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A1c Level Chart

A1c Test

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 >>

Public Health And Clinical Implications Of High Hemoglobin A1c Levels And Weight In Younger Adult Native American People With Diabetes

Public Health And Clinical Implications Of High Hemoglobin A1c Levels And Weight In Younger Adult Native American People With Diabetes

Background Type 2 diabetes mellitus is a major public health issue for Native American people. Because glycemic levels are predictive of diabetes outcome, understanding determinants of high hemoglobin A1c (HbA1c) levels may provide targets for prevention efforts. Objectives To investigate determinants of high HbA1c levels in Native American people. Methods We conducted a population-based, cross-sectional study of 206 participants with diabetes from 8 Native American communities in New Mexico. We used linear regression to assess the relationship of HbA1c level with age, body mass index (BMI), treatment type, duration of diabetes, physical activity, and diet. Results Age, dietary pattern, and treatment type were determinants of HbA1c levels. Participants younger than 55 years had the highest adjusted HbA1c levels at 9.5% and those 65 years and older had the lowest levels at 7.8%. According to a participant's dietary intake, HbA1c levels were highest for those who consumed the most fat and sugar, and high consumption of fat and sugar affected HbA1c levels most among those younger than 55 years. Participants treated with insulin had the highest hemoglobin A1c levels. Physical activity was not associated with HbA1c level. Conclusions We found an increasing severity of diabetes among younger people. To avoid increased morbidity and mortality in the future, young Native American adults with diabetes need vigorous therapy to maintain tight glucose control. TYPE 2 diabetes mellitus is a major health problem among Native Americans, with some communities experiencing 50% prevalence among adults.1 Prevalence of type 2 diabetes mellitus is rising nationwide, largely due to environmental influences on genetic susceptibility.1,2 In New Mexico, diabetes is a major concern for Native Am Continue reading >>

Balancing Vascular Risk Is Part Of Setting A Proper A1c Level Goal

Balancing Vascular Risk Is Part Of Setting A Proper A1c Level Goal

DEAR DR. ROACH: My father has Type 2 diabetes, and his primary care physician has said repeatedly that an A1c of 7.2 percent or 7.3 percent is nothing to worry about. He also says that the American Diabetes Association has told physicians to loosen their restrictions on diabetics. The wall chart in his office says that 7 percent is the max, and above that puts a person at risk for serious consequences. My father previously maintained an A1c of 5.5 percent to 6.2 percent. His A1c started going up after beginning a new blood pressure medicine. His ophthalmologist was concerned about the 7.2 percent A1c. His report says, "serious diabetes that is not managed properly -- strongly recommend getting a second opinion." What do you think? -- G.M. ANSWER: I can see why you might be upset, as you are getting mixed messages. Let's go over the study that has changed the A1c (measure of blood sugar control) goal for most older adults with Type 2 diabetes. The blood-sugar-control arm of the ACCORD trial was designed to test whether "tight" control of diabetes would be superior to "standard" control. Half of the group had an A1c goal of less than 6 percent, and the others had a goal of 7 percent to 7.9 percent. In what was a surprise to the investigators, the study was halted in 2008 by the data safety monitoring board when there were an excessive number of deaths in the "less than 6 percent group" (about 22 percent higher, mostly from heart attack and stroke, termed "macrovascular," since they involve large blood vessels). However, many other trials have shown that the rates of microvascular complications, especially diabetic eye disease (retinopathy) and kidney disease, are lower in people with lower A1c levels. This is why the ophthalmologist was concerned about your father's A1c b Continue reading >>

Knowing Your A1c

Knowing Your A1c

The A1C test measures your estimated average blood sugar over the past 2 to 3 months. It’s like a “memory” of your blood sugar levels. It shows how well you’re controlling your blood sugar over time. Both your A1C and your blood sugar levels indicate how well you’re managing your diabetes. Find out more about the numbers you need to know to keep track of your blood sugar, such as FPG, PPG, and A1C. Examples of A1C levels and how they relate to average blood sugar levels When you get your A1C result, you may see a blood sugar reading next to it. This is another way of showing your average blood sugar levels using the same measurement that you see on your meter, mg/dL (milligrams per deciliter). Continue reading >>

Fructosamine

Fructosamine

WARNING: RISK OF THYROID C-CELL TUMORS In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether Ozempic® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined. Ozempic® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Ozempic® and inform them of symptoms of thyroid tumors (e.g. a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Ozempic®. Ozempic® is not recommended as a first-line therapy for patients who have inadequate glycemic control on diet and exercise because of the uncertain relevance of rodent C-cell tumor findings to humans. Ozempic® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis. Ozempic® is not a substitute for insulin. Ozempic® is not indicated for use in patients with type 1 diabetes mellitus or for the treatment of patients with diabetic ketoacidosis. Risk of Thyroid C-Cell Tumors: Patients should be referred to an endocrinologist for further evaluation if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging. Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signs and symptoms of Continue reading >>

What Your Doctor Doesn't Know About Glucose Testing.

What Your Doctor Doesn't Know About Glucose Testing.

Blood sugar management is important for preventing everything from hypoglycemia to full blown diabetes. However, monitoring blood glucose is rarely as straightforward as it seems. In this article we’ll discuss the current gold standard for measuring a person’s blood sugar. We’ll share some problems with the most popular tests. And we’ll review the best ways to interpret your results. (Even if your doctor doesn’t know how). [Note: We’ve also prepared an audio recording of this article for you to listen to. So, if you’d rather listen to the piece, click here.] ++ Homeostasis is a fancy scientific word for “body balance”. Essentially, our bodies must keep internal levels of thousands of chemicals in check. Or else health can go awry. One of the most important homeostatic systems in our body is our blood sugar management system. When blood sugar is kept at a healthy range, we feel healthy, strong, energetic. On the other hand, unbalanced blood sugars put us at risk for problems ranging from reactive hypoglycemia to insulin resistance to full blown diabetes. But estimating blood sugar levels can be tricky. First, these levels change throughout the day, and with meals and exercise. So, unless you’re monitoring blood sugar levels continuously, every second of every day, it’s hard to get a complete picture of your glucose health. Second, the convenient glucose meters that many Type 1 diabetics use only give us a snapshot instead of a movie. They don’t show us how patients regulate blood sugars over time. And that may be the most important information of all when it comes to disease prevention. That’s why doctors and scientists have become obsessed with finding a test that measures blood glucose balance across days, weeks, or months. In other words, a t Continue reading >>

Your A1c Levels – What Goal To Shoot For?

Your A1c Levels – What Goal To Shoot For?

Measuring Your A1C An A1C test gives you and your provider insight into all of your blood glucose ups and downs over the past two or three months. It’s like the 24/7 video of your blood sugar levels. Observing your A1C results and your blood glucose (also known as blood sugar) results together over time are two of the key tools you and your health care provider can use to monitor your progress and revise your therapy as needed over the years. Recent research is changing the way health professionals look at A1C levels. Instead of setting tight controls across the board, a healthy A1C level is now a moving target that depends on the patient. In the past, an A1C of 7 percent was considered a healthy goal for everyone. Yehuda Handelsman, M.D., medical director of the Metabolic Institute of America in Tarzana, California, says experts now recommend taking a patient-centered approach to managing A1C levels, which means evaluating goals based on individual diabetes management needs and personal and lifestyle preferences. Current ADA Goals The 2015 American Diabetes Association (ADA) Standards of Medical Care in Diabetes advise the following A1C levels: • 6.5 percent or less: This is a more stringent goal. Health care providers might suggest this for people who can achieve this goal without experiencing a lot of hypoglycemia episodes or other negative effects of having lower blood glucose levels. This may be people who have not had diabetes for many years (short duration); people with type 2 diabetes using lifestyle changes and/or a glucose-lowering medication that doesn’t cause hypoglycemia; younger adults with many years to live healthfully; and people with no significant heart and blood vessel disease. • 7 percent: This is a reasonable A1C goal for many adults with d Continue reading >>

The Normal A1c Level

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 >>

A1c Calculator*

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 >>

Why Hemoglobin A1c Is Not A Reliable Marker

Why Hemoglobin A1c Is Not A Reliable Marker

i was recently tested for Hemoglobin A1c because i presented to an endocrinologist with extremely low blood glucose on lab test and some scary symptoms, not the ordinary hypoglycemia symptoms. My A1c was 4.7 which registered as low (L) on the lab print out–it was only slightly low. Does a low score on this suggest a possibility of short-lived RBCs? Does it have any relationship with extremely low blood glucose? my result at the lab, fasting, was 32mg/dL. Not long after that i got a home glucometer and i get the same kind of results on that as the lab got, in the 20s and 30s first thing in the morning, every day. did not know i had hypoglycemia until i had that lab test, though i had had one episode where i woke up with ataxia, i fell while walking to the bathroom first thing in the morning, i got up and immediately fell again. I soon found that i had very impaired coordination. i did not know why and i was very worried. Eventually i wanted to have breakfast but had great difficulty holding the measuring cup under the faucet, to get some water to heat, to make instant oatmeal, i lacked the coordination to get the water into the cup. I persisted and did make the instant oatmeal (pour hot water onto flakes and it’s done), and i got my lap top and was eating the oatmeal and i suddenly was aware that the symptoms were going away. Previously i had been unable to type. While eating the small amount of oatmeal, i realized i could type. That was about a month before the lab test. Since it only happened that once, i put it out of my mind. About 5 days after the lab test, i had the second episode, worse than the first, i woke falling out of bed to the floor, couldn’t use my arm to break the fall, i didn’t have the coordination. i sat on the floor, i could not get up and wa Continue reading >>

Passing The A1c “test”…what Do I Need To Score?

Passing The A1c “test”…what Do I Need To Score?

No one quite agrees on where your A1C score should be, but we all agree on where it shouldn’t be. The scale does not look anything like the BGL numbers you are used to. For all practical purposes, it runs from 5.0 up to 14.0 where most in-house A1C machines max out. Labs can test higher, but at 14.0 your doctor will run screaming for the hills anyway, so it really doesn’t matter. At that level your blood sugar is lethal and your body is slowly dissolving, just as if you had battery acid in your veins and arteries. As a side note, many offices have in-house A1C machines that give results in six minutes. Very handy. I personally love being able to discuss the score with the patient during the visit. Other offices do a “send out.” We generally do them in-house, but if we are also running other lab tests we’ll sometimes piggyback the test onto the blood draw. Both are highly accurate and reliable. So back to your score. Scores below 6.0 are usually considered to be in the non-diabetic range. At 9.0 we cross the threshold where kidney damage starts. So we can all agree that above 9.0 you are in deep shit and the higher above 9.0 that the number is, the worse off you are because A1C tests are curvilinear. Just like Category 3 hurricanes are much worse than Category 2 storms, or like 7.3 earthquakes are much worse than 7.0s, each increase in your A1C number packs a larger punch than you’d expect. The numbers are sufficiently confusing that the ADA has introduced a new measure called eAG, for estimated average glucose. This is a formula that “translates” an A1C score into a “meter number.” It hasn’t been widely adopted yet and the jury is still out on how useful eAG is. I use it for some patients, but not for others, but I always like to have a lot of tool 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 >>

What Do Your A1c Test Results Really Mean?

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 >>

This Calculator Uses The 2007 Adag Formula To Estimate A1c And Average Blood Glucose Equivalents.

This Calculator Uses The 2007 Adag Formula To Estimate A1c And Average Blood Glucose Equivalents.

Enter a value into one of the fields below then press convert. A1c Value: Average Blood Glucose mg/dl or mmol/L 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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