A1c Level And Future Risk Of Diabetes: A Systematic Review
Go to: RESEARCH DESIGN AND METHODS Data sources We developed a systematic review protocol using the Cochrane Collaboration's methods (9). We formulated search strategies using an iterative process that involved medical subject headings and key search terms including hemoglobin A, glycated, predictive value of tests, prospective studies, and related terms (available from the authors on request). We searched the following databases between database establishment and August 2009: MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science (WOS), and The Cochrane Library. Systematic searches were performed for relevant reviews of A1C as a predictor of incident diabetes. Reference lists of all the included studies and relevant reviews were examined for additional citations. We attempted to contact authors of original studies if their data were unclear or missing. Study selection and data abstraction We searched for published, English language, prospective cohort studies that used A1C to predict the progression to diabetes among those aged ≥18 years. We included studies with any design that measured A1C—whether using a cutoff point or categories—and incident diabetes. Titles and abstracts were screened for studies that potentially met inclusion criteria, and relevant full text articles were retrieved. X.Z. and W.T. reviewed each article for inclusion and abstracted, reviewed, and verified the data using a standardized abstraction template. If A1C measurement was standardized by the National Glycohemoglobin Standardization Program (NGSP) and both standardized and unstandardized A1C values were reported, standardized values were used in the analyses. A sensitivity analysis, however, was conducted using both standardized and unsta 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 >>
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 >>
My Son’s A1c Was 6.1, But The Doctor Said He Had Highs And Lows And That Wasn’t Good. Isn’t A1c The Important Thing?
Q: My son is type 1 and 23 years old. His A1c was 6.1, but the doctor said he had highs and lows and that wasn't good. I thought your A1c was important? You are right in thinking that your son’s A1c is important, but it is not the whole story. A good way to think of an A1c reading is a three-month average of blood sugar levels. If your average blood sugar level is 120-130mg/dl (which is what an A1c of 6.1 usually represents), that's a good thing. However, if your blood sugar fluctuates from 40mg/dL (which is dangerously low) to 500mg/dL (which is dangerously high) and those extreme highs and lows average out to a blood sugar level of 125mg/dl, that's not a good thing. Basically, big swings in blood sugar levels means that they are not well controlled. The good thing is that your son is checking his blood sugar levels, and that can be helpful in developing a plan to get your son's blood sugar under control. One other thing your son may want to consider is to have his doctor or another member of his diabetes care team evaluate his blood sugar monitoring technique to make sure the fluctuations are not due to a problem with the testing procedure. Or if your son uses a continuous blood glucose monitor (CGM), he may want to check with his trainer (or whoever helps him manage his CGM) to make sure there is no problem with it. Originally answered by Kirk Spero, RPh Answered By dLife Expert: Franziska Spritzler, RD, CDE Certified diabetes educator and registered dietitian living in Southern California. The content of this website, such as text, graphics, images, and other material on the site (collectively, “Content”) are for informational purposes only. The Content is not intended to be a substitute for, and dLife does not provide, professional medical advice, diagnosis o Continue reading >>
Patient Comments: Hemoglobin A1c Test - High Results
I have been doing a lot of research on CIN1. I was 26 when my doctor told me I have cervical dysplasia (CIN1), January of 20017. I didn't think anything of it. But then she told me I have HPV high risk E6/E7 mRNA. One day I was looking through my medical records online and discovered I had CIN1 3 years ago July of 2014 and my doctor never told me. Now I am stressing over it because my periods are irregular and when I do have them they are strange. Also the year of 2014 I told my doctor I was having clots the size of 2 half dollars put together and she didn't say anything either. I get pelvic pain sometimes. She did a biopsy and I was positive for CIN1 and high risk HPV and ascus. I don't know what I should do, maybe I should get a new doctor. In May 2015 I was really tired, lethargic and bloated all the time. I was so constipated and miserable. I had been gluten free for 4 years by self-diagnosis. Finally, I went to a gastroenterologist. My blood work came back positive for Helicobacter pylori. The doctor said that H. pylori causes similar symptoms as gluten allergies. I had an endoscopy and colonoscopy which showed all of the internal inflammation and prior damage from the bacteria. It seemed to be dormant so there was no need for eradication, however the prescription acid reflux pills made me sick so I stopped that. Now I take probiotics and manuka honey and feel great. Try to avoid the prescription drugs. I have to go back for a check up to see if the bacteria is gone. I just had a laparoscopy 2 days ago and other than feeling full and bloated from the gas and a soreness around the incisions, I feel pretty good. The day of the surgery when I came home, I was very sleepy and slept for almost 2 days with getting up, except here and there to use the bathroom and eat. My 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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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 And Metformin
Good morning. When I had lab work done mid last year my A1c was 6.9, then I went on a diet and 3 months later it was 7.3. Doctor said it wasn't my fault and wrote me out a prescription for metformin. Well I never took the metformin. Instead I stayed on my diet and got a home A1c test. It went to 6.4 and about a month ago it went to 6.2. I am scheduled for lab work finally this coming week. My question is: Since my A1c has gone down to 6.2 or maybe down further - do you think I need to be on Metformin at this time. I have been really watching my food intake for the last 9 months. I do have an appointment with my family doctor next week (first appt this year) but I really feel you know more than my doctor does regarding diabetes! Your input would be very much appreciated. Thanks, Julie D.D. Family Getting much harder to control I guess my question would be is how is the weight loss. Do you need to lose any, metformin helps both weight loss and controlling bgl. I know folks do not want meds and hey I was there 30 yrs ago, we do what we have to do. It would seem the numbers are good so its up to what you need it to do. Julie that's a decision you have to make entirely for yourself. My A1C in June 2013 (at diagnosis) was 10.5 and I was immediately put on 2000 mg of Metformin ER. In early October I had my follow-up A1C and it was at 6.1 and I had lost over 30 pounds (20 to go). The Metformin was a choice and I chose to stay on it. Metformin has many benefits and since I tolerate it well I choose to stay on it and will for some time to come. My goal at diagnosis was to be drug-free but my outlook has changed. Others here feel the absolute, complete opposite of me and they're doing great. It's entirely a personal choice and one that you can change at any time. My HbA 1 c wrnt Continue reading >>
Print The American Diabetes Association (ADA) recommends that blood glucose screening for adults begin at age 45, or sooner if you are overweight and have additional risk factors for prediabetes or type 2 diabetes. There are several blood tests for prediabetes. Glycated hemoglobin (A1C) test This test indicates your average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. In general: An A1C level below 5.7 percent is considered normal An A1C level between 5.7 and 6.4 percent is considered prediabetes An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (hemoglobin variant). Fasting blood sugar test A blood sample is taken after you fast for at least eight hours or overnight. In general: A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes. Oral glucose tolerance test This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours. In general: A blood sugar level less than 140 mg/dL (7.8 mmo Continue reading >>
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 >>
Diabetes Discussion Boards - Joslin Diabetes Center
I am a 36 year old overweight female. About 2 years ago I went through IVF fertility treatments to have my child. During the 7th month of my pregnancy I developed Gestational Diabetes that was treated with insulin. After my pregnancy things seemed to resolve. I continued to test on my own every now and then with my meter that I had from the Gestational Diabetes and the numbers were a little high but not over 200. As part of my fertility medications the first time around I was on low dose metformin (500-1000mg). I stayed on the metformin till about the 4th month of pregnancy. I am getting ready to go through IVF again now. In preparation I have started my hormones again and the fertility doctor put me back on 1-2 metformin a day. I have been taking 1 pill a day for about 1 month (I haven't taken 2 pills because they have been causing me diareaha). And, I am not great about taking the metformin every day. I recently had some blood work done at the fertility clinic in prep for IVF this summer. They did an A1c test. The doctor called me tonight to say the A1C was 6.1% and the IVF clinic wants it at 6.0% or lower before doing the IVF. He asked me who I see to manage my diabetes. I told him that I have never been diagnosed with diabetes. I had gestational diabetes but it seemed to have gone away. He seemed surprised and asked me who prescribed the Metformin? I told him he did and he seemed to have forgotten about that. He told me to call my PCP or an endocrinologist and bring them into the loop on the A1C #. He also said that since I had about 3-4 months before the IVF that he thought diet, exercise, upping the metformin does and losing some weight would bring the A1C number down to 6.0% or lower before the IVF. But he again indicated that I need to call my doctor since the Continue reading >>
Is My Husband's A1c Too Low?
My husband has type 2 diabetes, and for years his endocrinologist urged him to keep his A1C under 7 percent. A few months ago we went on a low-carb diet, and my husband lost over 30 pounds. The doctor took him off a sulfonylurea, cut his metformin dose in half, and removed two blood pressure meds.When my husbands A1C test came back at 6.1 percent, I thought his doctor would be thrilled. But he said 6.1 was too low. Why? Faith Goldman, Ladera Ranch, California Although I dont know all the details, I wouldnt necessarily say that your husbands A1C is too low. The American Diabetes Association (ADA) recommends that many adults with diabetes strive to keep A1C less than 7percent, but the goal can differ from person to person. Even tighter goals, such as less than 6.5percent, might be reasonable for people with relatively recently diagnosed diabetes and many years to live. A bit looser goal (such as less than 8percent) may be fine for those with advanced diabetes complications , other chronic illnesses, or shorter life expectancies. In all cases, hypoglycemia (low blood glucose, under 70mg/dl) should be avoided as much as possible. The ADA recommendations do not specify a low end of the target range for A1C, because it matters how people get to lower A1Cs. People without prediabetes or diabetes have A1Cs in the mid-5percent range or below. Many people with type2 diabetes can lower their A1C with healthy changes in their diet and exercise, or with bariatric surgery. It would be hard to say that these A1Cs are too low. When is someones A1C too low? It can be if its low due to frequent episodes of hypoglycemia, or if its lower than it needs to be to provide benefit but causing a lot of treatment burden (the expense of multiple medications, for example). It doesnt sound as if th Continue reading >>
What Is A Good Score On The A1c Diabetes Test?
Normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time can have an A1C level above 9 percent. A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate dates indicates diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which is high risk of developing diabetes. For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan. Remember, the higher your A1C level, the higher your risk of diabetes complications. A good score on the A1C test depends on whether you’ve been diagnosed with diabetes. For those who do not have diabetes, a score of less than 5.7% is considered normal, while 5.7% to 6.4% indicates prediabetes and 6.5% or higher means you have diabetes. If you already have diabetes, a score of 7% or lower is desired. You and your doctor can decide what score is best for you. The A1C diabetes test is a way to get an average of how well your blood sugar has been controlled for the past three months. The standard A1C goal for most people with diabetes is less than 7%. However, the goal may be individualized or may be different for some people, especially older adults, people with heart disease or those who are prone to frequent low blood glucose. It's a good idea to find out what your A1C goal should be from your healthcare provider and then use that as a benchmark for your A1C results. No one quite agrees on where your A1C score should be, but we all agree on where it shouldn’t be. The scale does not look anything like the BGL numbers you are used Continue reading >>
Diagnosed As Prediabetic Because My Hemoglobin A1c Is 6.1?
Diagnosed as prediabetic because my hemoglobin A1C is 6.1? Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Diagnosed as prediabetic because my hemoglobin A1C is 6.1? I feel a little guilty being on here because I am not diabetic...but I went to the Dr. a couple of days ago and while going over my old charts she said...and you are prediabetic. I said what do you mean? I had actually went to her to be tested because my mom thought I had "symptoms". The Dr. said well you are not diabetic, and I do not want to alert the insurance...your sugar is fine, your just prediabetic. So we did all the routine yearly check up blood work. Today the nurse called me back, gave me my results...and said my hemoglobin A1C is 6.1 and again....I have pre-diabetes. she said my blood sugar is fine, but I need to cut back on my carbs. I am just wondering what exactly this means, and if that is all I need to do. I am 40, 5.8, 165 pounds. Thanks for reading my post! Hi Everyone!my hemoglobin A1C is 6.1 and again....I have pre-diabetes 1. Most doctor and ADA consider a normal person has a1c of 4 to 6. Then 6.1 to 6.5 as pre-diabetes and anything above as diabetes. 2. The number is just a guidance for the doctor. It is not a perfect scale. 3. Since your a1c is 6.1 twice. You already have the condition "diabetes". No sugar coated. You are just at an early stage. Pre-Diabetes is just a label. This label does not even exist years ago. So do not let it fool you. By that I mean if you do not start watching what you eat, increase your exercise regimen, your condition will continue to progress. Catching it at this early stage can stop the progression or at the very least slow Continue reading >>
Endo Visit Report (6.1 A1c)
Endo is largely impressed with my tight blood sugar control this past month. She's fine with the 60g of carbs (total 40g net) I am eating per day as well, along with the 70% fat in the diet. A1C was 6.1, the best A1C I've had in the past 5 years. Averaged 99 mg/dL on meter for the past month. I imagine in 3 months from now, when I get my A1C tested again, if I keep up the good work, I might be close to A1C of 5? That'd rock. (My blood sugar before a month ago wasn't that good, so that's why my A1C was higher this time at 6.1.. but again still my best overall.) Endo gave me a free sample of U-200 3ml Humalog Kwikpen, but didn't get any needles with it. Do I need a script for the needles? She also gave me a Novolog U-100 3ml pen as sample with 7 "disposable" needles. Do I really need to dispose of them after a single use? Because in reality 3ml of U-100 will be about 30 injections for me. Can I use those disposables like 5 times if I am very careful with the needle, not contaminating it? I know nothing about pens.. have always used vials and syringes until now. I've been the 5% club for 10 years and it is still a lot of work. I just do the best I can and that is the most important to me. Yes you need a script for needles, just call your doc and tell him what you need. I would imagine you will get a mixed bag of answers regarding the use of needles. I can only tell you how I use mine and that is twice. I won't advice you one way or the other, feel it is a personal choice. The pens are convenient and easy to use. You may need to adjust with changing types of insulin that you have been using. I just realized that Humalog and Novalog are both fast acting. Were you advised to use both? D.D. Family Getting much harder to control I think you can get them without, its been so lo Continue reading >>