Passing The A1c “test”…what Do I Need To Score?
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 to. For all practical purposes, it runs from 5.0 up to 14.0 where most in-house A1C machines max out. Labs can test higher, but at 14.0 your doctor will run screaming for the hills anyway, so it really doesn’t matter. At that level your blood sugar is lethal and your body is slowly dissolving, just as if you had battery acid in your veins and arteries. As a side note, many offices have in-house A1C machines that give results in six minutes. Very handy. I personally love being able to discuss the score with the patient during the visit. Other offices do a “send out.” We generally do them in-house, but if we are also running other lab tests we’ll sometimes piggyback the test onto the blood draw. Both are highly accurate and reliable. So back to your score. Scores below 6.0 are usually considered to be in the non-diabetic range. At 9.0 we cross the threshold where kidney damage starts. So we can all agree that above 9.0 you are in deep shit and the higher above 9.0 that the number is, the worse off you are because A1C tests are curvilinear. Just like Category 3 hurricanes are much worse than Category 2 storms, or like 7.3 earthquakes are much worse than 7.0s, each increase in your A1C number packs a larger punch than you’d expect. The numbers are sufficiently confusing that the ADA has introduced a new measure called eAG, for estimated average glucose. This is a formula that “translates” an A1C score into a “meter number.” It hasn’t been widely adopted yet and the jury is still out on how useful eAG is. I use it for some patients, but not for others, but I always like to have a lot of tool Continue reading >>
5 Simple Ways To Lower Your A1c This Week
The A1C blood test is a simple test that analyzes your glucose (blood sugar) levels by measuring the amount of glycated hemoglobin in your blood. Hemoglobin is a protein in your red blood cells; when glucose enters the blood, it attaches to the hemoglobin. The result is glycated hemoglobin. The more glucose in your blood, the higher your glycated hemoglobin. The A1C is a valuable indicator of how well your diabetes management plan is working. While your individual A1C goal will depend on factors including your age and your personal medical profile, most people with diabetes aim to keep their A1C below 7 percent. By keeping your A1C number within your target range, you can reduce the risk of diabetes complications. While it is important to develop a long-term diabetes management plan with your physician, there are several steps you can take right away to help reduce your A1C. Small changes add up, so consider trying some of these strategies to lower your A1C this week. 1. Try Short Sessions of High Intensity Exercise According to research presented at the American Heart Association's Scientific Sessions 2015, type 2 diabetes patients who did 10 minutes of exercise three times a day, five days a week at 85 percent of their target heart rate had a twofold improvement in A1C levels compared to patients who exercised for 30 minutes a day at 65 percent of their target heart rate. Be sure to check with your doctor before trying high intensity exercise, and wear a heart rate monitor so you don’t overdo it. 2. Shrink Your Dinner Plate Instead of a large dinner plate for your meals, use a smaller salad plate. This simple swap can trick your eyes and brain into thinking you’re eating more than you really are, and you’ll feel satisfied with less food. It’s especially helpfu 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 >>
My A1c Is At An All-time High - 7.6
I'm new to this forum and am glad to have found it, as I've got so many questions and am scared about what will happen to me. I'm very overweight - have been for most of my life (just turned 50). I was diagnosed with pre-diabetes, then diabetes, about 7 years ago. My A1C has always been 6.something, but today I found that with my most recent test, it went up to 7.6, meaning my fasting blood sugar was about 171. I have numerous health problems besides being overweight, and they include an underactive thyroid, arthritis, asthma, fluid retention (bp is ok though), depression, anxiety, and a history of multiple abdominal surgeries. I had a hysterectomy in '04 because of a borderline ovarian cancer (thank God that it was caught early, and no chemo or radiation was needed). I had my gallbladder out in '05, and two emergency hernia surgeries - one in '09 and the other last year. I went to the hospital about 3 weeks ago and was diagnosed with my third hernia. I remember having a late breakfast that day, and when I was in the ER early that evening, they did a number of blood tests, with my blood sugar being one of them. It was 131. How long I've been fasting that day I can't remember, but I don't think it was 12 hours. I didn't feel like eating lunch or dinner. I've been through alot of stress lately....and along with that I've been stress eating and not getting the proper amount of exercise. Just having found out that I have another hernia didn't help any. This latest A1C was done just last week. This is going to sound stupid, but I'm scared to eat. I don't want to mess this up any more. I'm scared that my doctor will want me to go on insulin. I never had to before. Up to this point I was able to manage this with diet and exercise, and for awhile my weight was going down. My A Continue reading >>
Why Do We Need An Artificial Pancreas?
ADA Glycemic Guidelines Targets Age A1c % ** < 6yrs 7.5-8.5 6-12 yrs <8 13-18 yrs <7.5 adult <7 ** Goals should be individualized, a lower A1C goal is reasonable based on benefit:risk assessment and if it can be achieved without excessive hypoglycemia Silverstein, et al. Care of Children with type 1 DM. Diabetes Care, 28:186-212, 2005 ADA Standards of Care. Diabetes Care, Suppl 1, 2010 Initially developed in 2002- 2004 Rational based on DCCT results attempting to balance the risk for long term microvascular complications with the immediate risk of hypoglycemia and the concern for the effect of setting goals that at least 50% of families/adolescents could not meet with then current technology Continue reading >>
After Nearly Ten Years Of A Rising A1c (8.2 Last Count). 3 Months Of Low Carb And It's Finally Taken A Positive Turn! : Diabetes
Thanks! Yeah it's been a big set of changes . I used to eat a lot of Larabars which would be like 27g. But changes are working. And don't need snacks now because of the nature of the food I'm having at meals... not hungry til the next one. So that makes it easier keeping carb count down. Also avoids insulin stacking by having 5+ hours between meals.. making dosages/ management easier Breakfast is now usually a cheesy almond meal pancake with a bit of ham, turkey or bacon on top. OR if it's a special day, smoked salmon and few slices of avocado. OR I'll have a cheesey omelette with some mushrooms/but of spinach. Trying to keep carbs even lower at breakfast because I have a pretty strong dawn phenomenon. Still working out te best dose for that too. Tried going without breakfast for a bit but that didn't really work. I also have a coffee with 2 tbsp full fat cream. Lunch: I'm not always that hungry because of breakfast, or I'm busy, but sometimes will have a salad. My current favourite is shredded chicken breast salad with blue cheese mayo (just some blue cheese and mayo with some salt and pepper blended....). OR if I'm feeling like a break from meat, tofu. Just with a cup or two of mixed greens or iceberg lettuce and mix all together . Chuck a few walnuts in and count the carbs from these. Or I'll go for a more Mediterranean salad with a few olives, cucumber - olive oil/apple cider vinegar dressing... dressings need to be homemade (which is quick and easy) as is usually source of extra carbs when eating out or buying premade... mayo seems to be a safe option when eating out. Playing around with a few different salad options. Dinner: one of chicken/pork/fish/other seafood (120-150g) and a couple of serves of low carb cooked vegetables (usually one of broccoli/ brussel spr Continue reading >>
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 >>
One Drop Demonstrates Dramatic Improvements In A1c Among People With Diabetes Using The One Drop | Mobile Platform
One Drop demonstrates dramatic improvements in A1c among people with diabetes using the One Drop | Mobile platform Company presents evidence of substantial reduction in A1c among people with diabetes using the One Drop | Mobile platform at the 38th Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine. March 31, 2017 New York One Drop today announced findings from a retrospective study demonstrating that One Drop | Mobile app users report a substantial improvement in glycemic control, reducing A1c by 1.0 percentage point after only 2 to 12 months of using One Drop | Mobile. Data was presented yesterday at the 38th Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine in San Diego. One Drop analyzed data from One Drop | Mobile app users who self-identified as having either type 1 or type 2 diabetes and had entered two hemoglobin A1c (A1c) values at least 60 days, but no more than one year, apart. The initial analysis in July 2016 showed a 0.7 percentage point reduction (7.8% to 7.1%) in A1c among the app users. In March 2017, One Drop repeated the analysis on a much larger sample, finding a 1.0 percentage point reduction (8.2% to 7.2%) in A1c among users of the app. The more people tracked blood glucose and food in the One Drop | Mobile app, the more their A1c improved. The .30 percentage difference between results from July and March is likely due to a much larger number of users and continued improvements to the One Drop | Mobile app. People want to know if health apps work. Doctors, payers, and other healthcare entities ask this all the time, said Dr. Chandra Y. Osborn, Vice President of Health and Bioinformatics at One Drop. One Drop is continuously evaluating its impact and were sharing that value. These results suggest a c 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 >>
What Is Xultophy® 100/3.6 (insulin Degludec And Liraglutide Injection) 100 Units/ml And 3.6 Mg/ml?
What is the most important information I should know about Xultophy® 100/3.6? Xultophy® 100/3.6 may cause serious side effects, including: Possible thyroid tumors, including cancer. Tell your health care provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. In studies with rats and mice, liraglutide, one of the components of Xultophy® 100/3.6, and medicines that work like liraglutide caused thyroid tumors, including thyroid cancer. It is not known if Xultophy® 100/3.6 will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people. Who should not use Xultophy® 100/3.6? Do not use Xultophy® 100/3.6 if: you or any of your family have ever had MTC or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). you are allergic to insulin degludec, liraglutide, or any of the ingredients in Xultophy® 100/3.6. you are having an episode of low blood sugar. Xultophy® 100/3.6 is an injectable prescription medicine that contains 2 diabetes medicines, insulin degludec, 100 units/mL, and liraglutide, 3.6 mg/mL. Xultophy® 100/3.6 should be used along with diet and exercise to lower blood sugar (glucose) in adults with type 2 diabetes mellitus when blood sugar levels are not well controlled on: 1) basal insulin (less than 50 units daily) or 2) liraglutide (less than or equal to 1.8 mg daily). Xultophy® 100/3.6 is not recommended as the first choice of medicine for treating diabetes. It is not known if Xultophy® 100/3.6 can be used in people who have had pancreatitis. Xultophy® 100/3.6 is not recommended for use in combination with any other product containing liraglutide or another GLP-1 receptor Continue reading >>
Glycemic Response And Attainment Of A1c Goals Following Newly Initiated Insulin Therapy For Type 2 Diabetes
ObjectiveTo identify the characteristics associated with glycemic response to newly initiated insulin therapy. Research Design and MethodsWe identified 1,139 type 2 diabetic patients who initiated insulin therapy between 1 January 2009 and 30 June 2010. Outcomes of interest were the proportion of patients achieving A1C <7% and mean change in A1C within 39 months. ResultsMean A1C at insulin initiation was 8.2 vs. 9.2% among those who did and did not attain A1C <7% (P < 0.001). Within a mean of 5 months, 464 (40.7%) patients attained A1C <7%. In multivariable analyses controlling for insulin regimen, dose, and oral agent use, preinsulin A1C was responsible for nearly all the explained variance in A1C change. Each one percentage point of preinsulin A1C reduced the probability of attaining <7% by 26% (odds ratio 0.74 [95% CI 0.680.80]). ConclusionsInsulin initiation at lower levels of A1C improves goal attainment and independently increases glycemic response. Most type 2 diabetic patients require ongoing therapy intensification that eventually includes exogenous insulin administration.[ 1 ] Despite the theoretical ability of insulin to correct any amount of hyperglycemia, in clinical practice only 3037% of insulin patients achieved A1C <7% in any given quarter over 7 years of observation.[ 2 ] Our objective was to examine the characteristics associated with better glycemic response to insulin and achievement of A1C targets. Continue reading >>
An A1c Of 8.7 Is Of Concern
I recently saw the following question: My hemoglobin A1c is 8.7 and serum glucose is 126; my doctor said it’s not serious. No medications were prescribed and he will test it again in 6 months. Should I be concerned? My reply: Yes, you should be concerned. An A1C over 7.0 indicates you have diabetes, and a value of 8.7 means the diabetes has been out of control during the past few months. The glucose value is right on the edge between prediabetes and diabetes, but in this case, it is not as meaningful as the A1C, as the BG may fluctuate widely when diabetes is present. It’s unclear whether you are younger and skinny, or older and overweight. If younger and skinny, you probably have type 1 diabetes (AKA T1D or T1DM); if older and overweight, probably type 2 diabetes (AKA T2D or T2DM). It’s also unclear from your question whether you have symptoms of diabetes, such as excessive thirst and excessive urination (especially at night, which is called nocturia). Fatigue, change in vision, increased likelihood of infection, wounds that won’t heal, irritability, and numb sensation in hands and feet are also on the list of diabetes symptoms. And sometimes there’s uncontrolled hunger and paradoxical loss of weight; these are more common with type 1 diabetes. If you do have any of these symptoms, it was completely inappropriate to sit tight and retest in six months. Whether you reported symptoms or not, you should have been advised to change your meal plan, and test your own blood glucose. And to see a diabetes nurse educator and perhaps a dietitian to help with these changes. If these folks are Certified Diabetes Educators, it would be even better. Is there a chance that the A1C value was due to something else rather than diabetes? Not really. Sometimes it might be worth r Continue reading >>
How Will Insulin Help Lower A1c?
Q: My doctor wants to put me on insulin. I have type 2 diabetes; my A1C was 8.2. I don't want to take shots. How will insulin help? A: An A1C of 8-9 percent equates to an average estimated glucose level of 183-212 mg/dl. Long-term glucose levels in this range drastically increase the odds of developing a complication such as kidney failure, vision loss, or damage to blood vessels or nerves that can lead to heart disease, stroke, and neuropathy. As type 2 diabetes progresses, the pancreas makes less and less insulin. Many oral medications can help control your glucose levels early on. But once insulin production declines to a certain point, insulin is necessary. Today's insulin needles are super thin. You may find injections hurt less than blood glucose testing: The place you inject (abdomen, preferably) has far fewer nerve endings than the fingertip. Keep an open mind about insulin as your diabetes therapy. Set up a one-on-one session with a diabetes educator who can coach you through that first injection and teach you how to best time your doses. Virginia Zamudio Lange is an R.N., M.S.N, and CDE. Continue reading >>
What Do Your A1c Test Results Really Mean?
The hemoglobin A1c test, as we all know, is supposed to give a sense of your average blood glucose levels over the past three months. But here’s a question for you: have you ever tried to figure out what those average blood glucose levels actually are? Say you have an A1c of 6.5% — what, in mg/dl, does that translate to? Try searching Google — it’s hard to find an answer. To quote from a post I wrote a few years ago (see entry from 4:45), that’s partially because: “Not only is there no one standardized definition as to the correlation between A1c and mean glucose levels (JDRF says 1% = 24.4 mg/dl, ADA says 28.7), but different people have different correlations. For example, if you are a ‘high glycolator’ (more glucose sticks to your hemoglobin than the average) you can have a relatively high A1c but a low mean glucose. The speaker gave the example of a patient who had a 8.2% A1c, but a mean glucose of 159 mg/dl (he was speaking using the generally accepted idea that 7% roughly equals a mean of 154 mg/dl). Treat him more aggressively, and you’ll end up with hypos. And if you’re a ‘hypoglycolator,’ it’s the opposite.” Well, just this week, a new paper was published in the American Diabetes Association’s Diabetes Care journal that provides a more solid answer to this question than I’ve seen — even though, as I must warn you, personal variability (as described above) means there’s still no precise answer. In the study, researchers wanted to find out what your average blood sugar would have to be in three situations — fasting, after meals and before bed — in order to achieve a particular A1c. Here are their results: A1c test results of 5.5-6.49% were associated with an average fasting blood glucose level of 122 mg/dl. A1c test results Continue reading >>
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 >>