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Hemoglobin A1c 6.8

H-b-a-1-c

H-b-a-1-c

(What It Is and Why It Matters) You’ve pulled out your logbook and are taking off your jacket to bare your upper arm for the blood pressure cuff, when the nurse walks in and asks you to hold out a finger. “Does it matter that I had breakfast this morning?” you ask, trying to remember if you were supposed to fast before coming in, as she pricks your finger and collects a blood sample. “No, it doesn’t,” she says. “There; all done. The doctor will be in shortly to discuss your result.” And, indeed, several minutes later, your doctor walks in and says with a smile, “Looks like things are coming together for you. You’re at 6.8%.” For some people, the doctor’s words would be enough for them to realize that the fingerstick in the imaginary scenario above was for a glycosylated hemoglobin (HbA1c) test. What is Hba1c? The HbA1c test gives an indication of your blood glucose control over the previous 2–3 months and is an important part of your diabetes-care regimen. This article discusses what the test is, why it’s important, and how it’s used to help better blood glucose control. What is HbA1c? The ABCs Figuring out how the HbA1c test can help with your blood glucose control starts with understanding a bit about the test and what it measures. Hemoglobin. Hemoglobin is a molecule found in great quantities in each of the body’s red blood cells. As red blood cells travel through the circulatory system, the hemoglobin molecules join with oxygen from the lungs for delivery to the peripheral tissues, where they exchange it for some of the carbon dioxide destined for release to the lungs. The hemoglobin molecule is made up of two pairs of protein chains (two alpha chains and two beta chains) and four heme groups (iron-containing structures that act as th Continue reading >>

A1c Test

A1c Test

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 >>

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin (a blood pigment that carries oxygen) that is bound to glucose. The blood test for HbA1c level is routinely performed in people with type 1 and type 2 diabetes mellitus. Blood HbA1c levels are reflective of how well diabetes is controlled. The normal range for level for hemoglobin A1c is less than 6%. HbA1c also is known as glycosylated, or glycated hemoglobin. HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose. High HbA1c levels indicate poorer control of diabetes than levels in the normal range. HbA1c is typically measured to determine how well a type 1 or type 2 diabetes treatment plan (including medications, exercise, or dietary changes) is working. 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 Continue reading >>

Hemoglobin A1c (hba1c) Test For Diabetes

Hemoglobin A1c (hba1c) Test For Diabetes

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes. Hemoglobin is a protein found in red blood cells. It gives blood its red color, and it’s job is to carry oxygen throughout your body. The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher change of getting of diabetes. Levels of 6.5% or higher mean you have diabetes. The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. A combination of diet, exercise, and medication can bring your levels down. People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year. People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can Continue reading >>

Ask A Diabetes Expert

Ask A Diabetes Expert

Description Over 18 million people in the U.S. have been diagnosed with diabetes. The disease of diabetes mellitus prevents your body from properly using the energy from the food you eat. This occurs if the pancreas produces little or no insulin, or makes insulin but the insulin does not work as it should. Diabetes mellitus (DM) is classified as type 1 DM or type 2 DM, based on the age of onset and certain features of the disease. Juvenile diabetes, or type 1 DM, affects children, teens and young adults. Type 1 DM is an autoimmune disease that destroys certain pancreatic cells called beta cells, leading to a reliance on insulin injections. Latent autoimmune diabetes in adults (LADA), or type 1.5 DM, affects adults with diabetes that is similar to type 1 DM. There is no family history of type 2 DM. These patients have positive antibodies and a decreasing ability to make insulin. Type 2 diabetes mellitus is known to affect middle-aged patients who are obese (20 percent or more over desired body weight), as well as certain ethnicities (e.g., Black-American, Hispanic or Native American) or with other known risk factors. (Other types of diabetes also exist.) To manage diabetes, patients must diligently measure their insulin levels; take oral medications, non-insulin injections or insulin injections; and monitor their diets and exercise levels each day. People who need to take insulin injections should be seen by their physician every three to four months to monitor disease progression and the onset of any related complications. Diabetes can cause serious related complications, affecting the eye, kidneys and nerves, as well as causing delayed wound healing (particularly in the feet). Proper management of diabetes begins with understanding the disease, the treatments and lifes 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 >>

[maturity-onset Diabetes Of The Young 2 With A Novel Mutation Of Glucokinase Gene In A Chinese Boy And The Clinical Follow-up].

[maturity-onset Diabetes Of The Young 2 With A Novel Mutation Of Glucokinase Gene In A Chinese Boy And The Clinical Follow-up].

[Maturity-onset diabetes of the young 2 with a novel mutation of glucokinase gene in a Chinese boy and the clinical follow-up]. Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China. Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China. Email: [email protected] To explore the clinical and gene mutation characteristics of a child with maturity-onset diabetes of the young 2 (MODY2). The clinical and follow-up data of 1 patient with MODY2 were reviewed. GCK mutational analysis was performed by PCR and direct sequencing in the proband and his family members. The 9 years and 6 months old boy was referred to our department for short stature and mild hyperglycemia. His fasting blood glucose was elevated to 7.4-7.8 mmol/L, hemoglobin A1C 6.7%. His height was 122 cm (-2 s), weight 25 kg (-1 s), body mass index (BMI) 16.8 kg/m(2). His physical exam was unremarkable without dysmorphic features or acanthosis nigricans. The oral glucose tolerance test (OGTT) showed fasting glucose 8.17 mmol/L, insulin <2.0 mU/L, 2 h glucose 8.69 mmol/L, insulin 5.06 mU /L. The boy was treated with insulin injection for half a year. His fasting blood glucose was stable at 5.6-8.5 mmol/L, hemoglobin A1C 6.7%-6.8%. His mother's fasting blood glucose was 6.86 mmol/L, OGTT 2 h blood glucose 10.36 mmol/L, hemoglobin A1C 6.8%. GCK sequence revealed a novel GCK mutation c.34_44+15del26 in the proband and his mother, which was co-segregated with diabetes. The boy's treatment was shifted from insulin injection to diet and exercise after the diagnosis of MODY2 was confirmed. Being followed up for 2 and a half years, his fasting blood glucose was stable at 4.6-8.0 mmol/L and hemoglobin A1C Continue reading >>

Overtreatment Of Elderly Diabetics

Overtreatment Of Elderly Diabetics

The last time I was directly responsible for treating diabetes was fifty years ago, when I was an intern in medicine at UCLA. In my subsequent career as a psychiatrist I was not directly responsible for diabetes care, and as an individual, I don’t have the condition. As a result, I haven’t kept up on diabetes treatment, so a June 11 article on “Diabetes Overtreatment in Elderly Individuals: Risky Business in Need of Better Management” was news to me. The opening two sentences of the American Diabetes Association’s article on “Tight Diabetes Control” make it sound as if “tight control” should be the goal of treatment: “Keeping your blood glucose levels as close to normal as possible can be a lifesaver. Tight control can prevent or slow the progress of many complications of diabetes, giving you extra years of healthy, active life.” In my uninformed state, that’s how I understood how diabetes should be managed, even for over 65ers. But I was wrong. Several paragraphs later there’s a very clear statement that elderly people with diabetes should be treated differently: “Elderly people probably should not go on tight control. Hypoglycemia [overly low blood sugar] can cause strokes and heart attacks in older people. Also, the major goal of tight control is to prevent complications many years later. Tight control is most worthwhile for healthy people who can expect to live at least 10 more years.” The American Geriatrics Society gives precise guidelines for the goal of diabetes treatment in over 65ers. The key measure of diabetes control is hemoglobin A1c. For healthy over 65ers with long life expectancy, the target should be 7.0 – 7.5%. For those with “moderate comorbidity” (so-so health) and a life expectancy of less than 10 years the targe Continue reading >>

Hemoglobin (low And High Range Causes)

Hemoglobin (low And High Range Causes)

Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues back to the lungs. Hemoglobin is made up of four protein molecules (globulin chains) that are connected together. The normal adult hemoglobin (abbreviated Hgb or Hb) molecule contains two alpha-globulin chains and two beta-globulin chains. In fetuses and infants, beta chains are not common and the hemoglobin molecule is made up of two alpha chains and two gamma chains. As the infant grows, the gamma chains are gradually replaced by beta chains, forming the adult hemoglobin structure. Each globulin chain contains an important iron-containing porphyrin compound termed heme. Embedded within the heme compound is an iron atom that is vital in transporting oxygen and carbon dioxide in our blood. The iron contained in hemoglobin is also responsible for the red color of blood. Hemoglobin also plays an important role in maintaining the shape of the red blood cells. In their natural shape, red blood cells are round with narrow centers resembling a donut without a hole in the middle. Abnormal hemoglobin structure can, therefore, disrupt the shape of red blood cells and impede their function and flow through blood vessels. Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal. Symtoms of anemia include Fatigue Feeling of unwellness Heart palpitations Hair loss Shortness of breath Hemoglobin is usually measured as a part of the routine complete blood count (CBC) test from a blood sample. Several methods exist for measuring hemoglobin, most of which are done currently by automated machines designed to perform different tests on blood. Within the machine, the red blood cells are broken dow Continue reading >>

Interference Of The Hope Hemoglobin With Hemoglobin A1c Results

Interference Of The Hope Hemoglobin With Hemoglobin A1c Results

Hemoglobin A1c (HbA1c) is now considered to be the marker of choice in diagnosis and management of diabetes mellitus, based on the results of certain landmark clinical trials. Herein, we report the case of a 52-year-old ethnic Southeast Asian Indian man with impaired glucose tolerance whose glycated hemoglobin (ie, HbA1c) levels, as measured via Bio-Rad D10 high-performance liquid chromatography (HPLC) and Roche Tina-quant immunoassay were 47.8% and 44.0%, respectively. No variant hemoglobin (Hb) peak was observed via the D10 chromatogram. We assayed the patient specimen on the Sebia MINICAP capillary electrophoresis platform; the HbA1c level was 6.8%, with a large variant Hb peak of 42.0%. This finding suggested the possible presence of the heterozygous Hb Hope, which can result in spuriously elevated HbA1c results on HPLC and turbidimetric immunoassays. Although the capillary electrophoresis system was able to identify the variant, the A1c results should not be considered accurate due to overlapping of the variant and adult Hb peaks on the electrophoretogram reading. Hb Hope is usually clinically silent but can present such analytical challenges. Through this case study, we critically discuss the limitations of various HbA1c assay methods, highlighting the fact that laboratory professionals need to be aware of occurrences of Hb Hope, to help ensure patient safety. HbA1c , hemoglobin Hope , interference , capillary electrophoresis , HPLC , immunoassay Diabetes mellitus (DM) is a syndrome of chronic hyperglycemia that can lead to complications as a result of macro- and microlevel vascular damage. The results of landmark clinical trials such as the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study Group (UKPDS) have establ Continue reading >>

What Do Your A1c Test Results Really Mean?

What Do Your A1c Test Results Really Mean?

The hemoglobin A1c test, as we all know, is supposed to give a sense of your average blood glucose levels over the past three months. But here’s a question for you: have you ever tried to figure out what those average blood glucose levels actually are? Say you have an A1c of 6.5% — what, in mg/dl, does that translate to? Try searching Google — it’s hard to find an answer. To quote from a post I wrote a few years ago (see entry from 4:45), that’s partially because: “Not only is there no one standardized definition as to the correlation between A1c and mean glucose levels (JDRF says 1% = 24.4 mg/dl, ADA says 28.7), but different people have different correlations. For example, if you are a ‘high glycolator’ (more glucose sticks to your hemoglobin than the average) you can have a relatively high A1c but a low mean glucose. The speaker gave the example of a patient who had a 8.2% A1c, but a mean glucose of 159 mg/dl (he was speaking using the generally accepted idea that 7% roughly equals a mean of 154 mg/dl). Treat him more aggressively, and you’ll end up with hypos. And if you’re a ‘hypoglycolator,’ it’s the opposite.” Well, just this week, a new paper was published in the American Diabetes Association’s Diabetes Care journal that provides a more solid answer to this question than I’ve seen — even though, as I must warn you, personal variability (as described above) means there’s still no precise answer. In the study, researchers wanted to find out what your average blood sugar would have to be in three situations — fasting, after meals and before bed — in order to achieve a particular A1c. Here are their results: A1c test results of 5.5-6.49% were associated with an average fasting blood glucose level of 122 mg/dl. A1c test results Continue reading >>

5 Ways To Lower Your A1c

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 Blood Test Isn't Perfect

Hemoglobin A1c Blood Test Isn't Perfect

The hemoglobin A1C is a great blood test for type 2 diabetics, but not for diagnosing diabetes. Don't misunderstand. I love the hemoglobin A1C blood test. It doesn't require fasting. It can be done in the doctor's office with a fingerstick just like your glucose monitor, and you can know the results before you leave the office. And it lets you know how your blood sugar has been doing over the past two or three months. It sounds perfect. But it isn't. For diabetes management you and I need to know what our blood sugar is doing all the time, not just every three months. A great HGA1C reading does not mean there have been no hyperglycemic or hypoglycemic episodes over that time. So the hemoglobin A1C cannot replace daily checks with a glucose monitor and log book records. Taken together with daily readings, the hemoglobin A1C gives an accurate picture of whether you are keeping your blood sugar in the ranges that will keep away the complications. There is more and more evidence that an HGA1C between 6.5 and 7 will do just that. And here's an encouraging fact. If your A1C was 9 and you lower it to 8, there is a 20% reduction in risk of complications even though you aren't in the target range yet. That's good to know. You should also know that the American Diabetic Association says to get the test done every three months if your are diabetic. Here's how it works. Hemoglobin is the medical term for red blood cells, and glycated hemoglobin is the term for red blood cells with sugar stuck to them. Over the life of a red blood cell, which is 120 days if all goes well, more and more sugar sticks to it as it travels through your bloodstream. The amount can be measured accurately, and doctors know how much should be on each normal cell. If the level is high, that signals diabetes. Continue reading >>

The Normal A1c Level

The Normal A1c Level

Wow Richard, 70 lbs? I have lost 24 lbs from low carb diet due to SIBO. It also helped my AC1 go down three points from 6.2 and my cholesterol is lower, which surprised me. I can’t afford to lose anymore weight because I was small to begin with. I had noticed much bigger people in the UK over the last 5 years compared to 15-20. Was quite shocking. I thought we had the patent on obesity! I am not diabetic that I know of but I had weird symptoms… Thirst that continued all day and night. My husband called me a camel. Dry eyes, rashes, strange dark discolouration on arm, under the arm to the side, some circulation issues and blurred vision. Eye specialist could not figure out why. Sores in the mouth also. I had observed about three weeks into super low carbs (30 Gms carb/day) that athlete’s foot symptom, sores in mouth and rashes were clearing up. So, lowering carbs for SIBO actually turned out for the best. By the way, I love your final paragraph. Research is what led me to SIBO diagnosis, and I then told the GI what to look for! He was barking up the wrong tree for months. Said I needed to eat more carbs so I don’t lose weight. Well, carbs fed the bacterial overgrowth!!! Dang fool. On Saturday, June 23, 2012, Diabetes Developments wrote: There is a new comment on the post “The Normal A1C Level”. Author: Richard Comment: I think part of the problem is that doctors are trained over many years to treat with pills, not with food. We continue to do what we are trained to do no matter what. I do believe they want to help us but don’t have the nutritional knowledge because that is not their expertise. When you have a hammer, etc. Nutritionist are no better unless they are those involved in research. They just peddle the messages they are told to. Then again, why wo Continue reading >>

Hba1c 6.8 , Need Urgent Input

Hba1c 6.8 , Need Urgent Input

I joined this group today & I am sure this forum is going to help me a lot. I am 35yr old working lady with a 7 yr old daughter. My Dad has type 2 diabetics & I was detected with sugar level in border line in 2013 wit hbac1 of 6.2. After that I started controlling my diet & maintained in good level with ranging from 5.4 to 5.8. But recently I did blood test & I got hba1c of 6.8 & doctor adviced me to start with medicine. 1st thing, I am little confused that is that I crossed the normal range (6.5 as per doct) once that means I am diabetic ? Can I do a trial by controlling diet for 2-3 months & recheck again ? I am really nervous as we are planning for second child & I am very confused too. Only observation now a days is I am feeling week, a pain in lower head or I would say neck. I feel tensed for small reasons. Can you please tell me really I am diabetics ? Can I still control this by dieting without taking medicine ? DO you have any good diet chart for me ? D.D. Family Getting much harder to control Hi and welcome to DD its nice to want to control without meds but many here including myself can not. There is no shame in it and it was either that or very high numbers. Do you have a home meter, if so what are your 2 hr readings after eating. What is your fasting reading, what I know today I would never wait for an a1c to find what my readings are. Can you diet well it looks like that is not working at this point, what exact foods are you eating now. How many grams of carbohydrates-sugar are you eating per day. Some can reduce the carbs and get better control but it shows your body is not able to keep up with what you are doing now. Please ask all the questions you would like. The improvement you can make without meds depends on how far away you are from an 'optimal' di Continue reading >>

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