diabetestalk.net

A1c 8.4

What Is A Good Score On The A1c Diabetes Test?

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 >>

Boston, Usa

Boston, Usa

8/7/2015 1 ADA Type 1 Diabetes Guidelines Pediatric and Adult Patients with T1D: Glycemic Targets and more Lori Laffel MD MPH Chief, Pediatric, Adolescent & Young Adult Section Senior Investigator, Genetics and Epidemiology Section Professor of Pediatrics Boston, USA AADE New Orleans, LA Disclosures Consultant • Johnson & Johnson, Eli Lilly, Sanofi-Aventis, NovoNordisk, Bristol Myers Squibb, Menarini, Bayer Healthcare (grant support), LifeScan/Animas, Roche Diagnostics, Oshadi, Dexcom, Boehringer Ingelheim Content of lecture unrelated to above 2014 CDC June Report • Prevalence estimates of T1D in youth 0-19 and T2D in youth 10-19 in 2001 and 2009 in 5 representative US areas in the SEARCH Study • T1D prevalence: 1.48/1000 in 2001 (1/676) 1.93/1000 in 2009 (1/518) • T2D prevalence: 0.34/1000 in 2001 (1/2941) 0.46/1000 in 2009 (1/2174) • T1D increased 21.1% (95% CI, 15.6-27.0%)* • T2D increased 30.5% (95% CI, 17.3-45.1%)* * After adjustment for case ascertainment T1D in Adults • No precise estimates of T1D in adults >20 y/o • Greatest number of patients with T1D are adults: – Increasing numbers of patients diagnosed with T1D at all ages – Patients w/ childhood onset T1D survive to adulthood • Estimated that 50-75% of T1D diagnosed in childhood (25-50% diagnosed in adulthood) • LADA: latent autoimmune diabetes in adults – ~9% of adults with diabetes ages 30-70 have +GAD ab – Prolonged period of residual beta cell function (T1DX) – Additional peak age of onset of T1D in 6th to 7th decades of life • Diabetes Care. 2015 Mar;38(3):476-81. Diabetes Care. 2015 Mar;38(3):476-81. Residual C-peptide present in 1/3 persons with T1D of 3+ years duration 8/7/2015 2 • Glycemic tar Continue reading >>

When To Check Blood Sugar

When To Check Blood Sugar

“I don’t get this diabetes thing,” Zach, a 50-year-old friend with Type 2, told me. “I check my sugars twice a day, and they’re always below 110. But my A1C is 8.4%. My doctor says that’s way too high. What’s going on?” Zach’s problem is easy to explain. He’s testing at the wrong time. Every day he checks on waking and before dinner, when he hasn’t eaten for four hours or so. His numbers are always good because he doesn’t have a problem with fasting sugars. If he checked after eating, he would find out where his high A1C level comes from. He probably runs high numbers for several hours after meals. Those highs are probably doing a lot of damage to Zach’s blood vessels. Zach is hardly alone. Many people check (or “self-monitor”) at the same times every day. They’re not trying to learn anything new, just keeping a record for their doctor. This mindless testing is a waste of time, as I wrote about here. So when should you check? Some things to consider: • The best times to check blood sugar may depend on your medications. If you’re on insulin or an oral drug that stimulates insulin such as a sulfonylurea or meglitinide (or a combination drug containing one of these medicines), you have to worry about both highs and lows. You have to check more often. If you’re not on those drugs, you’re mainly interested in what causes high blood sugar levels and how to prevent them. • You should check to answer questions for yourself. What foods raise your sugar (and by how much), and which ones don’t? How does your body respond to exercise? What time is best to take your evening metformin to get a good fasting level? How much does bitter melon lower your sugar? • Diabetes expert Wil Dubois wrote here that no single blood sugar value tells you Continue reading >>

Study Reveals Poor Disease Control Among Adolescents And Young Adults With Type 1 Diabetes

Study Reveals Poor Disease Control Among Adolescents And Young Adults With Type 1 Diabetes

T1D Exchange Clinic Registry data find a stagnant situation as little has changed in 25 years; underscores need for new technologies to help teens manage their disease BOSTON, May 22, 2015 – In a sweeping analysis assessing the current state of diabetes treatment in the U.S., T1D Exchange researchers conclude that there remains considerable room for improving treatment outcomes in type 1 diabetes across all age groups, but especially for adolescents and young adults. The analysis provides the most up-to-date picture of diabetes treatment, underscoring the need to address barriers to care and implement new therapies and technologies that can help type 1 patients achieve optimal metabolic control. The findings, published today in a special issue of Diabetes Care, come from data collected by the T1D Exchange Clinic Registry. Researchers from the Exchange evaluated data from more than 16,000 patients ages two to 95. Data were collected twice: between September 2010 to August 2012 and again, from September 2013 to December 2014. A key area of study was glycemic control across the age spectrum, determined by examining Hemoglobin A1c (HbA1c) levels, a standard test of average blood sugar levels over two to three months. According to the American Diabetes Association, the recommended target A1c level is less than 7 percent for adults with type 1 diabetes and less than 7.5 percent for youth under the age of 19. Researchers found that while 8.4 percent remains the average A1c level across the Registry, A1c levels are notably worse among 13 to 25-year olds. In fact, A1c levels for 13 to 17-year olds have barely changed since the initial Diabetes Control and Complications Trial (DCCT) results published in 1992. Specifically: Adolescents in the Registry averaged a 9.0 percent A1c Continue reading >>

Translating A1c To A Blood Sugar Level

Translating A1c To A Blood Sugar Level

In the USA, doctors recommend that you have your Hemoglobin A1c measured at least twice per year. This simple blood test will tell you an approximation of your blood sugar control for the past 3 months based on the amount of Advanced Glycogenated End-Products (AGEs) that have accumulated in your blood. The higher your blood sugar levels are, the more AGEs are present. AGEs are also responsible for the development of complications such as retinopathy and neuropathy, because that accumulation will build and irritate crucial nerve-endings. Now, let’s get back to your A1C: To help people with diabetes understanding their A1C in real day-to-day terms, the medical world has developed the “eAG” measurement. Estimated Average Glucose. Your eAG will give your A1C reading in a blood sugar level of milligrams per deciliter (mg/dL) just like you’re used to seeing on your glucose meter. The American Diabetes Association has this easy calculator, allowing you to enter and translate your latest A1C to your eAG. 12% = 298 mg/dL (240 – 347) 11% = 269 mg/dL (217 – 314) 10% = 240 mg/dL (193 – 282) 9% = 212 mg/dL (170 –249) 8% = 183 mg/dL (147 – 217) 7% = 154 mg/dL (123 – 185) 6% = 126 mg/dL (100 – 152) What can you do with that information? It is recommended that people with type 1 and type 2 diabetes achieve an A1C of 7.0 percent or lower for optimal health, and the prevention of complications. This translates to an average blood sugar before and between meals around 70 to 130 mg/dL. And after meals, under 180 mg/dL. For pregnancy with diabetes, an A1C lower than 6.5 percent is imperative for the healthy development of your baby, and your own health and safety. Post-meal blood sugars for pregnant women is suggested at lower than 120 mg/dL. A non-diabetic’s A1C is Continue reading >>

Ultimate Guide To The A1c Test: Everything You Need To Know

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 >>

Victoza® Consistently Outperformed Januvia® And Demonstrated Unsurpassed A1c Reductions Vs Trulicity®1-3

Victoza® Consistently Outperformed Januvia® And Demonstrated Unsurpassed A1c Reductions Vs Trulicity®1-3

WARNING: RISK OF THYROID C-CELL TUMORS Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Victoza® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Victoza® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Victoza® and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Victoza®. Victoza® (liraglutide) injection 1.2 mg or 1.8 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, and to reduce the risk of major adverse cardiovascular (CV) events (CV death, non-fatal myocardial infarction, or non-fatal stroke) in adults with type 2 diabetes mellitus and established CV disease. Victoza® is not a substitute for insulin and should not be used in patients with type 1 diabetes mellitus or diabetic ketoacidosis. Concurrent use with prandial insulin has not been studied. WARNING: RISK OF THYROID C-CELL TUMORS Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Victoza® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the hum Continue reading >>

Amazingly Easy Ways To Lower Your A1c

Amazingly Easy Ways To Lower Your A1c

What if there were a magical “lower your A1c” wand? You just pull it out, swoop it over your head (or your pancreas) and… voila! A1c lowered. If only it were that simple. Focusing on eeking down that ever shifting number can be one of the most frustrating things a person living with diabetes has to do. But here is some good news: while there may not be a magic wand, there are some pretty simple, pretty cool fixes to help you on your way to lower your A1c. Kick it old school: Remember those bulky paper logbooks we all used to lug around? Yeah, well there’s something about them that just works. Going back to actually logging blood sugars, meals and doses can really help a person lower an A1c. Why? Because while it’s great to have tools that automatically upload to our medical team (and our computers), writing things down forces us to face them more, study them more and yes, not ignore them. (A cool side trick: use one of those pens with four colors of ink in it. Write all of your in range numbers in green, your high numbers in blue and your low numbers in red. Use the black for notes. With this, you can look at a logbook page and the patterns will jump out at you.) Ramp it up new school: Never used a CGM? Or haven’t used it in a while? CGM’s are a great way to help you lower your A1c, says Regina Shirley, RD, LDN and person with diabetes. “I make a commitment with my CGM. I will wear it religiously until I can get my A1c back to where I like it. It is not as easy as it may seem to remember to check blood sugars, and inserting yet one more device in your body adds on time to your diabetes care regimen that you would rather spend doing something else. However, when you know you need to get in better control, either to help with such things as pregnancy prepa 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 >>

Hemoglobin A1c Level Is 8.4--is This Safe?

Hemoglobin A1c Level Is 8.4--is This Safe?

Diabetes uncontrolle. Hba1c below 6 is safe for dm. Above 6 , it shows inadequately controlled dm and you need to get your pcp/endocrinologist follwing you . From your side you need to see are you strict enough in terms of diet, medications -tablets/insulin , exercixe, regular follow up with blood checks at home and lab checks periodically recommended by your doctor of blood sugar in addition to hba1c once in 2-3 months. Continue reading >>

Euglycemic Diabetic Ketoacidosis: A Potential Complication Of Treatment With Sodiumglucose Cotransporter 2 Inhibition

Euglycemic Diabetic Ketoacidosis: A Potential Complication Of Treatment With Sodiumglucose Cotransporter 2 Inhibition

Table 1 presents nine patients with 13 episodes of euDKA or ketosis in the setting of treatment with SGLT-2 inhibitors. Among these patients, three had repeat episodes of ketosis on rechallenge. None of these patients had any prior episode of DKA other than at the diagnosis of diabetes (and no history of DKA in the patients with type 2 diabetes). No alcohol was ingested before the euDKA occurred except in the two patients where it is noted. In the female patients of childbearing age, pregnancy tests were negative. Narrative of the individual patients is provided below. Case patient #1 was a 40-year-old woman with type 1 diabetes and a BMI of 26.5 kg/m2 treated with a multiple daily insulin regimen (MDI) who was started on canagliflozin. Before initiating canagliflozin, her baseline A1C was 11.4% (101.1 mmol/mol). Two weeks after initiating the drug, the patient reduced her basal insulin dose by ~50% due to improved glycemic control, and the dose was increased to 300 mg/day. Approximately 2 weeks later, she developed a febrile illness with decreased oral intake and presented to an emergency department (ED) with tachypnea and tachycardia. Because of her illness, she had been consuming fewer carbohydrates and using less insulin, although the change in dose was not recorded. When she arrived in the ED, her point-of-care blood glucose value was 220 mg/dL (12.2 mmol/L), serum sodium was 142 mmol/L, and measured serum osmolality was 313 mOsm/kg. Serum ketones were positive. Her arterial blood gas showed a pH of 6.9, Pco2 of 10, and Po2 of 145. She had a normal chest X-ray but was intubated for agitation and respiratory distress. The ED physicians felt that she had an anion-gap acidosis not caused by DKA because of her lack of significant blood glucose elevation. She was treat Continue reading >>

Mini Payments May Help Teens Manage Type 1 Diabetes

Mini Payments May Help Teens Manage Type 1 Diabetes

Mini payments may help teens manage type 1 diabetes (Reuters Health) - Teenagers with type 1 diabetes might take better care of themselves if theyre rewarded, new research suggests. At the end of a three-month pilot study, teens with type 1 diabetes who got 10 cents every time they tested their blood sugar did so more often and had lower blood sugar levels. And their A1C levels, a common measure of longer-term blood sugar control, remained lower for a year after treatment, the study team reports in Diabetes Care. Lead author Nancy Petry noted that 70 percent of U.S. teens with type 1 diabetes do not meet their blood sugar goals. Testing blood sugar more frequently can help, as it helps people balance their insulin doses with their food consumption and exercise, she said. The teen years are when diabetes patients begin to take charge of their own care, often with negative consequences, said Petry, a professor of medicine at the University of Connecticut School of Medicine in Farmington. During adolescence blood sugar testing decreases, and A1Cs begin to rise in the vast majority of patients, Petry told Reuters Health in an email. The study, Petry noted, was inspired by her own experience having a young child with type 1 diabetes. I figured I have about 5-7 more years to develop a way to improve management of this disease in adolescents before she will be taking over many of the responsibilities. At Yale University in New Haven, Connecticut, the researchers recruited 10 adolescents, ages 12 to 19, who were having trouble controlling their condition. During the 12-week study, the teens earned 10 cents each time they tested their blood sugar, up to six times per day. They received additional cash bonuses of 25 or 50 cents a day if they tested at least four times per day, s Continue reading >>

Is A1c The Best Measure Of Glycemic Control?

Is A1c The Best Measure Of Glycemic Control?

Is A1C the Best Measure of Glycemic Control? US Endocrinology, 2005;(1):1-4 DOI: For years, the A1C test has been considered the gold standard for assessing glycemic status in patients with diabetes. Numerous prospective and epidemiologic studies have featured improved glucose control as measured by A1C as a primary end-point. From these studies, researchers have concluded that lowering A1C significantly reduces the risk and progression of diabetic complications.13 In a study examining the relative contribution of postprandial glucose and fasting glucose of the A1C, Monnier et al.4 found that fasting glucose was a much greater contributor when A1C was 8.4% and higher whereas postprandial glucose was more influential when A1C was below 8.4%. From a practical perspective, this finding may provide some guidance for clinicians in their therapeutic decision-making. For example, it may be more effective to focus on therapies that target fasting glucose when the A1C is above 9%. Conversely, a patient with an A1C of 8% who is struggling to achieve their goal may benefit from therapies that target postprandial glucose (i.e. rapidacting insulin or secretagogues). A1C measurement is a critical component of diabetes management; however, a key limitation of using A1C as a measure of glycemia is the lack of timeliness it does not provide guidance to clinicians or patients regarding glucose excursions throughout the day as it is simply a crude measurement of mean glycemia. This is particularly relevant when considering new data that show that glycemic variability may also play an important role in the development of complications, independent of A1C levels. In turn, these data prompt reconsideration of the lessons learned from the Diabetes Control and Complications Trial (DCCT). Few Continue reading >>

Hba1c And Diabetes – Glycated Hemoglobin (a1c) Explained

Hba1c And Diabetes – Glycated Hemoglobin (a1c) Explained

Diabetes and its complications remain a major cause of early disease and death worldwide. The diagnosis of diabetes is to a large extent based on detecting elevated levels of sugar (glucose) in the blood. Hemoglobin A1c (HbA1c) is a laboratory measure frequently used for this purpose. The test is also useful to monitor treatment in patients with established diabetes. Approximately 8 percent of the US populations suffer from type 2 diabetes, with as many as 40 percent of those undiagnosed (1). Worldwide, the prevalence of type 2 diabetes is estimated at 6.4 percent in adults but varies somewhat among countries with the rate of undetected diabetes as high as 50 percent in some areas (2). The term diabetes describes several disorders of abnormal carbohydrate metabolism that are characterized by high levels of blood glucose (hyperglycemia). Diabetes is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin (3). The Difference Between Type 1 and Type 2 Diabetes The prevalence of both type 1 and type 2 diabetes continues to increase worldwide, with type 2 diabetes much more common and accounting for over 90 percent of patients with diabetes. Type 1 diabetes used to be called juvenile onset or insulin-dependent diabetes because it often presents in childhood and it is characterized by the inability of the pancreas to produce the insulin. Insulin is necessary for the cells of the body to be able to utilize glucose for energy production. Without insulin, glucose accumulates in the blood leading to hyperglycemia. Due to the absence of insulin, most patients with type 1 diabetes need to be treated with insulin. Conversely, type 2 diabetes, formerly called adult-onset or non-insulin-depend Continue reading >>

How To Keep Your A1c In Range

How To Keep Your A1c In Range

A1C, sometimes called hemoglobin A1C or HbA1C, is the A of the diabetes ABCs. Your doctor orders a lab test of your hemoglobin A1C periodically; diabetes professionals pay careful attention to this number. Here are two important facts you should know now: A1C measures your average blood glucose levels over the 60 to 90 day period before the test. Even though yesterday’s blood glucose level influences the A1C value more than your level 6 weeks ago — a weighted average — A1C gives the clearest picture of blood glucose control hour to hour, day to day, and week to week. This test is especially important for people with type 2 diabetes who do not frequently test their blood glucose levels at home. A1C values are closely correlated with your risk for many diabetes-related complications, like heart disease and kidney failure. In that regard, the target values set for blood glucose control by the American Diabetes Association (ADA) or the American College of Clinical Endocrinologists (ACCE) are numbers with real meaning. The ADA target is an A1C less than 7 percent, and the ACCE target is less than 6.5 percent. The table shows the correlation between the A1C level and weighted average blood glucose in milligrams per deciliter (mg/dl) and in millimoles per liter (mmol/l). Remember that a normal fasting blood glucose level is 99 mg/dl (5.5 mmol/l) or lower, but levels rise after eating for everyone. The A1C target values represent the level of blood glucose control those organizations view as being both achievable, and effective at minimizing the risk for complications. Highly respected studies, including the Diabetes Control and Complications Trial (DCCT) in the U.S. and the United Kingdom Prospective Diabetes Study (UKPDS), demonstrated striking reductions in the risk fo Continue reading >>

More in diabetes