All About The Hemoglobin A1c Test
People with diabetes used to depend only on urine tests or daily finger sticks to measure their blood sugars. These tests are accurate, but only in the moment. As an overall measurement of blood sugar control, they’re very limited. This is because blood sugar can vary wildly depending on the time of day, activity levels, and even hormone changes. Some people may have high blood sugars at 3 a.m. and be totally unaware of it. Once A1C tests became available in the 1980s, they became an important tool in controlling diabetes. A1C tests measure average blood glucose over the past two to three months. So even if you have a high fasting blood sugar, your overall blood sugars may be normal, or vice versa. A normal fasting blood sugar may not eliminate the possibility of type 2 diabetes. This is why A1C tests are now being used for diagnosis and screening of prediabetes. Because it doesn’t require fasting, the test can be given as part of an overall blood screening. The A1C test is also known as the hemoglobin A1C test or HbA1C test. Other alternate names include the glycosylated hemoglobin test, glycohemoglobin test, and glycated hemoglobin test. A1C measures the amount of hemoglobin in the blood that has glucose attached to it. Hemoglobin is a protein found inside red blood cells that carries oxygen to the body. Hemoglobin cells are constantly dying and regenerating, but they have a lifespan of approximately three months. Glucose attaches, or glycates, to hemoglobin, so the record of how much glucose is attached to your hemoglobin also lasts for about three months. If there’s too much glucose attached to the hemoglobin cells, you’ll have a high A1C. If the amount of glucose is normal, your A1C will be normal. The test is effective because of the lifespan of the hemogl Continue reading >>
Goals For Blood Glucose Control
Discuss blood glucose (sugar) targets with your healthcare team when creating your diabetes management plan. People who have diabetes should be testing their blood glucose regularly at home. Regular blood glucose testing helps you determine how well your diabetes management program of meal planning, exercising and medication (if necessary) is doing to keep your blood glucose as close to normal as possible. The results of the nationwide Diabetes Control and Complications Trial (DCCT) show that the closer you keep your blood glucose to normal, the more likely you are to prevent diabetes complications such as eye disease, nerve damage, and other problems. For some people, other medical conditions, age, or other issues may cause your physician to establish somewhat higher blood glucose targets for you. The following chart outlines the usual blood glucose ranges for a person who does and does not have diabetes. Use this as a guide to work with your physician and your healthcare team to determine what your target goals should be, and to develop a program of regular blood glucose monitoring to manage your condition. Time of Check Goal plasma blood glucose ranges for people without diabetes Goal plasma blood glucose ranges for people with diabetes Before breakfast (fasting) < 100 70 - 130 Before lunch, supper and snack < 110 70 - 130 Two hours after meals < 140 < 180 Bedtime < 120 90- 150 A1C (also called glycosylated hemoglobin A1c, HbA1c or glycohemoglobin A1c) < 6% < 7% < = less than > = greater than > = greater than or equal to < = less than or equal to Information obtained from Joslin Diabetes Center's Guidelines for Pharmacological Management of Type 2 Diabetes. Continue reading >>
Blood Sugar Levels For Adults With Diabetes
Each time you test your blood sugar, log it in a notebook or online tool or with an app. Note the date, time, results, and any recent activities: What medication and dosage you took What you ate How much and what kind of exercise you were doing That will help you and your doctor see how your treatment is working. Well-managed diabetes can delay or prevent complications that affect your eyes, kidneys, and nerves. Diabetes doubles your risk for heart disease and stroke, too. Fortunately, controlling your blood sugar will also make these problems less likely. Tight blood sugar control, however, means a greater chance of low blood sugar levels, so your doctor may suggest higher targets. 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 >>
What Are The Ideal Levels Of Blood Sugar?
A blood sugar or blood glucose chart identifies ideal blood sugar levels throughout the day, including before and after meals. Doctors use blood sugar charts to set target goals and monitor diabetes treatment plans. Blood sugar charts also help those with diabetes assess and self-monitor blood sugar test results. What is a blood sugar chart? Blood sugar charts act as a reference guide for blood sugar test results. As such, blood sugar charts are important tools for diabetes management. Most diabetes treatment plans involve keeping blood sugar levels as close to normal or target goals as possible. This requires frequent at-home and doctor-ordered testing, along with an understanding of how results compare to target levels. To help interpret and assess blood sugar results, the charts outline normal and abnormal blood sugar levels for those with and without diabetes. In the United States, blood sugar charts typically report sugar levels in milligrams per deciliter (mg/dL). In the United Kingdom and many other countries, blood sugar is reported in millimoles per liter (mmol/L). A1C blood sugar recommendations are frequently included in blood sugar charts. A1C results are often described as both a percentage and an average blood sugar level in mg/dL. An A1C test measures the average sugar levels over a 3-month period, which gives a wider insight into a person's overall management of their blood sugar levels. Blood sugar chart guidelines Appropriate blood sugar levels vary throughout the day and from person to person. Blood sugars are often lowest before breakfast and in the lead up to meals. Blood sugars are often highest in the hours following meals. People with diabetes will often have higher blood sugar targets or acceptable ranges than those without the condition. These Continue reading >>
What Are Blood Sugar Target Ranges? What Is Normal Blood Sugar Level?
Understanding blood sugar target ranges to better manage your diabetes As a person with diabetes, you may or may not know what your target ranges should be for your blood sugars first thing in the morning, before meals, after meals, or at bedtime. You may or may not understand what blood sugar ranges are for people without diabetes. You may or may not understand how your A1C correlates with your target ranges. How do you get a clear picture of what is going on with your blood sugar, and how it could be affecting your health? In this article, we will look at what recommended blood sugar target ranges are for people without diabetes. We will look at target ranges for different times of the day for people with diabetes. We will look at target ranges for Type 1 versus Type 2 diabetes. Is there a difference? We will also look at what blood sugars should be during pregnancy for those with gestational diabetes. We will look at other factors when determining blood sugar targets, such as: Age Other health conditions How long you’ve had diabetes for Stress Illness Lifestyle habits and activity levels We will see how these factors impact target ranges for your blood sugars when you have diabetes. We will learn that target ranges can be individualized based on the factors above. We will learn how target ranges help to predict the A1C levels. We will see how if you are in your target range, you can be pretty sure that your A1C will also be in target. We will see how you can document your blood sugar patterns in a notebook or in an “app,” and manage your blood sugars to get them in your target ranges. First, let’s look at the units by which blood sugars are measured… How is blood sugar measured? In the United States, blood sugar is measured in milligrams per deciliter (by w Continue reading >>
Print Symptoms of type 1 diabetes often appear suddenly and are often the reason for checking blood sugar levels. Because symptoms of other types of diabetes and prediabetes come on more gradually or may not be evident, the American Diabetes Association (ADA) has recommended screening guidelines. The ADA recommends that the following people be screened for diabetes: Anyone with a body mass index higher than 25, regardless of age, who has additional risk factors, such as high blood pressure, a sedentary lifestyle, a history of polycystic ovary syndrome, having delivered a baby who weighed more than 9 pounds, a history of diabetes in pregnancy, high cholesterol levels, a history of heart disease, and having a close relative with diabetes. Anyone older than age 45 is advised to receive an initial blood sugar screening, and then, if the results are normal, to be screened every three years thereafter. Tests for type 1 and type 2 diabetes and prediabetes Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is considered normal. If the A1C test results aren't consistent, the test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — your doctor may use the following tests to diagnose diabetes: Random blood sugar Continue reading >>
Blood Sugar Level
The fluctuation of blood sugar (red) and the sugar-lowering hormone insulin (blue) in humans during the course of a day with three meals. One of the effects of a sugar-rich vs a starch-rich meal is highlighted. The blood sugar level, blood sugar concentration, or blood glucose level is the amount of glucose present in the blood of humans and other animals. Glucose is a simple sugar and approximately 4 grams of glucose are present in the blood of humans at all times. The body tightly regulates blood glucose levels as a part of metabolic homeostasis. Glucose is stored in skeletal muscle and liver cells in the form of glycogen; in fasted individuals, blood glucose is maintained at a constant level at the expense of glycogen stores in the liver and skeletal muscle. In humans, glucose is the primary source of energy, and is critical for normal function, in a number of tissues, particularly the human brain which consumes approximately 60% of blood glucose in fasted, sedentary individuals. Glucose can be transported from the intestines or liver to other tissues in the body via the bloodstream. Cellular glucose uptake is primarily regulated by insulin, a hormone produced in the pancreas. Glucose levels are usually lowest in the morning, before the first meal of the day, and rise after meals for an hour or two by a few millimoles. Blood sugar levels outside the normal range may be an indicator of a medical condition. A persistently high level is referred to as hyperglycemia; low levels are referred to as hypoglycemia. Diabetes mellitus is characterized by persistent hyperglycemia from any of several causes, and is the most prominent disease related to failure of blood sugar regulation. There are different methods of testing and measuring blood sugar le Continue reading >>
In diagnosing diabetes, physicians primarily depend upon the results of specific glucose tests. However, test results are just part of the information that goes into the diagnosis of type 1 or type 2 diabetes. Doctors also take into account your physical exam, presence or absence of symptoms, and medical history. Some people who are significantly ill will have transient problems with elevated blood sugars, which will then return to normal after the illness has resolved. Also, some medications may alter your blood glucose levels (most commonly steroids and certain diuretics, such as water pills). The 2 main tests used to measure the presence of blood sugar problems are the direct measurement of glucose levels in the blood during an overnight fast and measurement of the body's ability to appropriately handle the excess sugar presented after drinking a high glucose drink. Fasting Blood Glucose (Blood Sugar) Level A value above 126 mg/dL on at least 2 occasions typically means a person has diabetes. The Oral Glucose Tolerance Test An oral glucose tolerance test is one that can be performed in a doctor's office or a lab. The person being tested starts the test in a fasting state (having no food or drink except water for at least 10 hours but not greater than 16 hours). An initial blood sugar is drawn and then the person is given a "glucola" bottle with a high amount of sugar in it (75 grams of glucose or 100 grams for pregnant women). The person then has their blood tested again 30 minutes, 1 hour, 2 hours, and 3 hours after drinking the high glucose drink. For the test to give reliable results, you must be in good health (not have any other illnesses, not even a cold). Also, you should be normally active (for example, not lying down or confined to a bed like a patient in a Continue reading >>
Glucose: Reference Range, Interpretation, Collection And Panels
Postprandial plasma glucose at 2 hours: Less than 140 mg/dL Random plasma glucose: Less than 140 mg/dL Serum glucose values are 1.15% lower than plasma glucose values. [ 1 ] Values for diabetes mellitus are as follows: Fasting plasma glucose: Greater than 125 mg/dL Random plasma glucose: Greater than 200 mg/dL Postprandial glucose at 2 hours: Greater than 200 mg/dL Impaired fasting glucose: Fasting glucose of 100-125 mg/dL Impaired glucose tolerance testing: Postprandial glucose at 2 hours of 140-200 mg/dL The value for hypoglycemia is as follows: Collect 0.5-1 ml of blood in gray-top tube containing sodium fluoride. For serum glucose, a red-top tube can be used. Serum is separated within 45 minutes of collection. For fasting glucose testing, collect the blood sample in the morning after an overnight or 8-hour fast. For postprandial glucose testing, collect the blood sample 2 hours after a regular meal. For oral glucose tolerance testing, after oral intake of 75 g of glucose, collect blood samples at 1 hour and 2 hours. For gestational diabetes testing, parameters are 1 hour after 50 g of glucose and 2 hours after 100 g of glucose. Glucose is a monosaccharide and is a primary metabolite for energy production in the body. Glucose enters via GLUT receptors. Of the 10 GLUT receptors, GLUT-4 receptors are present in muscle and adipose tissues and require insulin for glucose transport. Glucose is initially used by glycolysis and is converted to pyruvate. During this process, 4 adenosine triphosphates (ATPs) and 2 NADHs are generated and 2 ATPs are used, resulting in net production of 2 ATPs. This process does not use oxygen (anaerobic metabolism). In the presence of oxygen, pyruvate undergoes metabolism by the Krebs cycle in the mitochondria. During the Krebs cycle, each mo Continue reading >>
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- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
Diabetes Tests & Diagnosis
Your health care professional can diagnose diabetes, prediabetes, and gestational diabetes through blood tests. The blood tests show if your blood glucose, also called blood sugar, is too high. Do not try to diagnose yourself if you think you might have diabetes. Testing equipment that you can buy over the counter, such as a blood glucose meter, cannot diagnose diabetes. Who should be tested for diabetes? Anyone who has symptoms of diabetes should be tested for the disease. Some people will not have any symptoms but may have risk factors for diabetes and need to be tested. Testing allows health care professionals to find diabetes sooner and work with their patients to manage diabetes and prevent complications. Testing also allows health care professionals to find prediabetes. Making lifestyle changes to lose a modest amount of weight if you are overweight may help you delay or prevent type 2 diabetes. Type 1 diabetes Most often, testing for occurs in people with diabetes symptoms. Doctors usually diagnose type 1 diabetes in children and young adults. Because type 1 diabetes can run in families, a study called TrialNet offers free testing to family members of people with the disease, even if they don’t have symptoms. Type 2 diabetes Experts recommend routine testing for type 2 diabetes if you are age 45 or older are between the ages of 19 and 44, are overweight or obese, and have one or more other diabetes risk factors are a woman who had gestational diabetes1 Medicare covers the cost of diabetes tests for people with certain risk factors for diabetes. If you have Medicare, find out if you qualify for coverage . If you have different insurance, ask your insurance company if it covers diabetes tests. Though type 2 diabetes most often develops in adults, children also ca 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 Is A Normal Blood Sugar Level?
The aim of diabetes treatment is to bring blood sugar (“glucose”) as close to normal as possible. What is a normal blood sugar level? And how can you achieve normal blood sugar? First, what is the difference between “sugar” and “glucose”? Sugar is the general name for sweet carbohydrates that dissolve in water. “Carbohydrate” means a food made only of carbon, oxygen, and hydrogen. There are various different kinds of sugars. The one our body uses most is called “glucose.” Other sugars we eat, like fructose from fruit or lactose from milk, are converted into glucose in our bodies. Then we can use them for energy. Our bodies also break down starches, which are sugars stuck together, into glucose. When people talk about “blood sugar,” they mean “blood glucose.” The two terms mean the same thing. In the U.S., blood sugar is normally measured in milligrams of glucose per deciliter of blood (mg/dl). A milligram is very little, about 0.00018 of a teaspoon. A deciliter is about 3 1/3 ounces. In Canada and the United Kingdom, blood sugar is reported in millimoles/liter (mmol/L). You can convert Canadian or British glucose levels to American numbers if you multiply them by 18. This is useful to know if you’re reading comments or studies from England or Canada. If someone reports that their fasting blood glucose was 7, you can multiply that by 18 and get their U.S. glucose level of 126 mg/dl. What are normal glucose numbers? They vary throughout the day. (Click here for a blood sugar chart.) For someone without diabetes, a fasting blood sugar on awakening should be under 100 mg/dl. Before-meal normal sugars are 70–99 mg/dl. “Postprandial” sugars taken two hours after meals should be less than 140 mg/dl. Those are the normal numbers for someone w Continue reading >>
Blood Sugar Level Ranges
Tweet Understanding blood glucose level ranges can be a key part of diabetes self-management. This page states 'normal' blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine people with diabetes. If a person with diabetes has a meter, test strips and is testing, it's important to know what the blood glucose level means. Recommended blood glucose levels have a degree of interpretation for every individual and you should discuss this with your healthcare team. In addition, women may be set target blood sugar levels during pregnancy. The following ranges are guidelines provided by the National Institute for Clinical Excellence (NICE) but each individual’s target range should be agreed by their doctor or diabetic consultant. Recommended target blood glucose level ranges The NICE recommended target blood glucose levels are stated below for adults with type 1 diabetes, type 2 diabetes and children with type 1 diabetes. In addition, the International Diabetes Federation's target ranges for people without diabetes is stated.    The table provides general guidance. An individual target set by your healthcare team is the one you should aim for. NICE recommended target blood glucose level ranges Target Levels by Type Upon waking Before meals (pre prandial) At least 90 minutes after meals (post prandial) Non-diabetic* 4.0 to 5.9 mmol/L under 7.8 mmol/L Type 2 diabetes 4 to 7 mmol/L under 8.5 mmol/L Type 1 diabetes 5 to 7 mmol/L 4 to 7 mmol/L 5 to 9 mmol/L Children w/ type 1 diabetes 4 to 7 mmol/L 4 to 7 mmol/L 5 to 9 mmol/L *The non-diabetic figures are provided for information but are not part of NICE guidelines. Normal and diabetic blood sugar ranges For the majority of healthy ind Continue reading >>
Is My Blood Sugar Normal?
“Is my blood sugar normal?” seems like a simple question – but it’s not! The answer can vary dramatically based on your situation. Let’s look at some of the factors to consider. Please remember: you should figure out your personal goals in consultation with your doctor. Normal Blood Sugar in Diabetic vs. Non-Diabetic First, a quick note on how we measure blood sugar. In the USA, blood sugars are measured by weight in milligrams per deciliter, abbreviated as mg/dL. Most everyone else uses millimole per liter, abbreviated mmol. If you are in the USA, look at the big numbers, most everyone else look at the small numbers. In a person without diabetes, blood sugars tend to stay between 70 and 100 mg/dL (3.8 and 5.5 mmol). After a meal, blood sugars can rise up to 120 mg/dL or 6.7 mmol. It will typically fall back into the normal range within two hours. In a person with diabetes, the story is much more complex: Below 70 mg/dL Below 3.8 mmol Low Blood Sugars (Hypoglycemia). When blood sugars drop below this level, you may start feeling hunger, shakiness, or racing of the heart. Your body is starved for sugar (glucose). Read how to detect and treat low blood sugars. 70 mg/dL to 140 mg/dL 3.8 mmol to 7.7 mmol Normal Blood Sugar. In this range, the body is functioning normally. In someone without diabetes, the vast majority of the time is spent in the lower half of this range. 140 mg/dL to 180 mg/dL 7.7 mmol to 10 mmol Elevated Blood Sugars. In this range, the body can function relatively normally. However, extended periods of time in this zone put you at risk for long-term complications. Above 180 mg/dL Abovoe 10 mmol High Blood Sugars. At this range, the kidney is unable to reabsorb all of the glucose in your blood and you begin to spill glucose in your urine. Your bo Continue reading >>