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# Average A1c

## Why Doesn't My Average Blood Glucose Match My A1c?!

Want to learn more about A1C? Download our Guide to A1C here! So, for most people, BGmeter average doesntaccuratelyreflect average blood glucose over a full 24 hours.A1C, on the other hand, does. If you want your BG meter average to better reflect your A1C values, check more often! And make sure you check at various times throughout the day, including 1-3 hours after eating. 2. The Average BG to A1C conversionequation is not perfect Most (if not all) average BG to A1C conversiontables and calculators use the below equation to estimate A1C: Average BG (mg/dL) = 28.7 X A1C (%) 46.7 This equation is based on data froma 2008 study of over 500 subjects (268 T1Ds, 159 T2Ds, and 80 non-diabetics)at 10 internationalcenters aroundthe world. The A1C values were all measured in a central laboratory, sodifferences in laboratory method or technique were not a factor. People were studied for 12 weeks, with two days of CGM and three days of 7-point glucose profiles each week. The BG meters used were carefully standardized and calibrated. The graph below shows the data used to derive the relationship between average glucose and A1C. As you can see, there is A LOTofscatter. A number ofdata points are offthe trend line by 1%. And for some A1C values,the spread is enormous Check out the range ofA1Cs for people with an average glucose of ~110 mg/dL it goesfrom below 4% to almost 9%! So, importantly, the study concluded that the equation could be used to convertA1C toaverage blood glucose values for most patients. Notallpatients, just most. Results of a study of 507 subjects. Published in Diabetes Care 31:1473-1478, 2008 . OK But whydo so many people have A1C values that dont follow the equation? As it turns out, the biological processesthat dictate A1C arenot exactly the same for everyone 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 >>

## What's A "normal" A1c? When Is It Misleading?

By Adithi Gandhi and Jeemin Kwon Why we use A1c, what values are recommended, and what impacts A1c – everything from anemia to vitamins Want more information just like this? Hemoglobin A1c (“HbA1c” or just “A1c”) is the standard for measuring blood sugar management in people with diabetes. A1c reflects average blood sugars over 2 to 3 months, and through studies like DCCT and UKPDS, higher A1c levels have been shown to be associated with the risk of certain diabetes complications (eye, kidney, and nerve disease). For every 1% decrease in A1c, there is significant pretection against those complications. However, as an average over a period of months, A1c cannot capture critical information such as time spent in a target range (70-180 mg/dl) and hypoglycemia (less than 70 mg/dl). This article describes why A1c is used in the first place, as well as factors that can lead to misleadingly high or low values. In a follow-up piece, we will discuss time-in-range, hypoglycemia, hyperglycemia, blood sugar variability, and how to measure and interpret them. Click to jump down to a section: What tools are available if an A1c test is not accurate or sufficient? What is A1c and why is it used? A1c estimates a person’s average blood sugar levels over a 2 to 3-month span. It is the best measure we have of how well blood glucose is controlled and an indicator of diabetes management. Though A1c doesn’t provide day-to-day information, keeping A1c low has been proven to lower the risk of “microvascular” complications like kidney disease (nephropathy), vision loss (retinopathy), and nerve damage (neuropathy). The relationship between A1c and “macrovascular” complications like heart disease is harder to show in clinical trials, but having high blood sugar is a major ris Continue reading >>

## What Does Your A1c Number Really Mean?

We dFolk are bombarded with numbers, goals, and targets. We’re frequently told where we should be, but not how high our risk is when we can’t reach our targets. Here, we break down A1C numbers into a simple green-light, yellow-light, red-light format, to give you perspective on when (and how much) to worry, when to relax, when to call your doc, and when to call 911. Green-light A1C score For most people, the target for A1C, the green light, is between 6.0% and 6.9%. These numbers are commonly expressed simply as 6.0 and 6.9, without the % sign. If your A1C falls into this zone, you’re considered to be in control. For perspective, these numbers can be converted into “meter” numbers called estimated average glucose—eAG for short. The green light eAG range is 126 mg/dL (7 mmol/l) to 151 mg/dL (8.39 mmol/l). But what if your numbers are higher than target? Or lower than target? When are you actually in danger? Yellow-light A1C score If the light turns yellow as you approach the intersection, you need to either speed up or stop. Whichever is safe under the circumstances, right? If your A1C is between 7.0 and 8.9, you’ll be classified as “out of control.” But how much danger are you in? Frankly, it depends upon how close you are to either end of the spectrum. Yellow-light A1Cs are higher than is strictly healthy, but pose no immediate harm. However, the higher you are in this range, the closer you are to a red light. We’ll talk about just how serious that can be in a minute. I should point out that there are some special cases. If you’re a very young type 1, a yellow-light A1C score may be considered in-target for you until you get older. Similarly, if you’re an elderly type 2, or have a history of severe hypoglycemia, you doctor may choose to “green Continue reading >>

## 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 >>