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A1c Diabetes Range

5 Ways To Lower Your A1c

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 >>

All About The Hemoglobin A1c Test

All About The Hemoglobin A1c Test

People with diabetes used to depend only on urine tests or daily finger sticks to measure their blood sugars. These tests are accurate, but only in the moment. As an overall measurement of blood sugar control, they’re very limited. This is because blood sugar can vary wildly depending on the time of day, activity levels, and even hormone changes. Some people may have high blood sugars at 3 a.m. and be totally unaware of it. Once A1C tests became available in the 1980s, they became an important tool in controlling diabetes. A1C tests measure average blood glucose over the past two to three months. So even if you have a high fasting blood sugar, your overall blood sugars may be normal, or vice versa. A normal fasting blood sugar may not eliminate the possibility of type 2 diabetes. This is why A1C tests are now being used for diagnosis and screening of prediabetes. Because it doesn’t require fasting, the test can be given as part of an overall blood screening. The A1C test is also known as the hemoglobin A1C test or HbA1C test. Other alternate names include the glycosylated hemoglobin test, glycohemoglobin test, and glycated hemoglobin test. A1C measures the amount of hemoglobin in the blood that has glucose attached to it. Hemoglobin is a protein found inside red blood cells that carries oxygen to the body. Hemoglobin cells are constantly dying and regenerating, but they have a lifespan of approximately three months. Glucose attaches, or glycates, to hemoglobin, so the record of how much glucose is attached to your hemoglobin also lasts for about three months. If there’s too much glucose attached to the hemoglobin cells, you’ll have a high A1C. If the amount of glucose is normal, your A1C will be normal. The test is effective because of the lifespan of the hemogl Continue reading >>

Glycated Hemoglobin

Glycated Hemoglobin

Glycated hemoglobin (hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also referred to as being Hb1c or HGBA1C) is a form of hemoglobin that is measured primarily to identify the three-month average plasma glucose concentration. The test is limited to a three-month average because the lifespan of a red blood cell is four months (120 days). However, since RBCs do not all undergo lysis at the same time, HbA1C is taken as a limited measure of 3 months. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. HbA1c is a measure of the beta-N-1-deoxy fructosyl component of hemoglobin.[1] The origin of the naming derives from Hemoglobin type A being separated on cation exchange chromatography. The first fraction to separate, probably considered to be pure Hemoglobin A, was designated HbA0, the following fractions were designated HbA1a, HbA1b, and HbA1c, respective of their order of elution. There have subsequently been many more sub fractions as separation techniques have improved.[2] Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous three months before the measurement as this is the lifespan of red blood cells. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, neuropathy, and retinopathy. A trial on a group of patients with Type 1 diabetes found that monitoring by caregivers of HbA1c led to changes in diabetes treatment and improvement of metabolic control compared to monitoring only of blood or urine glu Continue reading >>

Understanding Your A1c

Understanding Your A1c

The A1C is a blood test that helps determine if your diabetes management plan is working well. (Both Type 1 and Type 2 take this test.) It’s done every 2-3 months to find out what your average blood sugar has been. (You may also hear this test called glycosylated hemoglobin, glycohemoglobin, hemoglobin A1c, and HbA1c.) A1c is the most common name for it though. How the test works Essentially, the test can tell how much sugar is in the blood stream by looking for proteins (hemoglobins). When glucose (sugar) enters the blood, it binds to the protein in the red blood cells. This binding creates “glycated hemoglobin”. The more sugar in the blood, the more glycated hemoglobin. It’s important to test your blood sugar levels (BGLs) throughout the day; however, an A1C test gives you a bigger picture with a long-term average of those blood sugar levels. What do these numbers mean? The A1c is an average of what your blood sugar levels have been over the 3-month period. In general, the higher your A1C number, the higher your likelihood of diabetes complications. (You don’t want a high A1C; it means there is too much sugar in your blood and your body isn’t absorbing it.) A1C number 4.6 – 6.0 Normal (does not have diabetes) 5.7 – 6.4 Pre-diabetes (warning that someone may develop Type 2 or have the beginning onset of Type 1) 6.7+ Diabetes (someone diagnosed with diabetes) <7.0 – 7.5 Target range (for adults diagnosed with diabetes – children diagnosed with diabetes) This target range varies between individuals, some people naturally run a little higher, some lower. It is important to note that especially in children a higher A1C (of 7.5) is recommended. The A1C number will help you and your doctor determine though if your diabetes management plan is working well. Continue reading >>

A Diabetic Patient Should Know Their Hemoglobin A1c Level: Monitoring And Managing It Could Reduce Complications

A Diabetic Patient Should Know Their Hemoglobin A1c Level: Monitoring And Managing It Could Reduce Complications

Red blood cells carry oxygen (O2) to the tissues through the blood flow of the circulatory system (Figure 1). When the hemoglobin binds to oxygen, the cells appear red (that is why they are called red blood cells. Red blood cells contain hemoglobin, which normally carries oxygen to the tissue, and when the hemoglobin binds with glucose in the blood, it becomes “glycated.” The term HbA1c refers to glycated hemoglobin (Figure 2). The more glycated hemoglobin that is made, the higher the percentage of HbA1c. A hemoglobin A1c (HbA1c) test is good for monitoring long-term glucose (sugar) control in people with diabetes. HbA1c is a percentage of the glycated hemoglobin relative to the total hemoglobin in the blood (Figure 3). The normal range of HbA1c is 4-6%. More than 7% is high. With more glucose present in the blood, the more likely that the glucose will interact with the hemoglobin and make more glycated hemoglobin. HA1c is a better measurement used to track the progress of diabetes than a blood sugar test. The blood sugar test does not give the big picture. Blood sugar in the body changes during the day depending on diet and level of activity, so the blood sugar test is not very accurate. The A1c test is used to measure how much sugar a person has in their blood over a longer period of time, which is usually 3 months. The lifespan of red blood cells is about 120 days, while the life span of hemoglobin is on average only two months (Figure 4). The A1c test is usually done 2-4 times a year. The higher the A1c, the higher the risk of diabetic complications. A decrease of 1% in A1c decreases the risk of microvascular complication by 37%. Diabetes is a serious disease that affects the eyes, kidneys, heart and feet (Figure 5). How does hemoglobin work? The red blood cells Continue reading >>

The A1c Test & Diabetes

The A1c Test & Diabetes

What is the A1C test? The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, or glycohemoglobin test. The A1C test is the primary test used for diabetes management and diabetes research. How does the A1C test work? The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent. Can the A1C test be used to diagnose type 2 diabetes and prediabetes? Yes. In 2009, an international expert committee recommended the A1C test as one of the tests available to help diagnose type 2 diabetes and prediabetes.1 Previously, only the traditional blood glucose tests were used to diagnose diabetes and prediabetes. Because the A1C test does not require fasting and blood can be drawn for the test at any time of day, experts are hoping its convenience will allow more people to get tested—thus, decreasing the number of people with undiagnosed diabetes. However, some medical organizations continue to recommend using blood glucose tests for diagnosis. Why should a person be tested for diabetes? Testing is especially important because early in the disease diabetes has no symptoms. Although no test is perfect, the A1C and blood glucose tests are the best tools available to diagnose diabetes—a serious and li Continue reading >>

Ways To Lower Your A1c Levels

Ways To Lower Your A1c Levels

With diet and lifestyle changes, combined with modern medication, type 2 diabetes is almost always manageable. The results of your diabetes management efforts are measured each year via the A1C test. Unlike a home blood test that measures blood sugar levels in that exact moment, the results of the A1C test provide your doctor with a picture of your blood sugar levels over the course of the past eight to 12 weeks. A healthy adult should have A1C results between 4% and 6%. If you have diabetes, A1C results should be around 7% or less. Information provided by the test indicate whether your current diabetes management plan is effective, or whether it needs some tweaking on your part and/or on the part of modern medicine – via adjusting medication and/or insulin doses. If your A1C levels are higher than you’d like, there’s no need to panic. However, there is a need to take action. What Can I Do to Bring My A1C Levels Down? There are several things you can do on your own to bring the levels down, preventing the escalation of your diabetes as well as diabetes-related complications. Exercise, exercise, exercise. Did we mention exercise? Most of us intend to exercise more than we do but time gets away from us. A patient who exercises faithfully for 30 minutes per day, five days a week, will find it has a great impact on A1C levels. Moderate exercise has a remarkable effect on blood sugar because your muscles convert glucose into energy. They’ll use the glucose in your blood stream first, regardless of insulin production, which is why exercise is a natural blood sugar balancer. You don’t have to hit the gym; you simply need to find activities that you enjoy – and that keep you moving. Walking, biking, hiking, swimming, yoga, rumba, ballroom dancing – all are example Continue reading >>

Test Id: Hba1c Hemoglobin A1c, Blood

Test Id: Hba1c Hemoglobin A1c, Blood

Evaluating the long-term control of blood glucose concentrations in diabetic patients Diagnosing diabetes Identifying patients at increased risk for diabetes (prediabetes) Diabetes mellitus is a chronic disorder associated with disturbances in carbohydrate, fat, and protein metabolism characterized by hyperglycemia. It is one of the most prevalent diseases, affecting approximately 24 million individuals in the United States. Long-term treatment of the disease emphasizes control of blood glucose levels to prevent the acute complications of ketosis and hyperglycemia. In addition, long-term complications such as retinopathy, neuropathy, nephropathy, and cardiovascular disease can be minimized if blood glucose levels are effectively controlled. Hemoglobin A1c (HbA1c) is a result of the nonenzymatic attachment of a hexose molecule to the N-terminal amino acid of the hemoglobin molecule. The attachment of the hexose molecule occurs continually over the entire life span of the erythrocyte and is dependent on blood glucose concentration and the duration of exposure of the erythrocyte to blood glucose. Therefore, the HbA1c level reflects the mean glucose concentration over the previous period (approximately 8-12 weeks, depending on the individual) and provides a much better indication of long-term glycemic control than blood and urinary glucose determinations. Diabetic patients with very high blood concentrations of glucose have from 2 to 3 times more HbA1c than normal individuals. Diagnosis of diabetes includes 1 of the following: -Fasting plasma glucose > or =126 mg/dL -Symptoms of hyperglycemia and random plasma glucose >or =200 mg/dL -Two-hour glucose > or =200 mg/dL during oral glucose tolerance test unless there is unequivocal hyperglycemia, confirmatory testing should be Continue reading >>

Discussion: Hemoglobin A1c Levels

Discussion: Hemoglobin A1c Levels

Hemoglobin A1c levels, sometimes referred to as A1c or HbA1c, is an often confusing topic for many. And that's exactly why we're going to cover a bunch of questions in the discussion below. If you have questions of your own, please leave them at the bottom and join the discussion. What does A1c mean and how is it calculated? Hemoglobin A1c is “glycated hemoglobin.” Hemoglobin is a protein found in red blood cells whose job is to carry oxygen to the cells. As it does so, it comes in contact with other components in the bloodstream, including sugar (glucose). When sugar gets attached to a protein, it’s called “glycation.” The greater the glycation, the more reflective that is of sugar content in the bloodstream. Because red blood cells turn over every 3 months, measuring HbA1c gives us a 3 month average of blood sugar control. The A1c is a percentage whereas the number you get when monitoring at home is a numeric value (mg/dL or mmol/L). QUICK ANSWER: A1c is an average measure of glucose in your bloodstream from the previous 3 month period. The normal range is between 4-6% but your individual goal may be set higher initially or long term, depending on a few factors – keep reading to learn more. My blood readings range 5-7 (90-126), always. I understand that but so often the literature talks about your A1C readings. How do I get that and what is it? The HbA1c is a percentage whereas the value you get with daily testing is a number expressed in mmol/L or mg/dL. Your daily levels change on an ongoing basis whereas A1c provides a 3 month average. A1c/ Blood Sugar Conversation Table For example, if your A1c is 6%, your blood sugar has been running 7 mmol/L or 126 mg/dL on average. Both numbers are important as an indicator of blood sugar control. But one important Continue reading >>

10 Facts About A1c Levels

10 Facts About A1c Levels

What is A1C The use of A1c levels is a very convenient way of diagnosing and examining people with diabetes type 1 and 2. If the levels of glucose in the blood is high, then the A1c levels will be high. Before we proceed with the significant aspects of A1C, let us first identify what is hemoglobin A1C blood test below. What is A1C Test Hemoglobin A1C test (also hemoglobin A1c, Hgb A1c, glycohemoglobin, or HbA1c test) is a blood test to determine the average blood sugar levels of an individual for the past 3 months. Now, what is normal A1C? Hemoglobin A1C Range We can categorically place range positions for hba1c normal levels and high levels as indicated below. What is a normal A1C level? Normal A1C levels are within the A1C range of 4% to 5.6%. If within the A1C normal range, it means the person doesn’t have diabetes. What is a high A1C level? HgA1c levels out of the normal hemoglobin A1C range poses possible problem. A level between 5.7% and 6.4% is indicative of the risk of diabetes. While an A1C level of 6.5% or more is already A1C diabetes, meaning it indicates the presence of diabetes. A1C Calculator To compute your A1C you can simply use the formula below. Glucose in mg/dL: A1c = (46.7 + average_blood_glucose) / 28.7 Glucose in mmol/L: A1c = (2.59 + average_blood_glucose) / 1.59 For further details, you may refer to the A1C levels chart at the end of this post. Facts About Hemoglobin A1c Levels 1. Helps identify blood sugar levels HgbA1c levels is an effective way of testing blood sugar levels in the body. The test is performed by having an amount of blood taken for examination through the pricking of a finger. At times, the blood is drawn from the vein. 2. Evaluates glucose level for a longer period A1c levels evaluate and determine the average glucose level i Continue reading >>

Hemoglobin A1c

Hemoglobin A1c

If there’s one number all patients with diabetes should know, it’s their hemoglobin A1c (HbA1c or A1C) level: a measure of their overall blood glucose control for the past 3 months. Blood glucose levels fluctuate from hour to hour, day to day; but the A1C level reflects the overall average and is the best test to monitor blood glucose control in the past 3 months. How it works Hemoglobin (the protein that carries oxygen) in red blood cells gradually becomes coated with glucose molecules in diabetes. The A1C test works by measuring the percentage of hemoglobin with glucose molecules attached. The A1C test is an important tool for diagnosing and monitoring diabetes. After diagnosis, most patients should take the A1C test every 3 months, though the test might be spaced to every 6 months for patients with consistently good levels. Healthy range In people without diabetes, A1C levels range from about 4% to 6%. Optimal A1C levels to reduce the risk of developing complications in most non-pregnant persons with diabetes are less than 7%, though older persons with multiple medications and limited mobility may have less stringent goals at less than 8%. Levels higher than 9% usually reveal overall poor blood glucose control. The following table illustrates how A1C levels relate to average blood glucose, which is given in mmol/L (outside the United States) and mg/dl (within the United States). In general, an A1C level of 7% reflects an average blood glucose level of 154 mg/dl. Every increase of 1% in A1C adds about 30 mg/dl to the blood glucose level, while every decrease of 1% reduces the blood glucose level by 30 mg/dl. A1C level and estimated average blood glucose levels. A1C (%) Blood Glucose (mg/dl) Blood Glucose (mmol/L) 6 126 7.0 7 154 8.6 8 183 10.2 9 212 11.8 10 240 13 Continue reading >>

What Is The Normal A1c Range?

What Is The Normal A1c Range?

The A1C is a blood test that measures the average level of extra glucose in a person’s blood over the past two to three months. A1C results are expressed as the percentage of the hemoglobin molecules that have glucose bound to them. Identification A person without diabetes produces enough insulin to maintain an A1C between 4 percent and 6 percent. Significance A person with type 1 diabetes needs insulin injections to move glucose into his cells. If he receives too little insulin for the glucose he’s ingested, his A1C will rise. Target The American Diabetes Association recommends an A1C less than 7 percent for most adults with diabetes. ADA target ranges for children are age-specific: 7.5 to 8.5 percent for kids younger than 6, less than 8 percent for 6- to 12-year-olds, and less than 7.5 percent for teens from 13 to 19. Considerations A1C targets aren’t cut and dried. For example, a person with diabetes and heart failure has a greater risk of death if his A1C is between 6.4 and 7.1 percent than if he maintains an A1C between 7.1 and 7.8. But if his glucose goes above 7.8, his risk rises again. Tip It’s important to work closely with your doctor to identify an A1C range that reflects your medical history and lifestyle. Continue reading >>

Setting Appropriate A1c Goals For Patients With Type 2 Diabetes

Setting Appropriate A1c Goals For Patients With Type 2 Diabetes

Reviewed by Clifton Jackness, MD, Attending Physician in Endocrinology, Lenox Hill Hospital and the Mount Sinai Medical Center, New York, NY Assessment of glycemic control in patients with type 2 diabetes can be achieved through patient self-monitoring of blood glucose (SMBG) and A1C determinations.1,2 The American Diabetes Association (ADA) recommends regular A1C testing to evaluate the effectiveness of current management strategies, but the target A1C goal can vary depending on the individual patient profile as well as the set of professional consensus recommendations—and associated management philosophy—to which the treating clinician adheres. According to the ADA, the generally accepted standard A1C goal for adult patients with type 2 diabetes is 7.0%.1,2 Driving A1C below this level has been shown to reduce microvascular complications. In addition, if achieved quickly after a diabetes diagnosis, this A1C goal has been associated with a long-term reduction in macrovascular disease as well.1,2 The ADA suggests that physicians may lower the A1C target to 6.5% for some individuals with short duration of diabetes, a long life expectancy, and no significant cardiovascular disease if the target can be achieved without significant adverse effects of therapy, most notably hypoglycemia.2 Conversely, the ADA suggests a target A1C of closer to 8.0% for individuals with any of the following: history of severe hypoglycemia limited life expectancy advanced microvascular or macrovascular complications multiple comorbidities The higher target A1C is also recommended for patients for whom long-term management of diabetes with behavior modification, SMBG, and glucose-lowering therapy has not helped attain a lower target goal.1,2 These ADA recommendations are partly based on studi Continue reading >>

Type 1 Diabetes Stroke Risk And What A1c Levels To Aim For

Type 1 Diabetes Stroke Risk And What A1c Levels To Aim For

A study finds that those with type 1 diabetes have a higher risk for ischemic and hemorrhagic stroke, particularly in those with poor blood sugar management. Researchers in Sweden set out to estimate the elevated risk of stroke in relation to blood sugar management in patients with type 1 diabetes. The prospective, matched cohort study identified 33,453 patients with type 1 diabetes age 18 or older who were registered in the Swedish National Diabetes Register from 1998-2011 plus five control subjects per case from the general population which were matched for age, gender, and county of residence. Risk for any kind of stroke including ischemic and hemorrhagic stroke were estimated by Cox hazard regression. Does Poor Diabetes Management Increase Risk of Stroke in Type 1 Patients? Of the 33,453 patients with type 1 diabetes (mean age 35 and mean duration of diabetes 20 years), 762 were diagnosed with stroke compared with 1122 of 159,924 control subjects.The risk for ischemic and hemorrhagic stroke rose with A1c levels. Risk for ischemic stroke increased significantly with A1c levels at or above 6.9% (≤52 mmol mol-1). Risk for both ischemic and hemorrhagic stroke also increased significantly in A1c levels at or above 9.7% (≥83 mmol mol-1).Researchers in their study abstract concluded that the risk for ischemic and hemorrhagic stroke rose alongside poorer blood sugar management. How Low Should A1c Levels Be in Patients with Type 1 Diabetes? While it varies depending on personal circumstances, the American Diabetes Association recommends that A1c levels in people with type 1 diabetes be below 7%. The Association’s magazine Diabetes Forecast states in an article that a higher or lower goal may be best for the individual. “For example, an older adult with a limited life Continue reading >>

The Normal A1c Level

The Normal A1c Level

You want to control your diabetes as much as possible. You wouldn’t be reading this if you didn’t. So you regularly check your A1C level. This is the best measurement of our blood glucose control that we have now. It tells us what percentage of our hemoglobin – the protein in our red blood cells that carry oxygen – has glucose sticking to it. The less glucose that remains in our bloodstream rather than going to work in the cells that need it the better we feel now and the better our health will continue to be. Less glucose in the bloodstream over time leads to lower A1C values. As we are able to control our diabetes better and better, the reasonable goal is to bring our A1C levels down to normal – the A1C level that people who don’t have diabetes have. But before we can even set that goal, we have to know what the target is. The trouble with setting that target is that different experts tell us that quite different A1C levels are “normal.” They tell us that different levels are normal – but I have never heard of actual studies of normal A1C levels among people without diabetes – until now. The major laboratories that test our levels often say that the normal range is 4.0 to 6.0. They base that range on an old standard chemistry text, Tietz Fundamentals of Clinical Chemistry. The Diabetes Control and Complications Trial or DCCT, one of the two largest and most important studies of people with diabetes, said that 6.0 was a normal level. But the other key study, the United Kingdom Prospective Diabetes Study or UKPDS, which compared conventional and intensive therapy in more than 5,000 newly diagnosed people with type 2 diabetes, said that 6.2 is the normal level. Those levels, while unsubstantiated, are close. But then comes along one of my heroes, Dr. Continue reading >>

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