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 >>
Hemoglobin A1c Test (hba1c, A1c, Hb1c)
Hemoglobin A1c definition and facts Hemoglobin A1c is a protein on the surface of red blood cells that sugar molecules stick to, usually for the life of the red blood cell (about three months). The higher the level of glucose in the blood, the higher the level of hemoglobin A1c is detectable on red blood cells. Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time period. Normal ranges for hemoglobin A1c in people without diabetes is about 4% to 5.9%. People with diabetes with poor glucose control have hemoglobin A1c levels above 7%. Hemoglobin A1c levels are routinely used to determine blood sugar control over time in people with diabetes. Decreasing hemoglobin A1c levels by 1% may decrease the risk of microvascular complications (for example, diabetic eye, nerve, or kidney disease) by 10%. Hemoglobin A1c levels should be checked, according to the American Diabetic Association, every six months in individuals with stable blood sugar control, and every three months if the person is trying to establish stable blood sugar control. Hemoglobin A1c has many other names such as glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin, and HbA1c. To explain what hemoglobin A1c is, think in simple terms. Sugar sticks to things, and when it has been stuck to something for a long time it's harder to the get sugar (glucose) off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die. When sugar (glucose) sticks to these red blood cells by binding to hemoglobin A1c, it gives us an idea of how much glucose has been around in the blood for the preceding three months. Hemoglobin A1c is a minor component of hemoglobin to which gl Continue reading >>
...a Higher Average On-treatment A1c Was A Stronger Predictor Of Mortality Than The A1c For The Last Interval Of Follow-up Or The Decrease Of A1c In The First Year.
Over the past year I have heard from a horrifying number of people with diabetes whose doctors have reproached them for lowering their A1cs below 6% and warned them that lowering A1c to that level will give them heart attacks. This is obscenely bad advice. But there is a reason why so many doctors are giving it. It goes back to a study called ACCORD, which was published in Februrary of 2008. You can read it here: What ACCORD Really Found This study was designed to see if lowering A1c to 6.5%, instead of the ADA's recommended 7.0%, could prevent heart attacks. The study was stopped early when analysis of preliminary data showed a slight excess of heart attack deaths in the subjects in the group who were striving to lower their A1cs. This is all most doctors ever heard about ACCORD--that lowering A1c led to an increased risk of heart attack. What they didn't hear about was the methodology used in the study. That methodology makes it very clear that it wasn't the lowering of blood sugars that caused the deaths, but the way the study attempted to lower A1c. ACCORD studied only people with long-standing Type 2 diabetes who had been diagnosed with heart disease before the start of the study. These patients were put on a statin drug (which we now know can further raise blood sugar) and a fibrate drug. Then the researchers set out to lower blood sugar by putting their subjects the discredited high carbohydrate, low fat diet--which a large body of research has shown not only raises blood sugar but worses triglycerides and LDL. To counteract the blood-sugar-raising effect of this diet, the ACCORD researchers put the study subjects trying to lower blood sugar on a cocktail of every diabetes drug available at the time, including Avandia and Actos. 90.2% of ACCORD Subjects Were Taki Continue reading >>
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David's Guide To Getting Our A1c Under 6.0
The A1C test is our best scorecard to show how well we are controlling our diabetes. It measures how much glucose has been sticking to our red blood cells for the previous two or three months. Since our bodies replace each red blood cell with a new one every four months, this test tells us the average of how high our glucose levels have been during the life of the cells. The experts recommend that we should get our A1C level tested at least twice a year. People who take insulin need to get it about four times a year. If the test shows that our blood glucose level is high, it means that we have a greater risk of having diabetes problems. Think of the A1C as an early warning system for the insidious complications that we can get down the road when we don’t control our condition. But what do we mean by a “high” A1C level? Here the experts disagree. The American Diabetes Association says that we need to keep our A1C results below 7.0 percent. The American Association of Clinical Endocrinologists sets the target at 6.5 percent. The International Diabetes Federation, or IDF, also recommends that most people with diabetes keep their levels below 6.5 percent. The more our A1C level is higher than normal, the greater the likelihood that we will suffer from one or more of the complications of diabetes. And here too the experts disagree with how they define “normal.” People who don’t have diabetes have A1C levels below 6.0 percent. That’s the gist of what I wrote here recently in “The Normal A1C Level.” The IDF agrees. But more aggressive endocrinologists say that a truly normal A1C ranges from 4.2 percent to 4.6 percent. That’s what Dr. Richard K. Bernstein wrote in Dr. Bernstein’s Diabetes Solution. No matter what our level is, we can be sure that lower is Continue reading >>
Your A1c Results: What Do They Mean?
If you have diabetes, you should have an A1C test at least twice each year to find out your long-term blood glucose control. The A1C test measures your average blood glucose during the previous 2-3 months, but especially during the previous month. For people without diabetes, the normal A1C range is 4-6%. For people with diabetes, the lower the A1C value, the better the diabetes control and the lower the risk of developing complications such as eye, heart, and kidney disease. Your goal should be to have A1C values less than 7%. That may be a hard target to hit, but it is important to try because the lower your A1C, the lower your health risk. The table on this page shows what your A1C results say about your blood glucose control during the past few months. Some people are surprised when they have a high A1C result because when they check their blood glucose with their meter, they have relatively low numbers. But remember that checking your blood glucose gives you only a momentary sample of your blood glucose control. The A1C test measures your blood glucose control at all times during the previous 2-3 months, even times such as after meals or when you are asleep, when you don't usually check your blood glucose. Think of the A1C test as feedback to help you better control your diabetes and improve your diabetes care habits. By giving you important information about your long-term control, the A1C test can help you stay motivated to do your best on diabetes self care. Talk with your doctor and other members of the health care team about your A1C results and how you can use them to better manage diabetes. Within the next few months, the federal government will implement the first major reorganization of the Medicare system for many years: the Medicare Prescription Drug Imp Continue reading >>
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 >>
Ultimate Guide To The A1c Test: Everything You Need To Know
The A1C is a blood test that gives us an estimated average of what your blood sugar has been over the past 2-3 months. The A1c goes by several different names, such aswa Hemoglobin A1C, HbA1C, Hb1C, A1C, glycated hemoglobin, glycohemoglobin and estimated glucose average. What is Hemoglobin? Hemoglobin is a protein in your blood cells that carries oxygen. When sugar is in the blood, and it hangs around for a while, it starts to attach to the red blood cells. The A1C test is a measurement of how many red blood cells have sugar attached. So, if your A1C result is 7%, that means that 7% of your red blood cells have sugar attached to them. What are the Symptoms of a High A1C Test Level? Sometimes there are NO symptoms! That is probably one of the scariest things about diabetes, your sugar can be high for a while and you may not even know it. When your blood sugar goes high and stays high for longer periods of time you may notice the following: tired, low energy, particularly after meals feel very thirsty you may be peeing more than normal, waking a lot in the middle of the night to go dry, itchy skin unexplained weight loss crave sugar, hungrier than normal blurred vision, may feel like you need new glasses tingling in feet or hands cuts or sores take a long time to heal or don’t heal well at all frequent infections (urinary tract, yeast infections, etc.) When your blood sugar is high, this means the energy that you are giving your body isn’t getting into the cells. Think about a car that has a gas leak. You put gas in, but if the gas can’t get to the engine, the car will not go. When you eat, some of the food is broken down into sugar and goes into your bloodstream. If your body can’t get the sugar to the cells, then your body can’t “go.” Some of the sugar tha Continue reading >>
A1c Below 6.0 Without Insulin Or Other Meds? Introduce Yourself!
A1C Below 6.0 without insulin or other meds? Introduce yourself! Diabetic who are trying to be Med free, I would check out this book. "Diabetes Without Drugs: The 5-Step Program to Control Blood Sugar Naturally and Prevent Diabetes Complications" Suzy Cohen I probably shouldn't be writing this as I'm coming out of a low, but the shaking has calmed down and now my nerves to do the same. Here's the deal, I had an assignment due by midnight, so I drank 1.5 cups of coffee between 8-12am. I didn't go to sleep until 2am and I've been up since 6am (it's 7:30am). Before going to bed I had two rice krispy treat bars (the small 90 calories, 17g of carb ones). Well, just a few minutes ago I was on my laptop and started feeling like I was having a low. Palms sweaty and shaky. I just my glucose, I'm 58. I check again it was 60 something. I immediate go into panic mode. I eat graham crackers, yogurt, and half banana. I'm waiting for that to take affect. Does anyone here have lows like this? I've been med-free for four months and this is the 3rd low, but the first one in the morning. I'm reminded of when I was on insulin. I've been diabedic for 9 months. Coming up to another A1C. I don't test as often as I use too but that really helps me stay on course. The last 3 months have been stressful and I'm afraid I'm going to be higher than last time. Do any of you go off plan for special occasions. My blood sugard has only reached 138 a couple of times after desserts - and after a steroid shot for bursitues. OBX, I don't go off plan for anything because for ME it's too hard to get back on it. Also, I can gain 5 pounds (the permanent kind) overnight, even though my blood sugar stays low. So I avoid sugary carbs like the plague that they are for me. That said, I don't miss them. If I could e Continue reading >>
A1c Level And Future Risk Of Diabetes: A Systematic Review
The use of A1C for the identification of persons with undiagnosed diabetes has been investigated for a number of years (1–3). A1C better reflects long-term glycemic exposure than current diagnostic tests based on point-in-time measures of fasting and postload blood glucose (4,5) and has improved test-retest reliability (6). In addition, A1C includes no requirement for fasting or for the oral glucose tolerance test's 2-h wait. These advantages should lead to increased identification and more timely treatment of persons with diabetes. Recently, an American Diabetes Association (ADA)-organized international expert committee recommended the adoption of the A1C assay for the diagnosis of diabetes at a cut point of 6.5% (7). This cut point was primarily derived from a review of studies that examined the association of A1C values with incident retinopathy, and some of the most influential data were obtained from recently published prospective studies. Retinopathy was chosen as the ultimate criterion because it is among the main complications of diabetes. Identification of the point on the A1C distribution most closely related to future retinopathy will identify persons in the greatest need of interventions for the prevention of diabetes complications. In addition to utility and convenience, A1C could help identify persons at increased risk of developing diabetes. This is an important public health priority since a structured lifestyle program or the drug metformin can reduce the incidence of diabetes by at least 50 and 30%, respectively (8). Ideally, selection of diagnostic cut points for pre-diabetes would be based on evidence that intervention, when applied to the high-risk group of interest, results not only in the prevention of diabetes but also later complications. Howe Continue reading >>
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All About The Hemoglobin A1c Test
People with diabetes used to depend only on urine tests or daily finger sticks to measure their blood sugars. These tests are accurate, but only in the moment. As an overall measurement of blood sugar control, they’re very limited. This is because blood sugar can vary wildly depending on the time of day, activity levels, and even hormone changes. Some people may have high blood sugars at 3 a.m. and be totally unaware of it. Once A1C tests became available in the 1980s, they became an important tool in controlling diabetes. A1C tests measure average blood glucose over the past two to three months. So even if you have a high fasting blood sugar, your overall blood sugars may be normal, or vice versa. A normal fasting blood sugar may not eliminate the possibility of type 2 diabetes. This is why A1C tests are now being used for diagnosis and screening of prediabetes. Because it doesn’t require fasting, the test can be given as part of an overall blood screening. The A1C test is also known as the hemoglobin A1C test or HbA1C test. Other alternate names include the glycosylated hemoglobin test, glycohemoglobin test, and glycated hemoglobin test. A1C measures the amount of hemoglobin in the blood that has glucose attached to it. Hemoglobin is a protein found inside red blood cells that carries oxygen to the body. Hemoglobin cells are constantly dying and regenerating, but they have a lifespan of approximately three months. Glucose attaches, or glycates, to hemoglobin, so the record of how much glucose is attached to your hemoglobin also lasts for about three months. If there’s too much glucose attached to the hemoglobin cells, you’ll have a high A1C. If the amount of glucose is normal, your A1C will be normal. The test is effective because of the lifespan of the hemogl Continue reading >>
Why I'm Motivated To Maintain A 6.0 A1c With Type 1 Diabetes
At the age of 13, I was diagnosed with type 1 diabetes (I also have Celiac disease). Somewhere in my 20s—motivated by the promise of better health now, and in the long run—I started making changes to maintain a 6.0 A1C level. I have to admit, maintaining this number wasn’t easy at first. So why go to such lengths to maintain an A1C of 6.0 when the American Diabetes Association says an A1C of 7 or less is desirable for people with type 1 and type diabetes? And the recommendation from the American Association of Clinical Endocrinologist (AACE) is less than 6.5? That’s easy: I slept better, had fewer blood sugar highs and lows, required less insulin and felt much more energetic. When your blood sugars are running in the mid-to-high 100s every day (an A1C of 7) you might not realize just how sluggish you feel until you get them down. High blood sugars take HOURS to get back into range so if you’re working to prevent them from happening in the first place, you’re staving off a lot of stress on your body. I also discovered that high blood sugars during sleep interfered with me getting truly restful sleep. I also felt my muscles’ ability to perform during exercise was worse. The list goes on and on. Without becoming obsessive about my diabetes management, I’ve actually been able to maintain an average blood sugar of 125 mg/dL and an overall range of 100 to 152 mg/dL most of the time. Periodic testing of A1C levels, which cannot be done at home, is important. Research shows that being in a healthy blood sugar range correlates with fewer complications from diabetes, such as kidney disease, diabetic neuropathy and high blood pressure later in life. In other words, better diabetes control translates into better health. If you wind up having a high A1C level it may Continue reading >>
Achieving A 6.0 A1c By Eating 40 Grams Of Carb Per Meal
“6.0.” I didn’t think I heard him correctly. I asked my endocrinologist to repeat himself. “I said 6.0%. You’re A1C was 6.0%.” My mouth gaped in astonishment. Practically non-diabetic. The lowest A1C I have ever had in my 10+ years of type 1 diabetes. How Did I Do It? Over the past ten years since my diagnosis with type 1 diabetes, I would consider myself a “good diabetic.” That means multiple fingersticks a day, remembering to bolus at mealtimes, and an overall idea of what kinds of foods were entering my body. My A1C hovered between 6.8-7.4% — which my doctors thought was just fine. I had a strong desire to lower my A1C but nothing in the past seemed to significantly work. About a year ago, I began medical school and became inspired to take better control of my diabetes. I began doing a lot of reading on the subject and started to toy with the idea of lowering my carb intake. There have not been many (if any) conclusive studies on the effects of low-carb diets in type 1 diabetics, yet I had a hunch that something like that could be my long desired solution. I decided to perform a six-month-long clinical trial, testing the effects of a low-carb diet on a particular type 1 diabetic — me. The Rules I recognized that diabetes is a lifelong condition and that any new diet I would undertake would have to be sustainable over a long period of time. Many popular diets only allow minuscule portions of daily carbs and I knew that would not be maintainable long term. I didn’t want my diet to be unbearable and rebound. I therefore decided at the start that my diet was not to lose weight, and was not to start eating healthier. I allowed myself to eat cookies, cake etc. (although I did naturally end up eating more vegetables in order to stick to the rules of th Continue reading >>
Understanding Your Hba1c
You’ve heard about a diabetes test called a hemoglobin A1C. It’s sometimes shortened to HgbA1c or HbA1c or just A1C. Hopefully, you know what yours is. But do you know what it means and what to do with the information? Hemoglobin is what makes red blood cells red. It consists of several proteins wrapped around an iron-based molecule called heme. Heme attaches to oxygen and carries it to the cells. That’s why iron is important in our diets. We need iron to make heme to carry oxygen, so our cells can breathe. Glucose (sugar) molecules are also floating along in our blood. Glucose attaches itself to all kinds of proteins, including the hemoglobin in red blood cells (RBCs). When glucose levels are high, many more of them will attach. Hemoglobin coated with glucose is called “glycated” or “glycosylated” hemoglobin. Glycation (“sugar-coating”) may not harm an RBC, but it does tell us if the cell has encountered much glucose during its lifetime. The more glucose has been in the blood, the more RBCs will be glycated. This is what an HbA1c test measures. A1C isn’t measuring what your blood glucose level is at the moment. It measures how high glucose has been over the last two months or so. RBCs only live about 100–120 days in the bloodstream. Once they become glycated, they stay glycated for life, so the number of glycated RBCs (HbA1c) gives a good picture of how much glucose has been in the blood recently. The A1C test has several advantages over other tests such as a fasting blood sugar (FBS). You don’t have to fast for an A1C. It can be taken at any time of day. It doesn’t matter what you ate the day before or on the day of the test, because it’s not measuring your current sugar. Normally, between 4.2% and 5.6% of RBCs will be glycated. The America Continue reading >>
What Is The A1c Test? How Does A1c Relate To Blood Glucose?
Anyone with diabetes will be familiar with finger-prick testing for monitoring blood glucose to see how well they are managing their disease. This kind of regular testing is essential for most people with diabetes, but what role does an occasional hemoglobin A1C blood test play in controlling blood sugars, and how does it work? Contents of this article: What is the A1C test? The abbreviation A1C is used in the US (sometimes with a lower-case 'c' - A1c) and is short for glycated hemoglobin (sometimes called 'glycosylated' hemoglobin or glycohemoglobin). The other abbreviations in use are: HbA1c (widely used internationally) HbA1c Hb1c HgbA1C. The A1C test is a blood test used to measure the average level of glucose in the blood over the last two to three months. This test is used to check how well blood sugar levels are being controlled in a person with diabetes and can also be used in the diagnosis of diabetes.1 Hemoglobin is the protein in red blood cells which is responsible for transporting oxygen around the body. When blood glucose levels are elevated, some of the glucose binds to hemoglobin and, as red blood cells typically have a lifespan of 120 days, A1C (glycated hemoglobin) is a useful test because it offers an indication of longer term blood glucose levels.2 The particular type of hemoglobin that glucose attaches to is hemoglobin A, and the combined result is call glycated hemoglobin. As blood glucose levels rise, more glycated hemoglobin forms, and it persists for the lifespan of red blood cells, about four months.2 Therefore, the A1C level directly correlates to the average blood glucose level over the previous 8-12 weeks; A1C is a reliable test that has been refined and standardized using clinical trial data.3 There are two key things to know about the appl Continue reading >>
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5 Ways To Lower Your A1c
For some, home blood sugar testing can be an important and useful tool for managing your blood sugar on a day-to-day basis. Still, it only provides a snapshot of what’s happening in the moment, not long-term information, says Gregory Dodell, MD, assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai Health System in New York City. For this reason, your doctor may occasionally administer a blood test that measures your average blood sugar level over the past two to three months. Called the A1C test, or the hemoglobin A1C test, this provides a more accurate picture of how well your type 2 diabetes management plan is working. Taking the A1C Test If your diabetes is well controlled and your blood sugar levels have remained stable, the American Diabetes Association recommends that you have the A1C test two times each year. This simple blood draw can be done in your doctor's office. Some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes. The A1C test results provide insight into how your treatment plan is working, and how it might be modified to better control the condition. Your doctor may want to run the test as often as every three months if your A1C is not within your target range. What the A1C Results Mean The A1C test measures the glucose (blood sugar) in your blood by assessing the amount of what’s called glycated hemoglobin. “Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin, or glycates. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin,” Dr. Dodell says. An A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 perce Continue reading >>