Hemoglobin A1c In Home Parenteral Nutrition.
Abstract Hemoglobin A1C or glycosylated hemoglobin has been described as being effective in monitoring long-term glucose control in diabetics. The usefulness of HbA1C in reflecting glucose homeostasis during chronic hypertonic dextrose infusions in 6 patients receiving cyclic home TPN was studied at monthly intervals. Grouped data for the 34 values representing study periods of 5 to 10 months averaged 7.5 +/- 0.2% (Mean +/- SEM) indicating that HbA1C levels were not elevated above normal (4-8%) in these patients while receiving a dextrose based diet. Final values of HbA1C (7.3 +/- 0.4%, mean +/- SEM) although lower than early values (8.7 +/- 0.6%, mean +/- SEM) were not significantly different (p greater than 0.05, Student's paired t-test). The change in HbA1C that occurred in these patients probably reflects the response to an altered glucose load infused by the patient. HbA1C is a convenient and apparently accurate method of evaluating chronic glucose tolerance in patients receiving home TPN and may be used as an alternate method for monitoring glucose tolerance on an outpatient basis. Continue reading >>
A1c Home Test Kits For Diabetes
Hemoglobin A1C tests are used to screen for and diagnose prediabetes and diabetes. A1C home test kits are a good option if you want to testyour A1C at home in between visits to your doctor, whether you have type 1 or type 2 diabetes. An A1C test gives a picture of how well your diabetes treatment is working by showing your average blood sugar level for the past two or three months. This can be very helpful in your diabetes management plan. All A1C home test kits allow you to provide a small blood sample, about the same as your glucose meter ,in the convenience of your home. Depending on the type of kit you purchase, you either get immediate results at home or you send the sample to a lab for analysis. Home A1C tests are not approved for diagnosing diabetes. You need to see a doctor for a diagnosis. There are factors that will affect the accuracy of A1C tests, so discuss this with your doctor to ensure you know whether they're appropriate for you. A1C results are affected by hemoglobin variants (such as sickle cell), anemia, transfusion, blood loss, pregnancy, and rheumatoid factor. Portable consumer options for immediate results at home are now available at major retailers, with both name brand and house brand versions. A1CNow SELF CHECK was the original FDA-approved brand from Bayer Healthcare. PTS Diagnostics purchased the A1CNow business in 2014 and markets it under the original name, plus they license it for store brand devices. Walmart sells it as ReliOn Fast A1C Test and Walgreens and CVS as At Home A1C Test Kit. This technology received FDA approval and allows you to learn your A1C number in five minutes. It's similar in appearance to your daily glucose meter, but you don't use it on a continual basis. You purchase this A1C meter in a two-test kit. Once you have Continue reading >>
Home Care Diabetic Patients Under The Microscope
Home Care Diabetic Patients Under The Microscope Palmetto GBAs Local Coverage Determination (LCD- L35413) regarding monitoring glucose control in patients with Type II Diabetes Mellitus was effective 12/30/14. The LCD contains specific requirements for Type II diabetic patient care in the home care setting. L35413s goal is to ensure evidenced based medicine to reduce diabetic complications is incorporated into the delivery of home care services. L35132 contains the same requirements as L35413 but includes ICD-10 coding guidelines that is slated to become effective 10/1/15. The LCD recognizes that many factors, including comorbidities and the patients blood glucose levels, must be considered in the initial treatment of a diabetic patient while providing very specific directives relating to patient care. L35413 indicates the first oral glycemic agent to be prescribed if the physician determines the patient would benefit from oral medications to control blood glucose levels. The statement reads This policy establishes the expectation that for those Medicare beneficiaries requiring medications to achieve long-term control of glucose levels, Metformin shall be considered first-line therapy unless there is a specific contraindication to its use. Of course this would be the physicians decision but it is worth mentioning due to specificity of the oral anti-glycemic. Daily nursing visits to provide insulin injections would only be permitted if the patient is physically or mentally unable to self-inject AND there is no other person who is willing and able to provide the injections. It is imperative the documentation in each of the visit notes address these specific guidelines and paint the picture of the patient to support medical necessity. The LCD specified that the POC must c Continue reading >>
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- Home blood glucose test: How to test for diabetes at home
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Just Took My First Home A1c Test
Hello. I was told a little over 2 months ago (out of the blue) at an annual check up that I was pre-diabetic with an a1C of 6.4. The next day and every day since, I have been testing my blood glucose fasting, before meals, and diff time intervals afterward (30m, 1hr, 2hr, 3hr, 4hr), and at bedtime. I have been eating keto/very low carb since February 2017. This pre-diabetic dx took me by surprise for sure. Anyhow, still low carb, and testing upwards of 10x/day to see where I may be spiking any abnormal numbers. I've never received any number at any given time over 117. My FBG is pretty much in the 80s 99% of the time with an occasional higher 70s and a couple times 90, and 91. Looking at my spreadsheets, I averaged approx 90 (even) for November and December. From Jan 1 to present, I'm averaging 89. Granted, I am not taking it all day long, and only have a couple/few times in the middle of the night since November, but I was again somewhat surprised that my a1C today read at 5.5. I'm very happy to see it in a "normal" range, don't get me wrong. Still, scratching my head as when I go to the (glucose to a1C conversion) link I saw here before, it shows an average of 4.8. I get that I don't have a CGM to know what it does all day long, but still puzzled with this whole process/thing/disease. Also, hate that the a1C can be off .5 - which could be putting me .1 away from where I was over two months ago.... I would do the home OGTT, but haven't eaten more than 30 carbs (mostly under 20) in a day since February of last year. Doesn't this mean I will fail it? Something about my pancreas is probably "sleeping".... Pre-D, Type 1, 2, LADA, something else? I don't know what I have nor why I'm posting this, but here it is.. I think that your 6.4% A1c might have been erroneous, lab er Continue reading >>
Type 1 Diabetes Blog
I'm a big fan of having my A1C done every 3 to 5 months with my doctor. For me, it's my report card of how I'm doing managing my blood sugars, and it gives me a chance to course correct if needed, before too much time has gone on. Throughout the last ten years, I've had an average A1C in the mid-6%'s. That's a number that feels good to me, personally. With the challenge of managing my blood sugars while traveling for a year, I know my A1C has gone up. I had the lab test done in June, when I was back in the US for a friend's wedding, and saw a number in the mid-7%'s that I was not thrilled with. Thoughout the last three months in Africa, I've been much more diligent to keep my number down through pre-bolusing and accurate carb counting. I'm now in a place where I'd like to see how much progress I've made. My meter averages tell me I'm close to a 7% A1C, but I'd really like to see the weighted average of an A1C. I feel like the meter doesn't account for how much time I spent at 106 or 198 mg/dl; it just simply averages each blood test. With that in mind, I've asked my younger brother to bring me a home A1C test when I meet him in Spain in a few weeks. I figured this is the closest I'll get to getting a real-deal test done. I've done a lot of googling about the accuracy of these tests. Beyond many opinion pieces, the only study I've seen is here, and says that 93.2% of study paticipants had a home A1C results wihtin the acceptable range of ±13.5% of the laboratory reference value. To me, 13.5% is a fairly close range. But I'm curious if anyone has had experience with these home A1C tests? And if you think ±13.5% is truly accurate? Continue reading >>
What Is A1c?
Your A1C number Consider your A1C number (also known as HbA1c or glycated hemoglobin) as a snapshot of your blood glucose levels over two to three months. Over time, glucose naturally attaches itself to your blood cells. When this happens, the cell is considered “glycated.” The more glucose in your blood, the more glycated A1C cells you have. What’s an optimal A1C number? The recommended A1C target for a person with diabetes is 7% or lower—some people remember this figure as “lucky number 7.” However, while your A1C number gives you and your doctor an idea of how your diabetes is being managed over time, it does not tell you about drastic drops and elevations in your day-to-day blood glucose levels during that period. How do fluctuations in my blood glucose levels affect my overall health? While drops (hypoglycemia) and peaks (hyperglycemia) in your blood glucose levels outside of your target zone can have an immediate impact on your sense of well-being, research shows that the long-term consequences of such fluctuations can be dangerous. Studies show that hyperglycemia can increase your risk of developing heart, eye and kidney disease. Your A1C is an important part of your diabetes management, but it cannot replace daily self-monitoring, which highlights how your body and blood glucose respond to meals, physical activity, medications, illness and stress over short periods of time. How often should I test my A1C? Generally, you should test your A1C no fewer than twice a year, and most medical professionals suggest testing every three months, which is the approximate lifespan of blood cells. Speak with your healthcare professional to determine where and how frequently you should test your A1C level. Reducing your A1C value to a healthier level can decrease yo 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 >>
What Is The A1c Test?
The A1C ("A-one-C") is a blood test that checks your child’s average blood sugar over the past 2 to 3 months. This average is different from your child’s day to day blood sugar. Sugar absorbed from food goes into the bloodstream. The sugar sticks to the hemoglobin protein in red blood cells, forming hemoglobin A1C. The A1C stays in the blood for the life of the red blood cell, which is 90 to 120 days. This means that the amount of A1C in your child’s blood reflects how high the blood sugar has been over the past 3 months. Another name for this test is hemoglobin A1C test. It is different from a regular blood sugar or blood glucose test. Why is this test done? There are 3 reasons to check your child’s A1C: To diagnose prediabetes To diagnose diabetes To see how well your child’s blood sugar is being controlled A1C tests are important because: They can check the accuracy of the blood sugar results you get at home. They help predict your child’s risk of diabetic complications. The higher the A1C percentage, the greater the risk of serious problems from diabetes, like eye, kidney, blood vessel, or nerve damage. If your child’s A1C is high, the plan for treating your child’s diabetes will need to be changed. How do I prepare my child for this test? Your child doesn’t need to do anything to prepare for this test. One of the advantages of this test is that your child does not have to fast before taking the test. How is the test done? Having this test will take just a few minutes. A small amount of blood is taken with a prick of the finger or from a vein in your child’s arm. At some pharmacies you may be able to buy a device that allows you to test A1C at home. You may find that the results of the home test are not the same as results of tests done at your h Continue reading >>
Evaluation Of An Over-the-counter Glycated Hemoglobin (a1c) Test Kit
Glycated hemoglobin (A1C) monitoring is an integral component of diabetes management. This study was conducted to evaluate the performance of the A1CNow® SELFCHECK device when used by lay users and health care professionals (HCPs) to measure A1C. Subjects performed two A1CNow SELFCHECK finger-stick self-tests followed by a finger-stick test of the subject’s blood by a HCP. The primary endpoint assessed accuracy of the subject and HCP A1CNow SELFCHECK readings. Secondary endpoints included precision, comprehension of instructional material (written material ± DVD), and product satisfaction. For accuracy comparison, a venous blood sample was drawn from each subject and tested by laboratory (TOSOH) analysis. Subject comprehension of product instructional material was evaluated via first-time failure (FTF) rate as recorded by the HCP, and subject satisfaction was assessed through written survey. A total of 110 subjects with (n = 93) and without (n = 17) diabetes participated. Of 177 subject A1C values, 165 (93.2%) were within the acceptable range of ±13.5% of the laboratory reference value and considered accurate. Regression analysis showed good correlation of subject values to laboratory and HCP results (R2 = 0.93 for both). The average within-subject coefficient of variation was 4.57% (n = 74). The FTF rates with and without instructional DVD were 11.3% (n = 56) and 39.6% (n = 54), respectively. Subjects with diabetes/prediabetes overwhelmingly indicated that they were “very” to “extremely” likely (93.5%) to discuss their home A1C results with their HCP. Lay users found the A1CNow SELFCHECK easy to use, and both lay users and HCPs were able to measure A1C accurately. Keywords: A1CNow, diabetes, glycated hemoglobin A1c, in vitro diagnostic for home use, over-t Continue reading >>
Home A1c Testing Vs. The Lab
So it was time again for my A1C and other blood tests last week. Over-time, in fact. You know how I hate going in to the lab when I have to be fasting for lipid tests and can't even have a latte on the way over in the morning. Ugh! And who ever said diabetics don't mind needles?! Anyway, I'd been saving the review unit A1c Now SelfCheck pack I got from Bayer a few weeks ago for just this occasion. What better way to test the accuracy of home a A1C testing kit? I don't mind admitting I had very little faith in the thing. My endo had some of these in her office last year, and we tried them several times. The results were always differed wildly from the A1C I got at the hospital lab. She thought her packs might be too old, although the date on the box seemed OK. So after dragging my behind to the hospital that day, and then enjoying a lovely post-needle cafe breakfast with my husband, I went home and snipped the seal on my A1C Now pack. Inside were all the trimmings for two tests, along with a lot of documentation and a mini-CD that's supposed to explain how to use it — which I didn't watch of course. I figured I'd be representative of the "average patient" who is too lazy to watch the CD. (Not to mention that I have ZERO patience myself and ripped right into the thing without thinking ;) ) Lucky for me, the little fold-out Reference Guide with photos did the trick. It told me what to open first, how to prick my finger for the blood (not more than a usual BG test!), and what to open only "AFTER blood collection!" And I must have done it right, because wouldn't you know, I got 6.3 on the Bayer test, and a 6.4 reported back from the hospital lab. Pretty impressive! (Yes, for those science guys but also for me -- under 6.5, Baby!) So I got to experience the "5-minute home A Continue reading >>
At Home A1c Testing Systems & Kits: Review
The A1C, a Glycated hemoglobin, is a form of hemoglobin that is measured primarily to identify the three-month average blood glucose concentration. The A1C test is limited to a three-month average because the lifespan of a red blood cell is only four months. In other words, it’s the indication of your blood sugar level for a three-month period. Typically, your doctor will test your A1C levels every 90 to 180 days depending on how well your blood sugar levels have been managed. In basic terms, the A1C test checks to see how much glucose is attaching to your red blood cells. You can work to keep your A1C within your target range using a recommended diabetes management regimen along with a well-managed diet, exercise routine and other healthy lifestyle . Normal a1C Prediabetes a1C Diabetic a1c Under 5.7 5.7 to 6.4 6.5 and above A1C Test Features and Pricing While most hospital conducted A1C tests cost around $86 per test (depending on your co-pay), you can now buy the A1C self-check home kit for around $40. Each kit includes one test with two strips, but you can buy a double test kit as well. The kits are not reusable so once you use your two lancets, you must buy another kit. Use Most people use this test every 30 days instead of waiting 90 days to be seen by the doctor. This helps patients have a more accurate reading on where their levels fall throughout the month. Insurance Coverage Most insurances will cover 1 or 2 tests per year and some hospitals will have a sample take-home A1C test that you can ask for. However, not all hospitals do so you may still need to buy over the counter kits depending on how many results a year you want to have or how many your doctor requires. Pros and Cons of Home Testing The A1C at home kit needs four large drops of blood which is eas Continue reading >>
Hba1c Test Kits: Home A1c Testing Kits
Tweet Home HbA1c testing kits allow you the chance to get a good idea of your HbA1c level. This can be useful in between getting scheduled HbA1c tests from your doctor. Note that home HbA1c tests should not be used as a substitute for the tests from your doctor and should be not be used in place of an official diagnosis. How home HbA1c test kits work Home HbA1c tests can often be carried out within a relatively short space of time. Most home HbA1c tests require a sample of blood from the finger which is then applied to a solution. The solution usually requires a small bit of processing, which can vary depending on the kit. The solution may require one or more of the following: shaking, heating or letting to stand. The solution is then applied to a reagent. The result may be given in different ways depending on the kit. Some kits provide a numeric result, others may provide a yes or no answer as to whether the HbA1c value is above or below a certain number. Make sure you read the instructions through carefully before beginning. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they 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 >>
- Home blood glucose test: How to test for diabetes at home
- Diabetes and the A1C Test: What Does It Tell You?
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
What Is The A1c Test?
The A1C (“A-one-C”) is a blood test that checks your average blood sugar over the past 3 months. This average is different from your day to day blood sugar. There are 3 reasons to check your A1C: · To diagnose prediabetes · To diagnose diabetes · To see how well you are controlling your blood sugar Sugar absorbed from your food goes into the bloodstream. The sugar sticks to the hemoglobin protein in red blood cells, forming hemoglobin A1C. The A1C stays in the blood for the life of the red blood cell, which is 90 to 120 days. This means that the amount of A1C in your blood reflects how high your blood sugar has been over the past 3 months. Another name for this test is hemoglobin A1C test. It is different from a regular blood sugar or blood glucose test. WHY IS THIS TEST DONE? A1C is an excellent way to check how well you are controlling your blood sugar over a 3-month period. A1C tests are important because: · They can check the accuracy of the blood sugar results you get at home. · They help predict your risk of diabetic complications. The higher the A1C percentage, the greater your risk of serious problems from diabetes, like eye, kidney, blood vessel, or nerve damage. If your A1C is high, your diabetes plan will need to be changed. HOW DO I PREPARE FOR THIS TEST? You don’t need to do anything to prepare for this test. One of the advantages of this test is that you do not have to fast before you take it. HOW IS THE TEST DONE? A small amount of blood is taken from a vein in your arm with a needle. The blood is collected in tubes and sent to a lab. Having this test will take just a few minutes of your time. At some pharmacies you may be able to buy a device that allows you to test A1C at home. You may find that the results of the home test are not the same a 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 >>