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 >>
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 >>
What Are The Normal A1c Levels For Children?
The A1c blood test is one of the laboratory tests used to diagnose diabetes and an important measure of average blood sugar levels in someone who has diabetes. This test determines the amount of glucose or sugar that has attached to the blood's hemoglobin -- the oxygen-carrying protein in red blood cells -- during the 3-month lifespan of these cells. Target A1c levels have been established to help healthcare providers, as well as children with diabetes and their families, understand the blood sugar goals needed to reduce the risk of the long-term complications of diabetes. While there are some situations where the A1c result may not be reliable, as a rule this test is accurate and an essential part of a child's diabetes management program. Video of the Day Normal A1c Levels Diagnostic criteria for children is similar to the guidelines used in adults, and the A1c is one of the tests used to diagnose diabetes. A1c levels are reported as a percentage, and often the estimated average glucose (eAG) -- a number calculated from the A1c reading -- is also included with the results. Using the same units as a blood glucose meter, the eAG makes understanding the A1c result a bit easier by comparing the A1c to average blood sugar levels. A normal, nondiabetic A1c level is below 5.7 percent, which reflects an eAG below 117 mg/dL. The level used to diagnose diabetes is 6.5 percent and above, which reflects an eAG of 140 mg/dL or higher. A1c levels above normal but below the diabetes range fit into a prediabetes range. Target A1c Levels Along with its role in diagnosing diabetes, the A1c test is performed between 2 and 4 times per year to estimate average blood sugar levels over the previous 3 months. This test is used to monitor the effectiveness of diabetes treatment and to determin Continue reading >>
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 >>
Diabetes Simplified: A1c Testing
By Wil Dubois “Mirror, mirror, on the wall, who’s the best-controlled of all?” —what the Wicked Queen would have asked if she’d had diabetes instead of vanity issues If you’ve had diabetes for any time at all, you’ve probably heard of the A1C test. Sometimes, it’s also called the HbA1c test, the Hemoglobin A1c test, or the glycated hemoglobin test. They’re all the same thing. This is a lab test that allows your doctor, by consulting with a magic mirror, to determine how well your diabetes has been controlled, night and day, for the last three months. If that’s not black magic, I don’t know what is. Of course, as sci-fi writer Arthur C. Clarke famously said, “Any sufficiently advanced technology is indistinguishable from magic.” The A1C has become the widely accepted benchmark for diabetes control. It’s used to classify who is in control and who is not, and to quantify the risk levels of those not in-target. The higher the A1C, the greater the risk of complications. The A1C is now also used diagnostically, with A1C scores actually used to diagnose new-onset diabetes. The A1C Test: How Does It Work? Well, like I said, it’s magic: in this case, the magic of biochemistry. The test measures the average blood sugar level for the past three months. It can do this because glucose sticks to red blood cells, just like powdered sugar sticks to freshly-fried doughnut holes. The result of the test is expressed as a percentage: 6.2 percent…7.8 percent…8.3 percent…9.6 percent…12.4 percent…and so on. Most A1C scores are only expressed in tenths of a percent, but some labs report twentieths, as well, so you might see an A1C of 6.79 percent or 8.32 percent. Wait a sec. A percentage of what, exactly? The percentage of hemoglobin in the sample of red Continue reading >>
A Life-changing Critically High Diabetes Diagnosis
This post is a hybrid re-post from my food blog (April) and my hiking blog (June), where I have previously shared about my diagnosis. Since those posts, some aspects of my diagnosis and treatment have changed. The ongoing challenges and discoveries in this diabetic journey have prompted this already overextended blogger to yes…start another blog, about my diabetes. There is so much about this disease to learn, and so many frustrations. I need someplace to talk about it without cluttering up my other blogs and my Facebook stream. And if my journey can help even one other person, it’s worth the extra blogging time. My Diagnosis On April 14, 2014, my life changed. That is the day that my husband Jeff and I went together to my doctor’s office early in the morning to learn the results of the full physical my doctor performed on me a few days prior, on April 10th. During the actual physical, when I described my symptoms, the doctor initially suspected a hyperactive thyroid. When she got my lab results back that morning, my doctor was shocked. The doctor diagnosed me with a very extreme case of Type 2 Diabetes, along with extremely high cholesterol. I would never in a million years think this would be my diagnosis. The doctor was very upset when she went over my lab work with me. My A1C was 15! (I recently learned it was actually 15.8, almost a 16!) To put that in context, diabetics should be at A1C 7 or lower, and a 13 is considered dangerously high. My doctor said that in 30 years of practicing medicine, she has never had a patient at that level. She couldn’t believe I hadn’t lapsed into a diabetic coma. My cholesterol was sky high (378!). My resting heart rate was the highest she’d ever encountered. She said I was near cardiac arrest. She said I was at fatally h Continue reading >>
14 Amazing Herbs That Lower Blood Sugar
We live in a world where prescription medicine is getting more and more expensive as well as controversial. Alternative medicine is gaining momentum and with good reason! The same is true for treatments for diabetes type 2. You have therapies that can reverse diabetes through lifestyle and diet changes, natural supplements that can help stabilize blood sugar levels, and also herbs that lower blood sugar. Not only are these alternative therapies safer, but they are also easier on your pocket, on your body and mind. Maintaining normal blood sugar levels is necessary for the body’s overall health. Erratic blood sugar levels can affect the body’s ability to function normally and even lead to complications if left unchecked. Some herbs and spices found in nature do a tremendous job of naturally lowering blood sugar levels, making them a boon for diabetics and pre-diabetics. What’s more, being nature’s multi-taskers, herbs and spices also produce overall health benefits beyond just helping balance blood sugar. We want to clarify one thing right away – not everything on our list can be classified as ‘herbs’. However, they are all from natural sources. Herbs come from the leafy and green part of the plant. Spices are parts of the plant other than the leafy bit, such as the root, stem, bulb, bark or seeds. RELATED: Decoding The Dawn Phenomenon (High Morning Blood Sugar) With that in mind, let’s take a look at some of the best herbs that lower blood sugar, along with a few spices thrown in, to give you a more comprehensive list. Please note that while we normally do not use animal studies to support any dietary supplement, several herbs like garlic and ginger are considered ‘food’ and so, are used traditionally by cultures across the world in their daily diet Continue reading >>
Management Of Blood Glucose In Type 2 Diabetes Mellitus
Evidence-based guidelines for the treatment of type 2 diabetes mellitus focus on three areas: intensive lifestyle intervention that includes at least 150 minutes per week of physical activity, weight loss with an initial goal of 7 percent of baseline weight, and a low-fat, reduced-calorie diet; aggressive management of cardiovascular risk factors (i.e., hypertension, dyslipidemia, and microalbuminuria) with the use of aspirin, statins, and angiotensin-converting enzyme inhibitors; and normalization of blood glucose levels (hemoglobin A1C level less than 7 percent). Insulin resistance, decreased insulin secretion, and increased hepatic glucose output are the hallmarks of type 2 diabetes, and each class of medication targets one or more of these defects. Metformin, which decreases hepatic glucose output and sensitizes peripheral tissues to insulin, has been shown to decrease mortality rates in patients with type 2 diabetes and is considered a first-line agent. Other medications include sulfonylureas and nonsulfonylurea secretagogues, alpha glucosidase inhibitors, and thiazolidinediones. Insulin can be used acutely in patients newly diagnosed with type 2 diabetes to normalize blood glucose, or it can be added to a regimen of oral medication to improve glycemic control. Except in patients taking multiple insulin injections, home monitoring of blood glucose levels has questionable utility, especially in relatively well-controlled patients. Its use should be tailored to the needs of the individual patient. Type 2 diabetes mellitus, the sixth leading cause of death in the United States, is directly responsible for more than 73,000 deaths annually and is a contributing factor in more than 220,000 deaths.1 It is the leading cause of kidney failure and new cases of blindness in a Continue reading >>
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Hemoglobin A1c Levels And Risk Of Sudden Cardiac Death: A Nested Case-control Study.
Heart Rhythm. 2017 Jan;14(1):72-78. doi: 10.1016/j.hrthm.2016.08.044. Epub 2016 Aug 31. Hemoglobin A1c levels and risk of sudden cardiac death: A nested case-control study. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Center for Arrhythmia Prevention, Brigham and Women's Hospital, Boston, Massachusetts; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Center for Arrhythmia Prevention, Brigham and Women's Hospital, Boston, Massachusetts; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: [email protected]. Sudden cardiac death (SCD) is often the first manifestation of cardiovascular disease (CVD), and preventive strategies within this broad population are lacking. Patients with diabetes represent a high-risk subgroup, but few data exist regarding whether measures of glycemia mediate risk and/or add to SCD risk stratification. The purpose of this study was to examine the association between hemoglobin A1c (HbA1c) and SCD. We performed a case-control analysis among individuals enrolled in 6 prospective cohort studies. HbA1c levels were determined for 482 cases of SCD and 914 matched controls. Conditional logistic regression with fixed effects meta-analysis was used Continue reading >>
In Search Of: The Highest Diabetes A1c In History
My most recent A1C was nothing to be proud of, but I consoled myself with the thought that it was hardly the worst in history. That got me wondering: What was the all-time worst A1C? Who holds this dubious record, and how high is it possible to go? I decided to pound the pavement and try to find out. So where to start when looking for a diabetes record? Well, with the Guinness Book of World Records, of course. But oddly, the Guinness people don’t seem to have any listings related to A1Cs. They do, however, report that Michael Patrick Buonocore survived a blood sugar of 2,656 mg/dL upon admittance to the ER in East Stroudsburg, PA, on March 23, 2008. Michael was a T1 kiddo at the time, and that record-high sugar level was part of his diagnosis experience. So does Michael also hold the record for top A1C? No. Because while he’s living (thankfully) proof that stratospheric blood sugar levels are possible, a sky-scraping A1C requires both altitude and time. Remember that A1Cs provide a three-month average of our blood sugars. Individual high BG readings, even crazy-high ones, don’t alter the test as much as you’d think if they last only a short time. Because type 1 in kids Michael's age hit so quickly, I figured his A1C would have been rather middle of the road. It takes a slow burn to make an A1C boil. But just to be sure, I reached out to his parents, who tell me his A1C was 11.9 at diagnosis. Higher than I expected, but not too high given the four-digit BG reading. (If his 2,656 had been his average blood sugar for three months, his A1C would have been roughly 95! Yes, that’s 95.0, not 9.5). The highest A1C turns out to be a tricky piece of data to ferret out. If you try Google, you find a gazillion people talking about their own personal highest A1Cs, and comp Continue reading >>
Hemoglobin A1c Test (hba1c, A1c, Hb1c)
Hemoglobin A1c definition and facts Hemoglobin A1c is a protein on the surface of red blood cells that sugar molecules stick to, usually for the life of the red blood cell (about three months). The higher the level of glucose in the blood, the higher the level of hemoglobin A1c is detectable on red blood cells. Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time period. Normal ranges for hemoglobin A1c in people without diabetes is about 4% to 5.9%. People with diabetes with poor glucose control have hemoglobin A1c levels above 7%. Hemoglobin A1c levels are routinely used to determine blood sugar control over time in people with diabetes. Decreasing hemoglobin A1c levels by 1% may decrease the risk of microvascular complications (for example, diabetic eye, nerve, or kidney disease) by 10%. Hemoglobin A1c levels should be checked, according to the American Diabetic Association, every six months in individuals with stable blood sugar control, and every three months if the person is trying to establish stable blood sugar control. Hemoglobin A1c has many other names such as glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin, and HbA1c. To explain what hemoglobin A1c is, think in simple terms. Sugar sticks to things, and when it has been stuck to something for a long time it's harder to the get sugar (glucose) off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die. When sugar (glucose) sticks to these red blood cells by binding to hemoglobin A1c, it gives us an idea of how much glucose has been around in the blood for the preceding three months. Hemoglobin A1c is a minor component of hemoglobin to which gl Continue reading >>
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 >>
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A1c Calculator*
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 >>
5 Simple Ways To Lower Your A1c This Week
The A1C blood test is a simple test that analyzes your glucose (blood sugar) levels by measuring the amount of glycated hemoglobin in your blood. Hemoglobin is a protein in your red blood cells; when glucose enters the blood, it attaches to the hemoglobin. The result is glycated hemoglobin. The more glucose in your blood, the higher your glycated hemoglobin. The A1C is a valuable indicator of how well your diabetes management plan is working. While your individual A1C goal will depend on factors including your age and your personal medical profile, most people with diabetes aim to keep their A1C below 7 percent. By keeping your A1C number within your target range, you can reduce the risk of diabetes complications. While it is important to develop a long-term diabetes management plan with your physician, there are several steps you can take right away to help reduce your A1C. Small changes add up, so consider trying some of these strategies to lower your A1C this week. 1. Try Short Sessions of High Intensity Exercise According to research presented at the American Heart Association's Scientific Sessions 2015, type 2 diabetes patients who did 10 minutes of exercise three times a day, five days a week at 85 percent of their target heart rate had a twofold improvement in A1C levels compared to patients who exercised for 30 minutes a day at 65 percent of their target heart rate. Be sure to check with your doctor before trying high intensity exercise, and wear a heart rate monitor so you don’t overdo it. 2. Shrink Your Dinner Plate Instead of a large dinner plate for your meals, use a smaller salad plate. This simple swap can trick your eyes and brain into thinking you’re eating more than you really are, and you’ll feel satisfied with less food. It’s especially helpfu Continue reading >>
My Hba1c Is Over 14%
Q. My HbA1c is over 14%. My diabetes has never been under control mostly because of myself never doing blood tests. Lately I'm feeling ill every day, constantly tired and weak, blurry vision, headache's, stomach pains and being sick quite a lot so now I'm scared at what diabetes could do to me in later life if all this is happening now. I do want to start taking control but is it too late? A. You are taking control. Things will change and this can make a difference to your long term health. People deal with their diabetes in different ways, and although you can still lead a long and healthy life and do all the things you want to do, that does not mean that diabetes is not a challenge. You have to think about the diabetes on a daily basis, as well as dealing with all the other stuff going on in your life. It can feel like too much at once. So maybe one way of coping with it all, is to not think about the diabetes. So this works for you, and you perhaps felt happier dealing with your diabetes this way. It sounds like things are different now and you feel tired and ill most of the time. You have now made a decision to change this and have started to think about your diabetes, that may have caused you to feel anxious and scared as you start imagining what diabetes could do to you in later life. Once again you have decided to make a change, so you are now thinking about monitoring your blood glucose levels and working towards bringing them down. You can start to feel more in control, less tired and sick and your long term health prospect will improve a great deal. It is never too late to make a change and I understand why you can feel scared. It is good to be able to communicate that. You are not alone in experiencing these types of emotions. I have spoken and corresponded w Continue reading >>
