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Hemoglobin A1c 7.0

2017 Mips Measure #001: Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%)

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 >>

A1c Calculator*

A1c Calculator*

Average blood glucose and the A1C test Your A1C test result (also known as HbA1c or glycated hemoglobin) can be a good general gauge of your diabetes control, because it provides an average blood glucose level over the past few months. Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you check blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target of 7% or lower recommended by the American Diabetes Association (ADA) for many adults who are not pregnant. For some people, a tighter goal of 6.5% may be appropriate, and for others, a less stringent goal such as 8% may be better.1 Talk to your doctor about the right goal for you. GET YOURS FREE The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management. See how average daily blood sugar may correlate to A1C levels.2 Enter your average blood sugar reading and click Calculate. *Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes. What is A1C? Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a Continue reading >>

Elevated Hemoglobin A1c Is Associated With Readmission But Not Complications

Elevated Hemoglobin A1c Is Associated With Readmission But Not Complications

studies have shown that elevated hemoglobin A1c levels are associated with worse short-term outcomes after cardiac surgery. However, the effect on readmission has not been studied. The primary purpose of this study was to determine the independent effect of hemoglobin A1c level on the readmission rate after cardiac surgery. The secondary purpose was assess its effect on complications and mortality. 300 (34%) patients had normal hemoglobin A1c levels (<6.0%), 305 (35%) had mildly elevated levels (6.0%–6.9%), and 275 (31%) had markedly elevated levels (≥7.0%). Postoperative glucose levels were similar among all 3 hemoglobin A1c groups. Compared to patients with normal hemoglobin A1c levels, those with higher levels were more likely to be readmitted: adjusted odds ratio 2.091 (95% confidence interval: 1.074–4.069, p = 0.036) for hemoglobin A1c 6.1%–6.9%; and adjusted odds ratio 2.089 (95% confidence interval: 1.050–4.155, p = 0.036) for hemoglobin A1c ≥ 7.0. Overall, 381 (43%) patients suffered complications, and hemoglobin A1c levels were similar in those with and without complications (6.8% ± 1.6% vs. 6.9% ± 1.7%, p = 0.837). Mortality was equivalent in all 3 hemoglobin A1c groups. Continue reading >>

Hemoglobin A1c

Hemoglobin A1c

This report is not a substitute for the regular medical care of your physician. If you have questions resulting from this information, please contact the staff at Meeker Memorial Hospital Laboratory. You must visit your regular physician for any treatment that you may need. MCMH Laboratory does not send your physician a copy of these results. Hemoglobin A1C Hemoglobin A1C is an indicator of how well you have controlled your diabetes over the last few months. This test measures the amount of hemoglobin (the red protein that carries oxygen in your red blood cells) that has attached to glucose (blood sugar) molecules. The amount of hemoglobin A1C formed is directly related to the amount of glucose in your blood. If your diabetes is not well controlled, your blood glucose levels are high, causing higher hemoglobin A1C levels. Hemoglobin A1C levels do not change quickly since red cells can live for 2-3 months. A healthy person without diabetes will have an A1C between 4% and 6%. If you are diabetic, the closer your A1C is to 6%, the better your diabetes is in control. For every 1% increase in A1C, blood increases approximately 30 mg/dL and the risk of complications increases. The American Diabetes Association recommends the goal of therapy should be hemoglobin A1C values of <7.0% and that physicians should reevaluate the treatment regimens in patients with A1C values consistently > 8.0%. The American Diabetes Association recommends testing your A1C: 4 times each year if you have type 1 or type 2 diabetes and use insulin: or 2 times each year if you have type 2 diabetes and do not use insulin. Once again, this report is not a substitute for the regular medical care of your physician. If you have any questions or concerns, please schedule an appointment with your regular physi Continue reading >>

New Guidelines For Diabetes In Seniors

New Guidelines For Diabetes In Seniors

Mom is 82, a diabetic, and her sugars often drop below 100 and she feels lightheaded. She’s been told that she should keep her sugars between 70 and 120 but we’ve noticed she often feels better if they are higher. What is a good range of finger-stick sugars for her? The guidelines for blood sugar control in seniors have changed recently. The Choosing Wisely Campaign from the AGS [American Geriatrics Society] I referenced in previous articles, now recommends that lower sugars are not good for seniors (as contrasted with younger adults, where tighter control is better). The new advice is: Avoid using medications to achieve hemoglobin A1c less than 7.5% in most adults age 65 and older; moderate control is generally better. What is the ‘A1c’? The ‘A1c’ is a protein—the hemoglobin A1c—produced in your blood in response to the level of sugar. As the sugar increases, the A1c rises, and reflects the average sugar over the preceding three months. Diabetics should have their A1c measured every 3-6 months. An A1c of 7% indicates an average blood sugar of 154; 7.5% means it’s been 168; 8.0%, it’s 182; for 9.0%, it’s 211. The AGS found no evidence that tight control in older adults with type 2 diabetes is beneficial. ‘Tight control’ means an A1c less than 7% which usually translates into finger-stick sugars under 100 before breakfast and under 200 the rest of the day. Compared with ‘looser control’, tight control in seniors results in more harm: higher death rates, and particularly higher rates of hypoglycemia—blood sugars that are too low, meaning less than 70-80, which increases the risk of dizziness, falling, injury, and generally just not feeling as well. Since it takes years for the benefits of ‘tight control’ to really be seen, the AGS recom Continue reading >>

Prevalence Of Hemoglobin A1c Greater Than 6.5% And 7.0% Among Hospitalized Patients Without Known Diagnosis Of Diabetes At An Urban Inner City Hospital

Prevalence Of Hemoglobin A1c Greater Than 6.5% And 7.0% Among Hospitalized Patients Without Known Diagnosis Of Diabetes At An Urban Inner City Hospital

Context: Bronx, New York, an urban county with a large low-income, immigrant and minority population, has a prevalence of diabetes that is among the highest in the United States. Objective: The aim of the study was to evaluate the utility of hemoglobin A1c (HbA1c) in identifying patients at risk for diabetes on an in-patient medical service of a hospital serving a high prevalence community. Design and Setting: We conducted a prospective cohort study at an urban public hospital. Patients: The study included 971 patients (1132 admissions) admitted to the general medicine service over 4 months. Main Outcome Measures: HbA1c was measured on all patients. Records were checked for prior diagnosis of diabetes and other clinical data. Follow-up data were obtained for those with repeat HbA1c testing or glucose within 1 yr after admission. Results: We found that 35.2% of the patients (n = 342) had an established diagnosis of diabetes. The remaining 629 patients defined the study cohort of patients without known diabetes. Mean HbA1c was 6.05 ± 0.87%. A total of 152 patients (24%) had admission HbA1c of at least 6.5% and 62 (9.9%) had HbA1c of at least 7.0%. Fifty-five patients with HbA1c of at least 6.5% had follow-up HbA1c within 1 yr. Of those, 44 (80.0%) met the criteria for diabetes as proposed by The International Expert Committee using repeated HbA1c testing. Conclusion: In communities with high prevalence of diabetes, a large percentage of patients without a diagnosis of diabetes who are admitted as in-patients have HbA1c of at least 6.5% and 7.0%. Hospital-based HbA1c testing might identify patients for whom further testing is indicated to make the diagnosis of diabetes. Context: Widespread thyroid hormone actions offer the possibility of developing selective thyromimetic 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 >>

Measure #1 (nqf 0059): Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%) €“ National Quality Strategy Domain: Effective Clinical Care

Measure #1 (nqf 0059): Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%) €“ National Quality Strategy Domain: Effective Clinical Care

2017 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Intermediate Outcome DESCRIPTION: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period INSTRUCTIONS: 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. Measure Reporting: The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data. 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, E10.3 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 >>

Effectiveness Of Cinnamon For Lowering Hemoglobin A1c In Patients With Type 2 Diabetes: A Randomized, Controlled Trial

Effectiveness Of Cinnamon For Lowering Hemoglobin A1c In Patients With Type 2 Diabetes: A Randomized, Controlled Trial

Abstract Purpose: Multiple trials in the past have shown conflicting results of whether cinnamon lowers glucose or hemoglobin A1C (HbA1C). The purpose of this study was to determine whether cinnamon lowers HbA1C in patients with type 2 diabetes. I performed a randomized, controlled trial to evaluate whether daily cinnamon plus usual care versus usual care alone lowers HbA1c. Methods: I randomized 109 type 2 diabetics (HbA1C >7.0) from 3 primary care clinics caring for pediatric, adult, and geriatric patients at a United States military base. Participants were randomly allocated to either usual care with management changes by their primary care physician or usual care with management changes plus cinnamon capsules, 1g daily for 90 days. HbA1c was drawn at baseline and 90 days and compared with intention-to-treat analysis. This study was approved by an institutional review board. Results: Cinnamon lowered HbA1C 0.83% (95% CI, 0.46–1.20) compared with usual care alone lowering HbA1C 0.37% (95% CI, 0.15–0.59). Conclusions: Taking cinnamon could be useful for lowering serum HbA1C in type 2 diabetics with HbA1C >7.0 in addition to usual care. As the worldwide incidence of diabetes increases, the search for dietary adjuncts to treat this life-altering disease has become far ranging. Cinnamon is purported to be a natural insulin sensitizer, with adverse events of perioral dermatitis and stomatitis reported uncommonly with high intake.1 Both in vitro and in vivo animal studies have shown that cinnamon is an insulin sensitizer.2,3 Kim et al3 showed that intestinal glucosidase activity in rats was increased by cinnamon. Polyphenols within cinnamon have been identified as upregulators of mouse adipocyte insulin receptors.4 Peng et al5 found that polyphenols from cinnamon inhibi Continue reading >>

How A1c Affects Life Insurance

How A1c Affects Life Insurance

When you’re shopping for life insurance coverage, the insurance company is going to look at dozens of different factors to determine how much they are going to charge you for coverage. One of the biggest factors is your overall health. If you have any pre-existing conditions, like diabetes, then you could encounter several problems when you’re trying to get affordable life insurance. Diabetes is a rapidly growing health issue in the United States. According to the American Diabetes Association, nearly 26 million children and adults have diabetes and 79 million Americans have pre-diabetes. This disease is characterized by the body’s inability to produce insulin or not being able to use insulin effectively. The result of having diabetes is high blood sugars, which has to be actively monitored and controlled by anyone who is a diabetic. Diabetes does affect term life insurance rates, but how much it affects your premiums depends on your level of blood sugar control. Your A1C is probably the biggest factor in the life insurance premium of a diabetic – more than whether you are type 1 diabetic or type 2, whether you use oral medication or if you are insulin-dependent, or whether you were diagnosed with diabetes as a child or at age 50. Life insurance is one of the most important investments that you’ll ever make for your loved ones. If something were to happen to you, your family could be left with a mountain of debt, which is going to make the whole situation a thousand times worse. We know that shopping for life insurance is never a fun experience, but we are here to help make it as quick and simple as possible for you. This agent is going to explore how your A1C levels will impact your life insurance rates, and we will also look at several ways that you can save Continue reading >>

Could Slightly High Blood Sugar Cause Neuropathy?

Could Slightly High Blood Sugar Cause Neuropathy?

My glucose levels usually run between 120 and 135 with a nonfasting blood test, though do not have a diagnosis of diabetes. I suffer greatly with my feet and been told by a podiatrist that it is neuropathy. Is it possible that my high glucose levels are causing the neuropathy? Dear Terry, Thanks for your question. I like to think of blood glucose values as a spectrum of numbers with no clear cutoff between nondiabetic and diabetic. In similar manner there is a gray area of blood glucose that defines pre-diabetes. Many people use blood sugar and blood glucose interchangeably. The definition of diabetes has changed over time. The numbers you quote might very well be considered diagnostic of diabetes today whereas they were not 20 years ago. In 1997, the American Diabetes Association definition of normal blood glucose decreased from 120 to 110 mg/dL (6.1 mmol/L). In 2002, the American Diabetes Association defined a normal fasting blood glucose as less than 100 mg/dL (5.6 mmol/L). Today we consider fasting blood sugars of 100 mg/dl to 125mg/dl to be in the realm of glucose intolerance which is sometimes called pre-diabetes. These patients are at increased risk for developing frank diabetes. Several fasting glucose levels over 125 or a single random glucose over 200 mg are considered diagnostic of diabetes. There are other tests used to make the diagnosis of pre-diabetes or diabetes. Pre-diabetes is defined as a blood sugar of 140 to 199 mg/dL (7.8 to 11.0 mmol/L) two-hour after drinking 75 grams of an oral glucose solution. The diagnosis of diabetes is confirmed with a blood sugar of 200 mg/dL or greater, two hours after ingestion of the glucose solution. Hemoglobin A1C is a blood test that gives an estimate of blood sugar levels over the previous three months. Persons with Continue reading >>

Combining Glycosylated Hemoglobin A1c And Fasting Plasma Glucose For Diagnosis Of Type 2 Diabetes In Chinese Adults

Combining Glycosylated Hemoglobin A1c And Fasting Plasma Glucose For Diagnosis Of Type 2 Diabetes In Chinese Adults

Abstract Glycosylated hemoglobin A1c (HbA1c) has been applied to identify type 2 diabetes (T2DM) in the U.S. and European countries. It has not been used in China mainly due to lack of a standardized approach to measure HbA1c, short of knowledge about racial-specific standard and deficiency of an optimal cut-off point. To evaluate combination of HbA1c and fasting plasma glucose (FPG) in diagnosing T2DM in Chinese adults, a multistage sampling cross-sectional study was conducted in Shanghai, China, in 2009. The FPG measurement, HbA1c assay, and oral glucose tolerance test (OGTT) were performed in 6,661 Chinese adults (3057 men, 3604 women) who had no prior history of diabetes to identify the unrecognized T2DM. A total of 454 participants were identified as T2DM based on the 1999 World Health Organization (WHO) diagnostic criteria. Of these patients, 239 were detected using an FPG ≥ 7.0 mmol/l and 141 were further identified using an HbA1c ≥ 43 mmol/mol (6.1%), achieving a sensitivity of 83.7% and a specificity of 89.3% for combining use of FPG and HbA1c. In subjects at high risk of diabetes, the combining use of FPG and HbA1c produced a higher sensitivity and an improved positive predictive value (PPV), and had a satisfactory specificity and negative predictive value (NPV). The combining use of FPG and HbA1c is a potential screening and diagnosis approach for T2DM in Chinese adults, especially among those at high risk of the disease. Background Type 2 diabetes mellitus (T2DM) is a common disease reflecting metabolic disorders characterized with hyperglycemia, which may lead to specific long-term complications affecting heart, brain, eyes, kidneys and nervous system [1]. Currently, diagnosis of T2DM in Chinese adults is principally according to the 1999 World Health O Continue reading >>

Why Doesn’t My Average Blood Glucose Match My A1c?!

Why Doesn’t My Average Blood Glucose Match My A1c?!

So, you test your meter for accuracy and everything looks good. You take your average BG and convert it to A1C using a table, calculator, or equation you find online. Then, you get your blood work done and learn that your actual A1C is… Not even close! What’s the deal? As it turns out, the relationship between average BG and A1C isn’t as clear as most of us think. After doing some research, I came across a couple reasons why someone’s actual A1C may be higher or lower than expected… But before we get into that, let’s briefly go over why A1C is used to approximate average glucose over ~3 months: As glucose enters your blood, it attaches to a protein in your red blood cells called “hemoglobin.” Hemoglobin is the same protein that carries oxygen in your bloodstream, and it is what gives blood its red color A1C measures the total amount of glucose that has attached to your hemoglobin over the lifespan of your red blood cells (typically ~3 months). OK, now that we’ve got the science down, here’s why your average BG and lab-measured A1C values might not match up: 1. BG meter average does not usually reflect the average over a full 24 hours This reason is pretty obvious. If you are not on a CGM, it’s tough to get a full picture of your average blood glucose throughout the day. We generally test much more during the day than at night, and nighttime glucose values may be very different from daytime values. We also tend to test more often before eating (when glucose is typically lower), and less often after meals (when glucose is typically higher). So, for most people, BG meter average doesn’t accurately reflect 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, che Continue reading >>

A1c-it’s Just A Number

A1c-it’s Just A Number

Yesterday, I had my endocrinologist appointment where I found out what my A1C was from blood work I had done last week. I’ve been trying sooooooooooo hard to get my A1C not only Below-Seven but below 6.5 because my hubby and I are planning on trying to get pregnant soon. I was so confident in my blood sugars over the last few weeks and months that I was positive I was going to have an amazing A1C, so positive that my husband and I made the decision for me to get off of my birth control pills so we could actually begin trying to get pregnant within the next few months. The last A1C I had done was 7.3 back in June. However, that was done a few weeks after we went to beach week, where my blood sugars stayed high the majority of the week thanks to grazing and alcohol. It was also after extensive basal testing in March and April, where I purposely kept my blood sugars in the high 200’s because I knew my basal rates were too high. I would drop drastically, more than 100 mg/dls during the tests until I tweaked them enough to stop the dramatic declines. So, my A1C in June of 7.3 made sense because I did have some highs. I was still disappointed though, because I felt that after I had completed the basal testing, my blood sugars were pretty solid, minus the high beach week. After getting the June result, I was more determined than ever to get my A1C Below-Seven. I have done all sorts of things to make that happen. I did a clean eating challenge back in September which resulted in a few changes in my eating habits overall such as limiting my carb intake and for the most part cutting out Diet Cokes. I have been working hard to pre-bolus before meals. I have been running a TON, at least four times per week. I’ve been getting used to lower blood sugar numbers and I’ve been t Continue reading >>

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