Your Good Health: Woman On Metformin Falls Short Of Goals
Your Good Health: Woman on metformin falls short of goals Dear Dr. Roach: My elderly sister, 73, has Type 2 diabetes, and is taking 500 mg of metformin twice a day. After two years on metformin, her fasting glucose level is only 125 mg/dl and A1C only 6.8 per cent. If she continues taking medication, will her fasting glucose level ever get to around 85 mg/dl and her A1C get to five per cent? She wants to be in the normal ranges. In your opinion, is the goal of drug therapy, like metformin, only the control of diabetes? If so, then how can she reach her goals of 85 mg/dl and A1C of five per cent? Type 2 diabetes mellitus is a common disorder of unknown exact cause, but which generally is caused by resistance to the action of insulin and by a gradual decrease in the amount of insulin the pancreas is able to put out. There are many types of treatment for diabetes, but the most important are a healthy diet and regular exercise (a registered dietitian nutritionist is a valuable source of information). In people who need medication, metformin is a very good first choice for many, especially people who are overweight. The goal of treatment is the control of symptoms, but also to reduce the risk of complications of diabetes, especially blood vessel disease. Small blood vessel disease leads to kidney failure, nerve damage and vision changes. Large blood vessel disease leads to heart attack, stroke and peripheral vascular disease, which sometimes can mean amputations. There remains debate about the optimal blood sugar goal. For older people and those at high risk for (or who already have) large blood vessel disease, treating people with a goal A1C level of five per cent actually has more risk than a goal of around seven per cent. However, for younger people, most diabetes expert Continue reading >>
H-b-a-1-c
(What It Is and Why It Matters) You’ve pulled out your logbook and are taking off your jacket to bare your upper arm for the blood pressure cuff, when the nurse walks in and asks you to hold out a finger. “Does it matter that I had breakfast this morning?” you ask, trying to remember if you were supposed to fast before coming in, as she pricks your finger and collects a blood sample. “No, it doesn’t,” she says. “There; all done. The doctor will be in shortly to discuss your result.” And, indeed, several minutes later, your doctor walks in and says with a smile, “Looks like things are coming together for you. You’re at 6.8%.” For some people, the doctor’s words would be enough for them to realize that the fingerstick in the imaginary scenario above was for a glycosylated hemoglobin (HbA1c) test. What is Hba1c? The HbA1c test gives an indication of your blood glucose control over the previous 2–3 months and is an important part of your diabetes-care regimen. This article discusses what the test is, why it’s important, and how it’s used to help better blood glucose control. What is HbA1c? The ABCs Figuring out how the HbA1c test can help with your blood glucose control starts with understanding a bit about the test and what it measures. Hemoglobin. Hemoglobin is a molecule found in great quantities in each of the body’s red blood cells. As red blood cells travel through the circulatory system, the hemoglobin molecules join with oxygen from the lungs for delivery to the peripheral tissues, where they exchange it for some of the carbon dioxide destined for release to the lungs. The hemoglobin molecule is made up of two pairs of protein chains (two alpha chains and two beta chains) and four heme groups (iron-containing structures that act as th Continue reading >>
How Is My Diabetes Doing (a1c Was 6.8), And Is 1,000 Mg Of Metformin Too Much Medicine (2's Per Day)?
Answered Jan 6, 2018 Author has 988 answers and 912.9k answer views This is not a question that should be asked on Quora. It should only be asked of a real licensed physician who has your medical history, diagnostic tests, and diagnosis in their hands. An A1C number without any other context means nothing. I always am troubled by people who reply to these A1C questions as if they have some insight into your health. I dont know your weight. I dont know how long youve had type 2 diabetes. I dont know your age. I dont know what your A1C numbers have been over time. I dont know anything about you. Please, dont ask critical healthcare questions about yourself on the internet. Youll mostly get junk answers, because real physicians will rarely ever answer your question. So you get amateurs and charlatans answering your question, which have no value whatsoever. Managing type 2 diabetes is a daily job. The consequences of not doing it right is that you could lose your eyesight, get heart disease, lose your kidneys, and/or die. Just talk to your physician. Continue reading >>
David's Guide To Getting Our A1c Under 6.0
The A1C test is our best scorecard to show how well we are controlling our diabetes. It measures how much glucose has been sticking to our red blood cells for the previous two or three months. Since our bodies replace each red blood cell with a new one every four months, this test tells us the average of how high our glucose levels have been during the life of the cells. The experts recommend that we should get our A1C level tested at least twice a year. People who take insulin need to get it about four times a year. If the test shows that our blood glucose level is high, it means that we have a greater risk of having diabetes problems. Think of the A1C as an early warning system for the insidious complications that we can get down the road when we don’t control our condition. But what do we mean by a “high” A1C level? Here the experts disagree. The American Diabetes Association says that we need to keep our A1C results below 7.0 percent. The American Association of Clinical Endocrinologists sets the target at 6.5 percent. The International Diabetes Federation, or IDF, also recommends that most people with diabetes keep their levels below 6.5 percent. The more our A1C level is higher than normal, the greater the likelihood that we will suffer from one or more of the complications of diabetes. And here too the experts disagree with how they define “normal.” People who don’t have diabetes have A1C levels below 6.0 percent. That’s the gist of what I wrote here recently in “The Normal A1C Level.” The IDF agrees. But more aggressive endocrinologists say that a truly normal A1C ranges from 4.2 percent to 4.6 percent. That’s what Dr. Richard K. Bernstein wrote in Dr. Bernstein’s Diabetes Solution. No matter what our level is, we can be sure that lower is Continue reading >>
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 >>
A1c Test
Print Overview The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c. The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Why it's done An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation, recommend that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes. After a diabetes diagnosis, the A1C test is used to monitor your diabetes treatment plan. Since the A1C test measures your average blood sugar level for the past two to three months instead of your blood sugar level at a specific point in time, it is a better reflection of how well your diabetes treatment plan is working overall. Your doctor will likely use the A1C test when you're first diagnosed with diabetes. This also helps establish a baseline A1C level. The test may then need to be repeated while you're learning to control your blood sugar. Later, how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you're managing your blood sugar. For example, the A1C test may be recommended: Once every year if you have prediabetes, which indicates a high risk of developing diabetes Twice a year if 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 >>
A1c Went From 8.1 To 6.1 To 5.4 In 3 Months!! So Happy!! =^-^=
A1C went from 8.1 to 6.1 to 5.4 in 3 months!! So Happy!! =^-^= Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. A1C went from 8.1 to 6.1 to 5.4 in 3 months!! So Happy!! =^-^= Just had a blood test last week. After 3 months of changing my diet and adding more days of exercise, my A1C went from 8.1 (when first diagnosed) to 5.4 in 3 months!! My fasting bg is now 88 from 138!! I'm so Happy!! That means my change in diet is working, and it's really not so bad. I have learned that portion is the key! Lost weight too, went from 157 to 142! =^-^= Good news. I take my A1C in the next couple of weeks and hope mine shows that much improvement. Good going. Excellent A1C and great weight loss to boot. Congratulations! Such improvement in 3 months - wonderful! Thank you so much everyone!! =^-^= I'm doing this without any medication, and am so glad that my diet and exercise is working!! I was really afraid to have to start on Metformin after reading all the posts on this site about most people getting diarrhea from it, at least for the first month or two! I used to have IBS, and the possibility of getting diarrhea on a constant basis really really scares and concerns me 'cause I have a really sensitive stomach!! Back when I had IBS, I couldn't even go two blocks without having to look for a restroom!! And having to worry about it during my one hour commute to and from work was definitely NOT fun! My younger son still remembers that I missed taking all the school trips with him because of it! Thank you so much everyone!! =^-^= I'm doing this without any medication, and am so glad that my diet and exercise is working!! I was really afraid to have to start Continue reading >>
Glu : Preparing For Pregnancy
When I was first diagnosed with type 1 diabetes at 6 years old, my biggest concerns were making sure I had a snack in my lunchbox and that my Barbie dolls were dressed in their best outfits for the day. Oh right, then there was pricking my finger and helping my mom count out 22 goldfish to bring to school. One of the first remarks I ever heard about diabetes was that, It will be really difficult for you to ever have kids; its really risky for people with diabetes. Although that statement didnt mean much to a kindergartner, as I grew older and attended camp and started being more aware of my awkward self, I realized that starting a family could be a real challenge. Will anyone want to marry me? Should I put all hope into adoption? Five years later, I was a counselor-in-training at diabetes camp. We had a new mom come and speak to our group about pregnancy and diabetes. She talked about how hard it was, but that it was totally doable and worth it. I was shocked at what was considered the ideal range for blood sugars. 60 when you wake up? Pretty sure Id be raiding the fridge. She also used an insulin pump which, as a swimmer and dancer, I hated the idea of being attached to a device, especially with my primary wardrobe outside school being a leotard or swimsuit. No thanks. Another 15 years has gone by, and Im now married and moving toward the reality of a small human entering our little family. Thank goodness for camp and close friends who have paved the way for me as phenomenal role models. Recently I started seeing a new doctor at the Joslin Diabetes Center. I was nervousId seen the same endo since I was 18! I called up the pregnancy clinic and made an appointment. The first appointment was pretty standard: basic diabetes info, A1c, and thenmore tests! Thyroid, liver, p Continue reading >>
A1c Of 6.8 | Children With Diabetes Forums
Yay! I was actually surprised because in December she was sick twice and we were fighting highs. Thank you CGM and Temp Basal! This is worth all the nights sleeping on the couch or lack of sleep! woohoo thats great news congrats on all the hard work paying off Yay! I was actually surprised because in December she was sick twice and we were fighting highs. Thank you CGM and Temp Basal! This is worth all the nights sleeping on the couch or lack of sleep! That is great news! How were the last couple of A1C's before the CGM? What a great A1C. Wish we were there! Lots of sleepless nights and CGM and temp basal and finally down to 8.1%. Hopefully we'll see those numbers again someday, too! Keep up the good work! Awesome Sandy ! Im sure your very proud of your DSD :cwds: That is great news! How were the last couple of A1C's before the CGM? We have had the CGM one year today actually (Feb 12). Our A1C was around 7.3 before it, and now after it we have had around 6.9 and a 7, but 6.8 has been our best number yet though. It's not a HUGE difference, but I think it is pretty good for just one year. I am happy Hopefully we can even get a little lower next time. What a great A1C. Wish we were there! Lots of sleepless nights and CGM and temp basal and finally down to 8.1%. Hopefully we'll see those numbers again someday, too! Keep up the good work! It seems at the time like our hard work isn't working, but it actually really is in the long run. So congrats on your hard work too! I'm sure you will see that number sooner than you think too. I think all parents need a pat on the back for the struggles with this disease. Isn't it funny how just that little number can make our day? We have had the CGM one year today actually (Feb 12). Our A1C was around 7.3 before it, and now after it we Continue reading >>
Hemoglobin A1c Blood Test Isn't Perfect
The hemoglobin A1C is a great blood test for type 2 diabetics, but not for diagnosing diabetes. Don't misunderstand. I love the hemoglobin A1C blood test. It doesn't require fasting. It can be done in the doctor's office with a fingerstick just like your glucose monitor, and you can know the results before you leave the office. And it lets you know how your blood sugar has been doing over the past two or three months. It sounds perfect. But it isn't. For diabetes management you and I need to know what our blood sugar is doing all the time, not just every three months. A great HGA1C reading does not mean there have been no hyperglycemic or hypoglycemic episodes over that time. So the hemoglobin A1C cannot replace daily checks with a glucose monitor and log book records. Taken together with daily readings, the hemoglobin A1C gives an accurate picture of whether you are keeping your blood sugar in the ranges that will keep away the complications. There is more and more evidence that an HGA1C between 6.5 and 7 will do just that. And here's an encouraging fact. If your A1C was 9 and you lower it to 8, there is a 20% reduction in risk of complications even though you aren't in the target range yet. That's good to know. You should also know that the American Diabetic Association says to get the test done every three months if your are diabetic. Here's how it works. Hemoglobin is the medical term for red blood cells, and glycated hemoglobin is the term for red blood cells with sugar stuck to them. Over the life of a red blood cell, which is 120 days if all goes well, more and more sugar sticks to it as it travels through your bloodstream. The amount can be measured accurately, and doctors know how much should be on each normal cell. If the level is high, that signals diabetes. Continue reading >>
Ask A Diabetes Expert
Description Over 18 million people in the U.S. have been diagnosed with diabetes. The disease of diabetes mellitus prevents your body from properly using the energy from the food you eat. This occurs if the pancreas produces little or no insulin, or makes insulin but the insulin does not work as it should. Diabetes mellitus (DM) is classified as type 1 DM or type 2 DM, based on the age of onset and certain features of the disease. Juvenile diabetes, or type 1 DM, affects children, teens and young adults. Type 1 DM is an autoimmune disease that destroys certain pancreatic cells called beta cells, leading to a reliance on insulin injections. Latent autoimmune diabetes in adults (LADA), or type 1.5 DM, affects adults with diabetes that is similar to type 1 DM. There is no family history of type 2 DM. These patients have positive antibodies and a decreasing ability to make insulin. Type 2 diabetes mellitus is known to affect middle-aged patients who are obese (20 percent or more over desired body weight), as well as certain ethnicities (e.g., Black-American, Hispanic or Native American) or with other known risk factors. (Other types of diabetes also exist.) To manage diabetes, patients must diligently measure their insulin levels; take oral medications, non-insulin injections or insulin injections; and monitor their diets and exercise levels each day. People who need to take insulin injections should be seen by their physician every three to four months to monitor disease progression and the onset of any related complications. Diabetes can cause serious related complications, affecting the eye, kidneys and nerves, as well as causing delayed wound healing (particularly in the feet). Proper management of diabetes begins with understanding the disease, the treatments and lifes Continue reading >>
A1c Was 11.3 Is Now 6.8 | Diabetic Connect
I just got diagnosed and have massive family history. The A1C was 6.5 though my FBG was 98. If my doc did not do the A1C it could have been years before I got diagnosed. This is the first time it is over 6 and she wants me to do the following things in the next 3 months before we meet and check my A1C again. cut way back on starches, since they are more of an issue than sweets in my diet. Work up to a solid exercise routine atm it is a bit of walking and working on adding minutes to the stationary bike until I get up to at least a decent work out Trying for 5 to 6 minutes then uppping it a minute or two till I get to at least 20 minutes on the bike plus walking in the mall before they open up. (too hot here to walk outside even in the morning the sun is bad). I did a complete overhaul of my food intake, no pasta whatsoever has been consumed, this is hard since my hubs is Italian and honestly I've never seen anyone put away so much pastalolwhich caused me to eat a lot more pasta than normal. I cut out all bread except for the occasional Sara Lee Low Carb Whole Grain bread which has, I think, 8 grams per slice or 13..I can't remember and/or I just use a whole grain flatbread I found at the local supermarket that only has 13 carbs and I usually use that for sandwiches. I have to admit that I was a dessert eater since I have such a sweet tooth and I've cut out all desserts except the occasional custard cones since ice cream is my weakness and if I'm going to cheat, it's going to be ice cream. I found Tofutti Hooray bars that are only 8 carbs and are made of soy protein which do not affect my blood sugars so I now have those instead of any other dessert usually. I found pasta from explore-asia.com that has soybean pasta and black bean protein pasta which I've incorporated i Continue reading >>
The Normal A1c Level
Wow Richard, 70 lbs? I have lost 24 lbs from low carb diet due to SIBO. It also helped my AC1 go down three points from 6.2 and my cholesterol is lower, which surprised me. I can’t afford to lose anymore weight because I was small to begin with. I had noticed much bigger people in the UK over the last 5 years compared to 15-20. Was quite shocking. I thought we had the patent on obesity! I am not diabetic that I know of but I had weird symptoms… Thirst that continued all day and night. My husband called me a camel. Dry eyes, rashes, strange dark discolouration on arm, under the arm to the side, some circulation issues and blurred vision. Eye specialist could not figure out why. Sores in the mouth also. I had observed about three weeks into super low carbs (30 Gms carb/day) that athlete’s foot symptom, sores in mouth and rashes were clearing up. So, lowering carbs for SIBO actually turned out for the best. By the way, I love your final paragraph. Research is what led me to SIBO diagnosis, and I then told the GI what to look for! He was barking up the wrong tree for months. Said I needed to eat more carbs so I don’t lose weight. Well, carbs fed the bacterial overgrowth!!! Dang fool. On Saturday, June 23, 2012, Diabetes Developments wrote: There is a new comment on the post “The Normal A1C Level”. Author: Richard Comment: I think part of the problem is that doctors are trained over many years to treat with pills, not with food. We continue to do what we are trained to do no matter what. I do believe they want to help us but don’t have the nutritional knowledge because that is not their expertise. When you have a hammer, etc. Nutritionist are no better unless they are those involved in research. They just peddle the messages they are told to. Then again, why wo Continue reading >>
- What Is a Normal Blood Sugar Level?
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
Hba1c 6.8 , Need Urgent Input
I joined this group today & I am sure this forum is going to help me a lot. I am 35yr old working lady with a 7 yr old daughter. My Dad has type 2 diabetics & I was detected with sugar level in border line in 2013 wit hbac1 of 6.2. After that I started controlling my diet & maintained in good level with ranging from 5.4 to 5.8. But recently I did blood test & I got hba1c of 6.8 & doctor adviced me to start with medicine. 1st thing, I am little confused that is that I crossed the normal range (6.5 as per doct) once that means I am diabetic ? Can I do a trial by controlling diet for 2-3 months & recheck again ? I am really nervous as we are planning for second child & I am very confused too. Only observation now a days is I am feeling week, a pain in lower head or I would say neck. I feel tensed for small reasons. Can you please tell me really I am diabetics ? Can I still control this by dieting without taking medicine ? DO you have any good diet chart for me ? D.D. Family Getting much harder to control Hi and welcome to DD its nice to want to control without meds but many here including myself can not. There is no shame in it and it was either that or very high numbers. Do you have a home meter, if so what are your 2 hr readings after eating. What is your fasting reading, what I know today I would never wait for an a1c to find what my readings are. Can you diet well it looks like that is not working at this point, what exact foods are you eating now. How many grams of carbohydrates-sugar are you eating per day. Some can reduce the carbs and get better control but it shows your body is not able to keep up with what you are doing now. Please ask all the questions you would like. The improvement you can make without meds depends on how far away you are from an 'optimal' di Continue reading >>
