I’ve ever had was 6.2% and the highest I’ve had was a few years ago when I started college, at 8.4%. **Here’s a chart for your A1C readings translated to your eAG: 12% = 298 (240 - 347) 11% = 269 (217 - 314) 10% = 240 (193 - 282) 9% = 212 (170 -249) 8% = 183 (147 - 217) 7% = 154 (123 - 185) 6% = 126 ( 100 - 152)** So, if your A1C is 11%, your average glucose reading is 269, which means ninty-five percent of the day your blood sugar is somewhere between 217 to 314. Numbers like those makes it much more difficult to ignore that 11% We all know we can’t be feeling very well or be treating Continue reading >>

More in blood sugar