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Low-carb Lab Testing – Part 1 – Blood Sugar Tests

Low-carb Lab Testing – Part 1 – Blood Sugar Tests

Welcome to part 1 of our series on low-carb lab testing, where we’ll look at common blood sugar test options and how to interpret and track your results. In these posts we’ll dig into the most common lab tests one will encounter on their low-carb journey. Our goal is to educate you on what these tests mean so you can be better informed as you work to optimize your health. In this first post, we look at three tests that can be used to monitor your blood glucose levels. In subsequent posts, we’ll shift focus to insulin, lipids, thyroid and other markers that are important for patients to understand. Heads Up Health was designed to help you centralize and track all of your vital health data in one place, including important lab test results, so you can make informed and empowered decisions about your health. To get started, simply click on the button below to create your account. Or, read on for more information about common tests to help you monitor your blood sugar levels. Blood sugar, insulin and health Chronic, long term pathological elevations in blood glucose or insulin have been linked to type 2 diabetes, obesity, Alzheimer’s disease, kidney problems, deterioration of eyesight, neuropathy, poor prognosis in cancer, connective tissue irregularities, orthopedic injuries and more. Links and associations are not necessarily causal relationships, but the medical literature is robust with research detailing potential mechanisms by which chronically high blood glucose or insulin might be either directly causing or at the very least exacerbating these outcomes. With this in mind, if you’re concerned about your long term health and quality of life, keeping blood glucose and insulin within healthy ranges is one of the most important and effective things you can do. Continue reading >>

Hemoglobin (hb) A1c With Glycomark® Reflex

Hemoglobin (hb) A1c With Glycomark® Reflex

Test Details Use GlycoMark® testing provides an estimate of the patient's postmeal glucose over a one- to two-week period, making it ideal for intermediate term monitoring of glycemic control in diabetic patients. GlycoMark® testing can also help monitor the effectiveness of therapeutics targeting postprandial glucose (PPG),1,2 and it is a useful adjunct to routine A1c testing because it responds more rapidly and sensitively to hyperglycemia than A1c.1,2 Hb A1c testing provides an estimate of the patient's average blood glucose over a period of two to three months. Hb A1c testing helps assess the long term diabetic control for individuals with diabetes mellitus. Limitations Individuals using INVOKANA® may demonstrate low levels of 1,5-AG. 1,5-AG blood levels are falsely lowered by the diabetes drug INVOKANA® which prevents reabsorption of 1,5-AG in the kidneys. INVOKANA® belongs to new class of diabetes medication known as sodium-glucose cotransporter 2 (SGLT2) inhibitors, which block reabsorption of glucose in the kidneys, and other SGLT2 inhibitors may have the same effect. INVOKANA® is a trademark of Janssen Pharmaceuticals Inc. Persistently positive urinary glucose levels, or oxyhyperglycemia after gastrectomy, may result in a low 1,5-AG value. Low values have also been observed in pregnancy, terminal stage renal failure, dialysis patients, advanced cirrhosis, and prolonged incapability of oral ingestion of food. Abnormal values have also been noted in individuals with abnormal glomerular filtration rates.3,4 For some patients with severe hyperglycemia, the internal pool of 1,5-AG may tend to remain depleted as a result of persistent glucosuria. In these cases, measurements of 1,5-AG may be less indicative of initial recovery following initiation of antidiabet Continue reading >>

Why Is My A1c High When My Blood Sugar Levels Are In My Target Range?

Why Is My A1c High When My Blood Sugar Levels Are In My Target Range?

Results of an A1C test and a blood glucose check don't always match up. The A1C test measures your average blood sugar levels over a 120-day period (the lifespan of a red blood cell). But a blood glucose check measures your blood sugar at a single moment. If your blood sugar levels were high last week, and you adjusted your diabetes treatment plan so that your blood sugar returned to normal, the A1C result may still be high, because it includes the high blood sugar levels from the previous week. The A1C test measures the percentage of glycated hemoglobin in your blood. Glycated hemoglobin is created when molecules of hemoglobin (the oxygen-carrying protein in your blood) attach to molecules of glucose (the sugar in your blood). The more sugar you have in your blood, the higher your percentage of glycated hemoglobin. I want you to picture a freshly fried doughnut hole, just out of the deep fryer. Steam wafts from its surface. Still gleaming wet with oil, it’s sent spinning across a tray of powdered sugar. As it tumbles, sugar sticks to the wet oil, coating it, covering it as it rolls and bounces along. Well, the same thing happens to your red blood cells. As they tumble and spin and roll through your blood vessels, sugar molecules stick to their skins. Or another way to think of it is to picture a windshield of a truck after driving through a swarm of mosquitoes. Splat-Splat-Splat-Splat-Splat! (OK, I just threw that in so you wouldn’t log off and drive straight to Dunkin Doughnuts.) So an A1C test is a measure of how much of the skins of your red blood cells are splattered with sugar, which in turn gives as a picture of the blood sugar environment in which the cells lived, which in turn gives us a notion of your average blood sugar over the last several months. So th Continue reading >>

Anemia Can Cause False A1c Reading

Anemia Can Cause False A1c Reading

Whoa! This was news to me. Just found this little gem on a wonderful site called Diabetes-Blood-Sugar-Solutions.com. Since I’m chronically and horribly anemic from heavy menstrual periods, this was of great interest to me. After reading this, I’ll definitely be having a discussion with my doctor on my next visit. Q: Can the Hgb A1c Blood Tests give false reading? A: The A1c test can read lower than it really is if you are anemic (have low levels of hemoglobin). The more anemic you are, the more the Hgb A1c blood test is falsely lowered. If you frequently have blood sugars that meet the definition of hypoglycemia, then your A1c blood test could be in target even though you might have high blood sugars often. The highs and lows seem to average out. Don’t fool yourself into believing all is well. The highs can still do damage despite all the low sugars (which can also be unsafe). If you have great blood sugar readings at home (for all times of the day including after meals) but your Hgb A1c blood test is high, your meter might be inaccurate. Check for diabetes test strips accuracy problems. If your glycated hemoglobin is high but your before meal tests are in target, then please consider doing post prandial or “after meal” blood sugar tests. These too can affect your chance of getting complications. The Hgb A1c blood test can be higher than it really is if you have unusual hemoglobin. For example, a very small population of people (particularly of African descent) have some fetal hemoglobin which can falsely elevate the A1c reading. Continue reading >>

When The A1c Is Unreliable

When The A1c Is Unreliable

Although hemoglobin A1c is usually the best test to estimate the average glycemic control in patients with diabetes, it is unreliable in some clinical circumstances. In select patient populations, measuring fructosamine and glycated albumin levels may also be useful. _______________________________________________________________________________________________________________________________________________________ Related Content Diabetes and Cardiovascular Disease: Does Lowering Hemoglobin A1c Help or Harm? Structured Diet Plan Improves A1c in Type 2 Diabetes _____________________________________________________________________________________________________________________________________________________ Q1. What is the A1c and why is it important? A: A1c represents the percent of hemoglobin A with glucose bound to it. While the percent is normally low, in diabetics the higher glucose circulating in the blood causes more hemoglobin binding which results in a higher A1c level. It also can correlate with average glycemic control during the past 2 to 3 months. The American Diabetes Association recommends measuring A1c—≥ 6.5% (48mmol/mol)—as a diagnostic criterion for diabetes and quantifying A1c as the standard laboratory assessment to determine control of type 1 and type 2 diabetes.1 Since the publication of the Diabetes Control and Complications Trial in 1993, we know that A1c levels also directly correlate to the risk of developing diabetic complications such as retinopathy, neuropathy and nephropathy.2 Q2. When is the A1c unreliable? A: For A1c standard test results to be reliable, normal adult hemoglobin A must be present for glucose binding. However, a number of clinically significant disorders alter hemoglobin either structurally or chemically thereby aff Continue reading >>

The A1c Blood Sugar Test May Be Less Accurate In African-americans

The A1c Blood Sugar Test May Be Less Accurate In African-americans

A widely used blood test to measure blood-sugar trends can give imprecise results, depending on a person's race and other factors. This test means diabetes can sometimes be misdiagnosed or managed poorly. Doctors have been cautioned before that results from the A1C test don't have pinpoint accuracy. A study published Tuesday underscores that shortcoming as it applies to people who carry the sickle cell trait. Glucose levels in the blood rise and fall all the time, so it can be tricky to look at a single exam to diagnose diabetes or manage the disease in people who have it. But one test gets around this problem. The A1C test measures sugar that binds to hemoglobin molecules in red blood cells. It provides an average of blood sugar over the past three months, "so this has turned out to be an incredibly powerful test, both for the diagnosis and treatment of diabetes," says Dr. Anthony Bleyer, a kidney specialist at the Wake Forest School of Medicine who was not involved in the study. The problem is that the test results can vary, depending on circumstance. For example, people with anemia may get inaccurate readings. So do people who carry unusual types of hemoglobin, the best known being sickle cell trait. Eight to 10 percent of African-Americans carry the sickle cell trait. But only people who inherit two copies of the sickle cell trait, one from each parent, develop the disease. And a few years ago, scientists realized that A1C readings for African-Americans typically don't match those from whites. They are generally higher. "The test was really standardized based on white individuals, and there were just a small number of African-American individuals in that study," Bleyer says. And while the difference isn't large, it can matter a lot, especially for people who are clo Continue reading >>

Factors That Interfere With Hba1c Test Results

Factors That Interfere With Hba1c Test Results

Information for physicians and patients regarding HbS, HbC, HbE and HbD traits More about hemoglobin variants and HbA1c can also be found at the NIDDK web site: Sickle Cell Trait and Other Hemoglobinopathies and Diabetes: Important Information for Physicians For People of African, Mediterranean, or Southeast Asian Heritage: Important Information about Diabetes Blood Tests Factors that Interfere with HbA1c Measurement: Genetic variants (e.g. HbS trait, HbC trait), elevated fetal hemoglobin (HbF) and chemically modified derivatives of hemoglobin (e.g. carbamylated Hb in patients with renal failure) can affect the accuracy of HbA1c measurements. The effects vary depending on the specific Hb variant or derivative and the specific HbA1c method. Table 1 contains information for most of the commonly used current HbA1c methods for the four most common Hb variants, elevated HbF and carbamylated Hb. Interferences from less common Hb variants and derivatives are discussed in Bry, et al [1]. All entries in Table 1 are based on published information. In addition, if a product insert indicates clearly that there is inference from a particular factor, then the interference is entered as “yes” and the product insert is cited. When selecting an assay method, laboratories should take into consideration characteristics of the patient population served, (e.g. high prevalence of hemoglobinopathies or renal failure). Factors that affect interpretation of HbA1c Results: Any condition that shortens erythrocyte survival or decreases mean erythrocyte age (e.g., recovery from acute blood loss, hemolytic anemia) will falsely lower HbA1c test results regardless of the assay method used [2]. HbA1c results from patients with HbSS, HbCC, and HbSC must be interpreted with caution given the patholog Continue reading >>

Hemoglobin A1c (hba1c) (cont.)

Hemoglobin A1c (hba1c) (cont.)

How Is Hemoglobin A1c Measured? The test for hemoglobin A1c depends on the chemical (electrical) charge on the molecule of HbA1c, which differs from the charges on the other components of hemoglobin. The molecule of HbA1c also differs in size from the other components. HbA1c may be separated by charge and size from the other hemoglobin A components in blood by a procedure called high pressure (or performance) liquid chromatography (HPLC). HPLC separates mixtures (for example, blood) into its various components by adding the mixtures to special liquids and passing them under pressure through columns filled with a material that separates the mixture into its different component molecules. HbA1c testing is done on a blood sample. Because HbA1c is not affected by short-term fluctuations in blood glucose concentrations, for example, due to meals, blood can be drawn for HbA1c testing without regard to when food was eaten. Fasting for the blood test is not necessary. What Are Normal Levels of Hemoglobin A1c (Chart)? In healthy people, the HbA1c level is less than 6% of total hemoglobin. A level of 6.5% signals that diabetes is present. Studies have demonstrated that the complications of diabetes can be delayed or prevented if the HbA1c level can be kept below 7%. It is recommended that treatment of diabetes be directed at keeping an individual's HbA1c level as close to normal as possible (<6%) without episodes of hypoglycemia (low blood glucose levels). Chart of Normal and Elevated HbA1c Levels Diagnosis* A1C Level *Any test for diagnosis of diabetes requires confirmation with a second measurement unless there are clear symptoms of diabetes. SOURCE: Centers for Disease Control and Prevention Normal Below 5.7 % Prediabetes 5.7% to 6.4% Diabetes 6.5% or greater What Are High (El Continue reading >>

Falsely Low Hemoglobin A1c Values In Diabetic Patients Receiving Peginterferon-alpha And

Falsely Low Hemoglobin A1c Values In Diabetic Patients Receiving Peginterferon-alpha And

內科å¸èªŒã€€ã€€2011:22:431-437 Ribavirin for Chronic Hepatitis C Yen-Kuang Tai1, Chiu-Ling Huang1, Chih-Ming Chien1, Ching-Yang Tsai2, and Hoi-Wan Lo2 1Division of Endocrinology and Metabolism, Department of Internal Medicine; 2Division of Gastroenterology, Department of Internal Medicine, Yuan's General Hospital, Kaohsiung, Taiwan Abstract Hemoglobin A1c (A1C) values are usually lower during hemolysis because of the shortened red cell survival. Ribavirin (RBV) used in combination with peginterferon-alpha (peg-IFN) for chronic hepatitis C virus (HCV) infection causes reversible hemolytic anemia. This study was aimed to examine the effect of RBV treatment on A1C values in diabetic patients. A retrospective analysis identified 27 type 2 diabetic patients receiving peg-IFN and RBV for HCV. Each subject had at least three measures of hemoglobin (Hb), A1C, fasting plasma glucose, GPT and total bilirubin: before, during and after HCV therapy. During therapy, Hb levels decreased from 14.0 g/dL at baseline to a nadir of 10.2 g/dL (p < 0.001). A1C values decreased from a pre-treatment level of 7.1% to the lowest on-treatment level of 6.1% [mean paired difference: -1.0%; 95% confidence interval (CI) -1.93 to -0.11; p = 0.023]. In contrast, matched fasting plasma glucose levels did not change significantly (mean paired difference: -4.4 mg/dL; 95% CI -26.9 to 18.2; p = 0.89). In addition, GPT decreased from a pre-treatment level of 129 U/L to an on-treatment level of 64 U/L (p < 0.001); simultaneously measured total bilirubin increased from 0.82 mg/dL to 1.08 mg/dL (p = 0.016) supporting the occurrence of hemolysis. In conclusion, HCV therapy with peg-IFN plus RBV caused a significant fall in A1C values without a change to fasting plasma glucose l 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 >>

A Review Of The A1c Test

A Review Of The A1c Test

November is National Diabetes Month. In honor of this very important month I would like to review the Hemoglobin A1c test (also referred to as A1c). What is the A1c test? The A1c test is a measure of your average blood glucose over the past 2 to 3 months. The A1c test measures how much glucose attaches to the hemoglobin portion of red blood cells. The higher the blood glucose is, the more glucose that will attach to hemoglobin, thus increasing A1c. Hemoglobin is a protein in the red blood cell responsible for carrying oxygen body tissues. Red blood cells are constantly forming and dying. The average lifespan of a red blood cell is 3 months. Why is the A1c test done? The A1c test can be done to diagnose diabetes and is also used to assess diabetes control for those with established diabetes. The Diabetes Control and Complications Trials (DCCT) was a landmark study that showed that tight glycemic control, as measured by A1c, could reduce the risk of microvascular complications (such as retinopathy and nephropathy). When is the test done? The test can be done at any time of day and does not require fasting How often should I have it done? The 2015 Standards of Medical Care In Diabetes recommends: “Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control).” “Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals” What are the target A1c ranges? Normal: 4 to 5.6 % Pre-diabetes: 5.7 to 6.4 % Diabetes Diagnosis: >6.5 % (* Repeat testing should be done in the absence of absolute hyperglycemia) A1c goal if you have diabetes: The 2015 Standards of Medical Care In Diabetes recommends: <7 % (for non-pregnant adults) A lower goal, 6.5 %, may be recommen Continue reading >>

Hemoglobin A1c

Hemoglobin A1c

On This Site Tests: Glucose Tests; Urine Albumin; Urine Albumin/Creatinine Ratio; Fructosamine Conditions: Diabetes In the News: Screening, Diet and Exercise Key Factors in Task Force's New Diabetes Guidelines (2015), Task Force Updates Recommendations for Screening for Pre-Diabetes and Diabetes in Adults (2014), New Report Finds that Diabetes is on the Rise (2014) Elsewhere On The Web American Diabetes Association: Diabetes Basics American Diabetes Association: Risk Test American Association of Diabetes Educators Centers for Disease Control and Prevention: Diabetes Public Health Resource National Diabetes Information Clearinghouse: Prevent diabetes problems - Keep your diabetes under control National Institute of Diabetes and Digestive and Kidney Diseases: Diabetes A to Z National Glycohemoglobin Standardization Program American Diabetes Association – DiabetesPro, estimated Average Glucose, eAG Ask a Laboratory Scientist Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, the American Society for Clinical Laboratory Science (ASCLS). Click on the Contact a Scientist button below to be re-directed to the ASCLS site to complete a request form. If your question relates to this web site and not to a specific lab test, please submit it via our Contact Us page instead. Thank you. Continue reading >>

A1c Test Review For Nurses And Nursing Students

A1c Test Review For Nurses And Nursing Students

A1C test review for nurses and nursing students An A1C test is a blood test that is used to diagnose both type 1 and type 2 diabetes. This exam is also been referred to as a hemoglobin A1C, HbA1c, glycosylated hemoglobin, and glycated hemoglobin. The A1c results show what your average blood sugar level was for the last 8-12 weeks. A1c exam will measure the percentage of hemoglobin is covered with sugar (glycated). The more elevated the A1c level will indicate the poorer the patients blood sugar control is and puts them at a higher risk for diabetic complications. Rational for test The A1c is the primary test utilized to diagnose prediabetes, type 1 diabetes, and type 2 diabetes. After the patient gets a diagnoses of diabetes, this test is used to observe the diabetic treatment plan. This is helpful since it measures the average of the blood sugars for the last 2-3 months instead of the blood sugar at one certain time. It shows the healthcare provider how well the diabetic treatment regime is working. The test is especially helpful when the patient is first learning how to manage their diabetes in the early stages of treatment. It will also assist with establishing a baseline level. Type 2 diabetics who do not use insulin and whose blood sugar levels have remained consistent, usually have their A1c level drawn twice a year. Type 1 diabetes may have this test drawn 3-4 times per year. Type 2 diabetes who are managed with insulin and have blood sugars that are difficult to maintain in currant target range, may have this test drawn at least 4 times per year. If diabetic treatment plan is altered, there may be a need for more frequent A1c exams. This exam is a simple blood draw and is it alright to eat and drink normally before the exam. Exam Reading A normal A1c level from Continue reading >>

The Hemoglobin A1c Quiz

The Hemoglobin A1c Quiz

This article from our Health Library is for educational purposes. Please contact us with questions specific to the services we provide, to find a doctor or to schedule an appointment. If you have diabetes, you should know about the importance of hemoglobin A1c. Test your knowledge of hemoglobin A1c by taking this quiz. Continue reading >>

Why Do My A1c Results From Different Sources Vary?

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 >>

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