What Is A Good Score On The A1c Diabetes Test?
Normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time can have an A1C level above 9 percent. A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate dates indicates diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which is high risk of developing diabetes. For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan. Remember, the higher your A1C level, the higher your risk of diabetes complications. A good score on the A1C test depends on whether you’ve been diagnosed with diabetes. For those who do not have diabetes, a score of less than 5.7% is considered normal, while 5.7% to 6.4% indicates prediabetes and 6.5% or higher means you have diabetes. If you already have diabetes, a score of 7% or lower is desired. You and your doctor can decide what score is best for you. The A1C diabetes test is a way to get an average of how well your blood sugar has been controlled for the past three months. The standard A1C goal for most people with diabetes is less than 7%. However, the goal may be individualized or may be different for some people, especially older adults, people with heart disease or those who are prone to frequent low blood glucose. It's a good idea to find out what your A1C goal should be from your healthcare provider and then use that as a benchmark for your A1C results. 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 Continue reading >>
My Site - Chapter 9: Monitoring Glycemic Control
Glycated hemoglobin (A1C) is a valuable indicator of glycemic treatment effectiveness and should be measured at least every 3 months when glycemic targets are not being met and when antihyperglycemic therapy is being adjusted. In some circumstances, such as when significant changes are made to therapy or during pregnancy, it is appropriate to check A1C more frequently. Awareness of all measures of glycemiaself-monitored blood glucose results, including self-monitored blood glucose (SMBG), flash glucose monitoring (FGM), continous glucose monitoring (CGM) and A1Cprovides the best information to assess glycemic control. Self-monitoring of blood glucose, FGM and CGM should not be viewed as glucose-lowering interventions, but rather as aids to assess the effectiveness of glucose-lowering interventions and to prevent and detect hypoglycemia. Timing and frequency of SMBG may be determined individually based on the type of diabetes, the type of antihyperglycemic treatment prescribed, the need for information about blood glucose levels and the individual's capacity to use the information from testing to modify healthy behaviours or self-adjust antihyperglycemic agents. SMBG, FGM and CGM linked with a structured educational and therapeutic program designed to facilitate behaviour change can improve blood glucose levels and prevent hypoglycemia. A1C is a measurement of your average blood glucose control for the last 2 to 3 months. Approximately 50% of the value comes from the last 30 days. You should have your A1C measured every 3 months when your blood glucose targets are not being met or when you are making changes to your diabetes management. In some circumstances, such as when significant changes are made to your glucose-lowering therapy or during pregnancy, your health-care Continue reading >>
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- Effect of Fructose on Glycemic Control in Diabetes
- Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators
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 >>
Population Health Approach For Diabetic Patients With Poor A1c Control
A population health management approach to identify, track, and intervene with diabetic patients before their blood sugar becomes poorly controlled can improve their overall health. Background: Diabetes is frequently monitored as part of quality programs and initiatives. The glycated hemoglobin (A1C) test and corresponding values are often used as quality metrics, and patients with values of 9.0% or above (9+) tend to utilize intensive resources. However, this strategy may be missing more profound opportunities to improve quality. Objectives: To analyze A1C outcomes in 2 ways: (1) year over year for patients identified as diabetic and (2) from test to test. Methods: This study was conducted using data on more than 23,000 patients identified as having diabetes and included A1C laboratory results extracted from electronic medical records. Results: The percentage of patients with poorly controlled diabetes (9+) is increasing annually, but there is sizable turnover within the population— meaning that new uncontrolled patients replace those whose outcomes improve. More than half (57.5%) of patients have their first 9+ score on their first test. And for those with a prior 9+ result, only 16.8% have 3 consecutive 9+ scores after their initial 9+ test. For all patients, the longer the interval between tests, the greater the probability that the next test result will be 9+. Conclusion: Instead of focusing resources only on the highly dynamic and relatively small subpopulation of patients with 9+ scores, a better option may be ensuring that all patients get regular testing according to appropriate protocols. This total population-based approach would engage all diabetic patients inside and outside practice walls to optimize provider ability to impact health outcomes. Am J Manag Continue reading >>
- Team-based approach helps patients better control type 2 diabetes
- Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case–control study
- Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators
What Is A1c? The Answers To Your Most Important A1c Questions
What is A1C? Nicole Fornabaio/Rd.com There are diabetes tests every diabetic should know about, and the A1C is a screen that has been used to monitor and track blood glucose for more than 40 years. Health-care providers use this tool to get a three-month window into a patient's blood sugar levels. "It helps us analyze if you are under good, moderate, or poor glucose control, and can thus help us direct comprehensive care recommendations, and work with you in achieving and maintaining good compliance of treatment goals," says Mona Morstein, a naturopathic doctor and author of Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes and founder and executive director of the Low Carb Diabetes Association. Don't miss this step-by-step plan for reversing diabetes. What is the A1C chart measuring? Nicole Fornabaio/Rd.com A1C is a protein in red blood cells, and it binds with glucose (blood sugar), explains Dr. Morstein. Because these red blood cells have a lifespan of about three to four months, the amount of glucose on A1C protein reveals a long-term picture of blood sugar levels. For example, an A1C of 6.0 simply means about 6 percent of glucose is attached to the red blood cells, and that can give both patients and doctors a sense of the average blood sugar level over time, as opposed to pinprick blood sugar tests, which capture levels at one particular moment. And if you're battling fluctuating levels, here are seven ways to control your blood sugar. What range should I shoot for? Nicole Fornabaio/Rd.com The American Diabetes Association recommends aiming under an A1C score of 7 percent (that translates to a daily average glucose level of 154 milligrams per deciliter of blood). However, your doctor may recommend a different number de Continue reading >>
What Is A1c?
Q: The doctor told my mother she has diabetes and her blood glucose is out of control. He said her A1C was 9. What does that mean? A: Glycosylated hemoglobin, often referred to as HbA1c or simply A1C, is the measure of a person's average blood glucose level (all the ups and downs) over the last two to three months. The purpose of the A1C test is to give you a sense of your blood glucose control. It is reported as a percent. The American Diabetes Association recommends that most people get their A1C down to 7 percent or less. Other diabetes organizations, such as the International Diabetes Federation, suggest 6.5 percent. If your mother's A1C level is 9 percent, this means her blood glucose level, on average, is about 210 mg/dl. This result is high and unhealthy. She should take some action to improve her blood glucose control, such as eating more healthfully, being more active, and changing or adding to her blood-glucose-lowering medications. To find out which course of action is right for her, encourage her to discuss this with her diabetes care providers. Thanks for asking. Knowledge is power! Jeannette Jordan, M.S., R.D., CDE, is the American Dietetic Association's national spokesperson for African-American nutrition issues and oversees nutrition education at the Medical University of South Carolina in Charleston. Continue reading >>
Hemoglobin A1c (hba1c) Poor Control (>9%) (cms 122v5)
Quality Payment Program >> Quality Measures >> Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) (CMS 122v5) Under MIPS, eligible clinicians will be required to report up to 6 quality measures, including at least one outcome measure or high-priority measure, for a minimum of 90 days during the 2017 performance year. Practice Fusion currently supports 23 eCQMs that can be reported for MIPS for the 2017 performance year. eCQM: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) CMS ID: CMS 122v5 NQF Number: 0059 NQS Domain: Effective Clinical Care Measure Type: Intermediate Outcome MIPS High Priority Measure: Yes Eligible for Quality Programs: Merit-Based Incentive Payment System (MIPS) Medicaid EHR Incentive Program (Meaningful Use) Comprehensive Primary Care Plus (CPC+) Description: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period Numerator: Patients from the denominator whose most recent HbA1c level (performed during the measurement period) is > 9.0%. Denominator: Patients 18-75 years of age with diabetes with an eligible visit (chart notes with one of the following encounter types: Office Visit, Nursing Home Visit, Nurse Visit or Home Visit) during the measurement period. Denominator Exclusions: None Denominator Exceptions: None Performance Benchmark for MIPS: 0% (Zero Percent*) This eCQM is an inverse measure, which means a lower performance rate indicates better performance. In Practice Fusion’s eCQM Dashboard, the EHR displays an inverse performance rate for this measure to make it easier to quickly see how you are performing. This means that the measure percentage will increase as the measure numerator decreases. Specifically, a higher measure percentage and lower measure numerator are an indic 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 >>
Is Insulin The Preferred Treatment For Hba1c >9%?
Abstract The algorithms and guidelines of the American Association of Clinical Endocrinologists and the American Diabetes Association recommend that insulin administration be strongly considered for people with type 2 diabetes (T2D) with HbA1c levels exceeding 9.0% and 10%, respectively. Although the caveat is given in both sets of recommendations that this is particularly appropriate when patients are "symptomatic," referring to urinary frequency with increased thirst and appetite, weight loss, and ketosis, the clinical definition of such presentations may be ill-defined, and it is noteworthy that both documents consider insulin to offer particular benefit under such circumstances. However, with multiple options for glycemic treatment, it is of interest to reconsider this argument for insulin use. It should be recalled that in the UK Prospective Diabetes Study, diet alone was associated with a reduction in HbA1c from 9% to 7%. Drug-naïve people with T2D do often show surprisingly strong reductions in HbA1c with metformin-based dual-agent oral treatment approaches; a recent report showed that even with baseline HbA1c >11%, the combination of metformin with a sulfonylurea, pioglitazone, or sitagliptin was associated with reduction in HbA1c from 11.6% to 6.0%. A 32-week study of the combination of rosiglitazone with metformin in patients with mean baseline HbA1c 8.9% showed a mean HbA1c reduction of 2.3%, and an open-label cohort with baseline HbA1c 11.8% had a reduction in HbA1c to 7.8%. With metformin plus sitagliptin, a mean placebo-adjusted HbA1c reduction of 2.1% from a baseline of 8.8% was reported, with those patients with baseline HbA1c >9% having a 2.6% reduction in HbA1c, and an open-label cohort with baseline HbA1c 11.2% having a 2.9% reduction in HbA1c. Simil Continue reading >>
Your A1c Results: What Do They Mean?
If you have diabetes, you should have an A1C test at least twice each year to find out your long-term blood glucose control. The A1C test measures your average blood glucose during the previous 2-3 months, but especially during the previous month. For people without diabetes, the normal A1C range is 4-6%. For people with diabetes, the lower the A1C value, the better the diabetes control and the lower the risk of developing complications such as eye, heart, and kidney disease. Your goal should be to have A1C values less than 7%. That may be a hard target to hit, but it is important to try because the lower your A1C, the lower your health risk. The table on this page shows what your A1C results say about your blood glucose control during the past few months. Some people are surprised when they have a high A1C result because when they check their blood glucose with their meter, they have relatively low numbers. But remember that checking your blood glucose gives you only a momentary sample of your blood glucose control. The A1C test measures your blood glucose control at all times during the previous 2-3 months, even times such as after meals or when you are asleep, when you don't usually check your blood glucose. Think of the A1C test as feedback to help you better control your diabetes and improve your diabetes care habits. By giving you important information about your long-term control, the A1C test can help you stay motivated to do your best on diabetes self care. Talk with your doctor and other members of the health care team about your A1C results and how you can use them to better manage diabetes. Within the next few months, the federal government will implement the first major reorganization of the Medicare system for many years: the Medicare Prescription Drug Imp 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 >>
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 >>
How To Lower Your A1c Levels: A Healthful Guide
An A1C blood test measures average blood sugar levels over the past 2 to 3 months. The American Diabetes Association (ADA) recommend the use of A1C tests to help diagnose cases of prediabetes, type 1, and type 2 diabetes. A1C tests are also used to monitor diabetes treatment plans. What is an A1C test? An A1C test measures how well the body is maintaining blood glucose levels. To do this, an A1C test averages the percentage of sugar-bound hemoglobin in a blood sample. When glucose enters the blood, it binds to a red blood cell protein called hemoglobin. The higher blood glucose levels are, the more hemoglobin is bound. Red blood cells live for around 4 months, so A1C results reflect long-term blood glucose levels. A1C tests are done using blood obtained by a finger prick or blood draw. Physicians will usually repeat A1C tests before diagnosing diabetes. Initial A1C tests help physicians work out an individual's baseline A1C level for later comparison. How often A1C tests are required after diagnosis varies depending on the type of diabetes and management factors. Lowering A1C levels Many studies have shown that lowering A1C levels can help reduce the risk or intensity of diabetes complications. With type 1 diabetes, more controlled blood glucose levels are associated with reduced rates of disease progression. With type 2 diabetes, more controlled A1C levels have also been shown to reduce symptoms affecting the small arteries and nerves in the body. This influences eyesight and pain while decreasing complications. Long-term studies have also shown that early and intensive blood glucose control can reduce cardiovascular complications in people with type 1 or 2 diabetes. Even small changes in A1C levels can have big effects. The ADA recommend that maintaining fair control 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 >>
2017 Mips Measure #001: Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%)
Valid Data Submission Method(s) Measure Type High Priority Measure? NQS Domain Specialty Measure Sets Claims, EHR, CMS Web Interface, Registry Intermediate Outcome Yes Effective Clinical Care Internal Medicine, Preventive Medicine, General Practice/Family Medicine Measure Description Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period Instruction This measure is to be reported a minimum of once per performance period for patients with diabetes seen during the performance period. The most recent quality-data code submitted will be used for performance calculation. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. Denominator Patients 18 – 75 years of age with diabetes with a visit during the measurement period Denominator Criteria (Eligible Cases): Patients 18 through 75 years of age on date of encounter AND Diagnosis for diabetes (ICD-10-CM): E10.10, E10.11, E10.21, E10.22, E10.29, E10.311, E10.319, E10.3211, E10.3212, E10.3213, E10.3219, E10.3291, E10.3292, E10.3293, E10.3299, E10.3311, E10.3312, E10.3313, E10.3319, E10.3391, E10.3392, E10.3393, E10.3399, E10.3411, E10.3412, E10.3413, E10.3419, E10.3491, E10.3492, E10.3493, E10.3499, E10.3511, E10.3512, E10.3513, E10.3519, E10.3521, E10.3522, E10.3523, E10.3529, E10.3531, E10.3532, E10.3533, E10.3539, E10.3541, E10.3542, E10.3543, E10.3549, E10.3551, E10.3552, E10.3553, E10.3559, E10.3591, E10.3592, E10.3593, E10.3599, E10.36, E10.37X1, E10.37X2, E10.37X3, E10.37X9, E10.39, E10.40, E10.41, E10.42, E10.43, E10.44, E10.49, E10.51, E10.52, E10.59, E10.610, E10.618, E10.620, E10.621, E10.622, E10.628, E10.630, E10.638, E10.64 Continue reading >>