A1c Of 7.4 And Doc Said To Not Take Any Meds. Is This Okay? - Diabetes
A1C of 7.4 and doc said to not take any meds. Is this okay? I am asking for my father, who has been pre-diabetic for almost a decade. This year, his A1C has passed the 6.2 mark (upper limit for "pre-diabetes" classification), with his most recent being 7.4. I learned in school that you should take metformin if your A1C is no longer well-controlled with just diet/exercise (which dad isn't all that on top of in the first place, unfortunately). He has no idea and I'm really concerned that his primary care doc of 10 years is still telling him not to take any meds. Am I just being overly worried? Or should we ask another doc for a second opinion? Just want to ask you guys first since you've probably had more experience with this. Additional info: Type 2 DM seems to run in his side of the family. Dad loves his wine, the occasional cookie and pies, and doesn't seem to get out as much as he should. I'm a second-year med student who is possibly paranoid about everything. TL;DR 51-yr-old dad with A1C 7.4; should he be taking metformin? I disagree with the others. I don't think it is time for a new doctor just because a medication has not been prescribed. I don't have a problem with deferring medication. I wish more doctors were less ready to push pills instead of giving lifestyle change a chance to work. I am type 2. There are differences in the treatment regimen between the types. This is one of them. Insulin is vital for a type 1, but medications are not necessarily vital for a type 2 at diagnosis stage. I was diagnosed with an A1c of 8.2%. My doctor was quite happy to let me try diet and exercise first. In hindsight I feel that was a wise decision. The real problem was finding the right way of eating, which turned out to be dramatically different to the diet recommended by my Continue reading >>
Average blood glucose and the A1C test Your A1C test result (also known as HbA1c or glycated hemoglobin) can be a good general gauge of your diabetes control, because it provides an average blood glucose level over the past few months. Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you check blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target of 7% or lower recommended by the American Diabetes Association (ADA) for many adults who are not pregnant. For some people, a tighter goal of 6.5% may be appropriate, and for others, a less stringent goal such as 8% may be better.1 Talk to your doctor about the right goal for you. GET YOURS FREE The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management. See how average daily blood sugar may correlate to A1C levels.2 Enter your average blood sugar reading and click Calculate. *Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes. What is A1C? Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a Continue reading >>
The Hemoglobin A1c (hba1c) Test For Diabetes
The Hemoglobin A1c (HbA1c) Test for Diabetes A1c testing is gaining support as the best standard of measuring blood sugar levels. Glycosylated (or glycated) hemoglobin (hemoglobin A1c, Hb1c , HbA1c, or A1C; sometimes also HgA1c) is a form of hemoglobin used primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic pathway by hemoglobin's normal exposure to high plasma levels of glucose. Glycosylation of hemoglobin has been implicated in nephropathy and retinopathy in diabetes mellitus. Monitoring the HbA1c in type-1 diabetic patients may improve treatment. Importance of Hemoglobin A1c Test The hemoglobin A1c test -- also called HbA1c, glycated hemoglobin test, or glycohemoglobin -- is an important blood test used to determine how well your diabetes is being controlled. Hemoglobin A1c provides an average of your blood sugar control over a six to 12 week period and is used in conjunction with home blood sugar monitoring to make adjustments in your diabetes medicines. Hemoglobin is a substance within red blood cells that carries oxygen throughout your body. When your diabetes is not controlled (meaning that your blood sugar is too high), sugar builds up in your blood and combines with your hemoglobin, becoming "glycated." Therefore, the average amount of sugar in your blood can be determined by measuring a hemoglobin A1c level. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. The amount of hemoglobin A1c will reflect the last several weeks of blood sugar levels, typically encompassing a period of 120 days. History of the A1c test Hemoglobin A1c was first separated from other forms of hemoglobin by Huisman and Meyering in 1958 using a chromatographic column. Continue reading >>
Asknadia: My Doctor Won’t Perform Surgery Because Of My High A1c
Dear Nadia: I have diabetes and am in desperate need of knee surgery. My doctor won’t perform the surgery because my A1c has been between 7.1% and 7.4% for the past year. My insulin doses have been adjusted but I can’t seem to get below 7%, which is where they want me. This has really affected my quality of life. Do you think I should get a second opinion? Kris Dear Kris: I think you should get a second opinion. But it’s not because I think you’ll find a doctor who is willing to accept a higher A1c. It’s because I think a second opinion will let you see for yourself how cautious doctors are when dealing with a person with diabetes who wants to undergo elective surgery. The reasons why surgeons are reluctant to operate on patients with high A1c’s is that high blood sugars substantially increase the threat of post-operative infections and cardiovascular problems. The 7% goal your doctor wants you to meet is the generally accepted A1c percentage in the medical community. The ideal range for avoiding complications from surgery is from 80mg/dL to 150 mg/dL. That higher figure is already way above the 4.4% A1c (80 mg/dL) that is considered a normal blood glucose reading for people who do not have diabetes. So, assuming that your second opinion confirms the first, how do you get yourself down to 7%? It depends on the effectiveness of your insulin(s) and your personal diet and exercise habits. (Obviously, your knee is preventing you from regular exercise, so you have to look at insulin and diet as your main means of control.) First, you may want to look at how you are using your basal insulin. Can you track when it reaches its peak and how long that peak lasts? If you can answer this and share it with your physician, they may want you to try a different basal insuli Continue reading >>
My 3 Monthly Average Test Came To 7.4 .am I A Diebatic Or Borderline.do I Need Medicine
MY 3 MONTHLY AVERAGE TEST CAME TO 7.4 .AM I A DIEBATIC OR BORDERLINE.DO I NEED MEDICINE WELL I HAVE BEEN PRESCRIBED AYURVEDIC PROGRAMME FOR 20 DAYS. I AM CONFIDENT WILL BRING DOWN THE LEVELS. THEREAFTER I PLAN TO CHECK THE LEVELS TO DECIDE IF MEDICINES WERE TO CONTINUE. DO U ENDORSE THIS The sugar levels constantly monitored on day to day basis both fasting and PP for three months is what depicted in A1c tests, but the test also indicates the ups and downs of the daily average. Get it done once in three months till you get uniform results. Continue reading >>
Getting Hemoglobin A1c Under Control After A Relapse
Getting hemoglobin A1c under control after a relapse Getting hemoglobin A1c under control after a relapse A patient with diabetes questions the necessity of starting a statin. A patient, aged 57 years, was diagnosed with type 2 diabetes 5 years ago when her blood sugar was found to be elevated at 300 mg/dL, with a hemoglobin A1c of 8.9%. She experienced extreme fatigue at that time. She was started on metformin, along with recommendations for diet, exercise, and weight loss. One year later with the addition of metformin and titration up to 1000 mg twice daily, as well as improved diet, exercise, and a 10% weight loss, her hemoglobin A1c (HbA1c) improved to 7.7%. With this elevation in HbA1c, it was recommended that she take glipizide 5 mg once daily in addition to metformin. It was also suggested that her blood glucose values be metered 2 to 3 times weekly at alternating times. Glipizide was later increased to 5 mg twice daily to improve control. Nine months ago, she was hospitalized for right knee surgery. Just prior to this admission, she stated that she had decided to stop taking glipizide and was continuing to work on eating a healthy diet. She denied hypoglycemia or other adverse effects on glipizide, and stated that she simply no longer wanted to take the medication. She was not currently exercising due to knee pain. Her HbA1c was found to be elevated at 7.4%. At time of discharge, it was recommended she continue with dietary modifications, exercise as tolerated, and resume glipizide 5 mg once daily, It was also recommended that she continue with metering blood glucose values 2 to 3 times weekly at alternating times, and take metformin again in an effort to improve control. She was seen 3 months later as an outpatient, and her HbA1c had improved to 6.7%. She admi 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 >>
Symptoms And Aclevels | Diabetic Connect
My personal opinion get to the doctor and get chcked out and tell him the symptoms. Could be something else underlying or current treament not working. Go see doctor today I'm sure our other DC friends here agree Thankswas waiting to see but based on your post will call doc today. Made appt with a registered dietician/diabe counselor or this Friday ad well. Thanks again. I'm a newly diagnosed Type 2 (5 months). My A1C is 5.4 and I "control" bg with diet and exercise. I still came down with neuropathy and it is a nightmare. You should get to a doctor right away because the longer you wait, the greater the damage you could do to yourself. So please, don't "wait this one out." I have managed to help myself with R-alpha lipoic acid and a TENS machine in an effort to get away from painkillers. It has helped a lot, but I do deal with it every single day. An A1c of 7.4 is higher than ideal but it's hard to really go off that because one A1c doesn't tell you how long you have had diabetes. Tingling in feet is often a symptom of diabetic neuropathy and blurry vision is also a symptom of high blood sugar. Neuropathy is not something you want and lowing blood sugar can help but you should tell your doctor about it sooner rather than later. Blurry vision can happen with rapidly changing blood sugar or high blood sugar. It could be a symptom of damage to your eye but it doesn't have to be. Diabetics should get a yearly dilated eye exam so it wouldn't be a bad idea to schedule one. You have to keep in mind that your blood sugar could have been high for weeks, months, even years before you were diagnosed so it's very possible to have side effects before you are even diagnosed. Continue reading >>
Just Diagnosed With An A1c Of 7.4. Weight Loss Question.
Just diagnosed with an A1c of 7.4. Weight loss question. Just diagnosed with an A1c of 7.4. Weight loss question. Hi everyone. I was just diagnosed last week with type 2. My Ac1 was 7.4, I didn't know my blood was being tested for Diabetes, thought it was a blood test for cholesterol. Anyway, after the initial diagnosis shock, my PCP wanted to start me on meds, I refused. She has given me two months to lose 20lbs and get my Ac1 down to an acceptable level, what that level is I do not know. I pretty much stopped eating, have gone to under 1000 calories a day, eating very clean, very low carb, probably under 40 a day. I have already dropped about 10 lbs (I'm sure a lot of it's water). My question is this, my wife is freaking out because she doesn't think i'm eating enough, I'm trying to eat even less because I would like to be at least 30lbs lighter by my next appointment. My wife aside, the main issue I am having right now is pain in my left lower rib cage that radiates to the back. This has been a recurrent issue prior to the diagnosis, this new diet seems to have triggered it again. I am "spacy", shaky and having difficulty thinking clearly or finding the right "words" but I don't know if it's calorie restriction causing it or my blood sugar. Any suggestion? D.D. Family Type 2 since June 2014, levemir & metformin Every diabetic is different and if you have an a1c of 7.4, that well puts you into the diabetic category. For many of us diabetics, any kind of fasting needs to be much more methodical. Your liver will dump glycogen into your blood stream if you are not careful so the reduction in eating can often times make things worse, not better (i.e. nutrition issues compiled with high blood sugar from your liver). There are many successful methods of fasting for diabeti 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 >>
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 >>
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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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 >>
Why Do My A1c Results From Different Sources Vary?
Dear Peter: You ask a fascinating question. The amount of sugar or glucose in the blood varies throughout the day. When a person eats a meal with a lot of starches or sugars, the glucose level blood goes up. In a nondiabetic person the glucose level goes down to normal, which is generally 80 to 110 milligrams per deciliter, in less than two hours. People with severe diabetes may require oral drugs or an insulin injection to lower their blood sugar. Hemoglobin is a protein that is found in red blood cells. Its primary purpose is to carry oxygen from the lungs to organs throughout the body. Red blood cells are made in the bone marrow and move to the blood stream where they live for about 120 days. While in the bloodstream, glucose can penetrate the red blood cell wall and bind to hemoglobin. Hemoglobin A1C (also called HgA1C or A1C) is a measure of glycated hemoglobin. This is the percentage of one's hemoglobin that has glucose bound to it. It can be used as a measure of what a persons' blood sugars have been over the previous three months or so. An HgA1C of 6.5 percent is an average blood sugar of 135 mg/dl. Someone with A1C results of 6.8 to 7.4 percent has reasonable control of his or her blood sugar, but I would want most patients to have even better control. A measure of 8 percent or greater really needs to be under better control. We see high HgA1Cs that are accurate measurements, but not reflective of glucose control in people with low red cell turnover from iron, vitamin B12 or folate deficiency. HgA1C values may be elevated or decreased in those with chronic kidney disease. These disorders can generally be diagnosed through some simple, highly available blood tests. There are a few drugs that can change hemoglobin distribution and cause A1C readings that are not Continue reading >>
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 >>