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Hemoglobin A1c And Hypoglycemia

Hypoglycemia In Diabetes Mellitus: Correlation With Hemoglobin A1c And Overall Glycemic Control

Hypoglycemia In Diabetes Mellitus: Correlation With Hemoglobin A1c And Overall Glycemic Control

Background: Hypoglycemia is a limiting factor for the effective management of glycemic control in both type 1 and 2 Diabetes Mellitus. We planned to analyze the correlation between hypoglycemia and Hemolgobin A1C (HbA1C), as well as other predictors of overall glycemic control in Diabetes Mellitus. Methods: A retrospective chart review of the UMass Diabetes clinic database was conducted, and included Diabetic adults on insulin who presented to the clinic in September 2013. Only individuals with frequency of home blood glucose (BG) monitoring more than twice a day in 90 days prior to the clinic visit were included. The final sample size satisfying criteria was 41. Outcome measures and variables studied were: frequency of episodes of hypoglycemia (BG 70 mg/dL) and severe hypoglycemia (BG 45 mg/dL); HbA1c, gender, type of Diabetes, age, treatment modality, body mass index, hypertension & evidence of nephropathy. The data was analyzed in SPSS. Results: Out of the 41 individuals, 52% had Type 2 Diabetes, 70% had hypertension, 70% were on ACE inhibitor/ARB, 36% had nephropathy & 27% were an oral agent in addition to insulin for management. There was a strong positive correlation between HbA1C and average blood glucose (Pearson coefficient +0.7), and a weak negative correlation between HbA1C and hypoglycemia frequency both BG 70 and BG 46 (Spearman coefficient -0.3). The frequency of hypoglycemia (both BG 70 and BG 45) was higher in Type 1 Diabetics, females, those with hypertension and using Insulin alone as treatment (p<0.05). The frequency of hypoglycemia also had a strong negative correlation with body-mass index, a weak negative correlation with age & almost no correlation with the range of blood glucose values. Conclusions: The frequency of episodes of hypoglycemia (BG Continue reading >>

All About The Hemoglobin A1c Test

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 >>

Nondiabetic Hypoglycemia

Nondiabetic Hypoglycemia

What is non-diabetic hypoglycemia? Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a mismatch of medicine, food, and/or exercise. Non-diabetic hypoglycemia, a rare condition, is low blood glucose in people who do not have diabetes. There are two kinds of non-diabetic hypoglycemia: Reactive hypoglycemia, which happens within a few hours of eating a meal Fasting hypoglycemia, which may be related to a disease Glucose is the main source of energy for your body and brain. It comes from what we eat and drink. Insulin, a hormone, helps keep blood glucose at normal levels so your body can work properly. Insulin’s job is to help glucose enter your cells where it’s used for energy. If your glucose level is too low, you might not feel well. What causes non-diabetic hypoglycemia? The two kinds of non-diabetic hypoglycemia have different causes. Researchers are still studying the causes of reactive hypoglycemia. They know, however, that it comes from having too much insulin in the blood, leading to low blood glucose levels. Types of nondiabetic hypoglycemia Reactive hypoglycemia Having pre-diabetes or being at risk for diabetes, which can lead to trouble making the right amount of insulin Stomach surgery, which can make food pass too quickly into your small intestine Rare enzyme deficiencies that make it hard for your body to break down food Fasting hypoglycemia Medicines, such as salicylates (such as aspirin), sulfa drugs (an antibiotic), pentamidine (to treat a serious kind of pneumonia), quinine (to treat malaria) Alcohol, especially with binge drinking Serious illnesses, such as those affecting the liver, heart, or kidneys Low levels of certain hormones, such as cortisol, growth hormone, glu 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 >>

Reactive Hypoglycemia Or Low Blood Sugar

Reactive Hypoglycemia Or Low Blood Sugar

There is a lot of talk about what happens when our blood sugar gets too high, but what about if it is too low? Blood sugar is the metabolic fuel for our body and is closely regulated. Most adults have about one gallon of blood in their bodies and are quite surprised to learn that in that gallon, there is only one teaspoon of sugar! If your blood sugar level were to rise to too high of levels, you could possibly die. Now that is serious stuff…But if is too low, it may cause severe enough symptoms that we might think we might be…..Okay, a little dramatic, but you get my point. How does the body regulate blood sugar? Your body works very hard to keep your blood sugar at the appropriate level. When you eat a meal, your body is designed to break it down and turn it into glucose. When the body detects glucose in the bloodstream, it signals a hormone called insulin to create openings in our cell membrane to which allow glucose to be brought into the cell. From there, it is converted by the mitochondria into something special called ATP which is the “energy currency” of the body. Any meal generates a rise in blood glucose. If the meal is well balanced, meaning that it contains the appropriate amount of protein, carbohydrates and fats, it causes a slow release of blood sugar and a modest release of insulin. If the meal is too high in carbohydrates, the blood sugar will spike and cause too much insulin to be released. This tends to drop the blood sugar level well below the pre-meal value. This then signals the need for more glucose, creating more sugar cravings and perpetuating the cycle. What is Reactive Hypoglycemia? Reactive hypoglycemia (or alimentary hypoglycemia) is low blood sugar that occurs after a meal, usually one to three hours after eating. It is different th Continue reading >>

Ultimate Guide To The A1c Test: Everything You Need To Know

Ultimate Guide To The A1c Test: Everything You Need To Know

The A1C is a blood test that gives us an estimated average of what your blood sugar has been over the past 2-3 months. The A1c goes by several different names, such aswa Hemoglobin A1C, HbA1C, Hb1C, A1C, glycated hemoglobin, glycohemoglobin and estimated glucose average. What is Hemoglobin? Hemoglobin is a protein in your blood cells that carries oxygen. When sugar is in the blood, and it hangs around for a while, it starts to attach to the red blood cells. The A1C test is a measurement of how many red blood cells have sugar attached. So, if your A1C result is 7%, that means that 7% of your red blood cells have sugar attached to them. What are the Symptoms of a High A1C Test Level? Sometimes there are NO symptoms! That is probably one of the scariest things about diabetes, your sugar can be high for a while and you may not even know it. When your blood sugar goes high and stays high for longer periods of time you may notice the following: tired, low energy, particularly after meals feel very thirsty you may be peeing more than normal, waking a lot in the middle of the night to go dry, itchy skin unexplained weight loss crave sugar, hungrier than normal blurred vision, may feel like you need new glasses tingling in feet or hands cuts or sores take a long time to heal or don’t heal well at all frequent infections (urinary tract, yeast infections, etc.) When your blood sugar is high, this means the energy that you are giving your body isn’t getting into the cells. Think about a car that has a gas leak. You put gas in, but if the gas can’t get to the engine, the car will not go. When you eat, some of the food is broken down into sugar and goes into your bloodstream. If your body can’t get the sugar to the cells, then your body can’t “go.” Some of the sugar tha Continue reading >>

Metrics Beyond Hemoglobin A1c In Diabetes Management: Time In Range, Hypoglycemia, And Other Parameters

Metrics Beyond Hemoglobin A1c In Diabetes Management: Time In Range, Hypoglycemia, And Other Parameters

Introduction Frequent evaluation and precise measurement of glucose control are a crucial part of optimal diabetes mellitus (DM) care. Hemoglobin A1C (A1C), along with self-monitoring of blood glucose (SMBG), is considered the gold standard treatment target for DM, due to the intervention studies in both type 1 DM and type 2 DM, associating improved glucose control with a decreased risk of complications.1–3 With the advent of new technologies to assess glycemia, recent evidence linking hypoglycemia with adverse outcomes, and the increased knowledge on the limitations of A1C and SMBG, new metrics need to be incorporated, to better understand the dynamic nature of glucose, how to help patients achieve optimal control, reduce complications, and also to improve patient satisfaction by decreasing the burden of the interventions recommended. Multiple parameters of glucose control other than A1C have been proposed, potentially creating a burden for DM providers. Continue reading >>

Will Increasing Target A1c Goals Reduce Hypoglycemia Risk In Elderly Patients With T2d?

Will Increasing Target A1c Goals Reduce Hypoglycemia Risk In Elderly Patients With T2d?

Will Increasing Target A1C Goals Reduce Hypoglycemia Risk in Elderly Patients With T2D? Will Increasing Target A1C Goals Reduce Hypoglycemia Risk in Elderly Patients With T2D? The mean number of insulin injections per day was 3.7. New research has concluded that hemoglobin A1c (HbA1c) levels are not linked to hypoglycemia risk in older, insulin-treated patients with type 2 diabetes. This finding, according to researchers, suggests that higher A1c goals are not protective against hypoglycemia. In the prospective study, researchers aimed to determine whether liberating A1c goals to decrease the risk for hypoglycemia in older patients, a strategy currently recommended by experts, is optimal for this purpose. The study included 65 older patients (mean age, 766; 51% men) on insulin who received continuous glucose monitoring. At baseline, hypoglycemia duration and A1c were assessed while patients were on multiple insulin injections; measurements were again taken after de-intensification to once daily basal insulin with non-insulin agents. Mean number of insulin injections per day was 3.7 (1.3). Baseline data indicated 26% of the patients had A1c <7% (53 mmol/mol); 42% were between 7.1% and 8% (54-64 mmol/mol); 21% were between 8.1% and 9% (65-75 mmol/mol); and 11% were >9% (76 mmol/mol). No differences in hypoglycemia duration were reported among A1c groups, regardless of whether treatment consisted of multiple insulin injections or once daily basal insulin with non-insulin agents. [H]ypoglycemia risk is significant in the older population with type 2 diabetes on one or more insulin injections. Simply liberating A1C goals is inadequate for lowering the risk of hypoglycemia, the researchers concluded. Lowering the complexity of the insulin regimen, use of [continuous glucose Continue reading >>

What Is The A1c Test? How Does A1c Relate To Blood Glucose?

What Is The A1c Test? How Does A1c Relate To Blood Glucose?

Anyone with diabetes will be familiar with finger-prick testing for monitoring blood glucose to see how well they are managing their disease. This kind of regular testing is essential for most people with diabetes, but what role does an occasional hemoglobin A1C blood test play in controlling blood sugars, and how does it work? Contents of this article: What is the A1C test? The abbreviation A1C is used in the US (sometimes with a lower-case 'c' - A1c) and is short for glycated hemoglobin (sometimes called 'glycosylated' hemoglobin or glycohemoglobin). The other abbreviations in use are: HbA1c (widely used internationally) HbA1c Hb1c HgbA1C. The A1C test is a blood test used to measure the average level of glucose in the blood over the last two to three months. This test is used to check how well blood sugar levels are being controlled in a person with diabetes and can also be used in the diagnosis of diabetes.1 Hemoglobin is the protein in red blood cells which is responsible for transporting oxygen around the body. When blood glucose levels are elevated, some of the glucose binds to hemoglobin and, as red blood cells typically have a lifespan of 120 days, A1C (glycated hemoglobin) is a useful test because it offers an indication of longer term blood glucose levels.2 The particular type of hemoglobin that glucose attaches to is hemoglobin A, and the combined result is call glycated hemoglobin. As blood glucose levels rise, more glycated hemoglobin forms, and it persists for the lifespan of red blood cells, about four months.2 Therefore, the A1C level directly correlates to the average blood glucose level over the previous 8-12 weeks; A1C is a reliable test that has been refined and standardized using clinical trial data.3 There are two key things to know about the appl Continue reading >>

Low Blood Sugar Symptoms And Ranges

Low Blood Sugar Symptoms And Ranges

Low blood sugar (hypoglycemia) definition and facts Hypoglycemia is the medical term for low blood sugar. It typically occurs as a side effect of medications for diabetes. The normal range of blood glucose is from 70 to 100 mg/dL in an individual without diabetes, Most people will feel the effects and symptoms of low blood sugar when blood glucose levels are lower than 50 mg/dL. Low blood sugar is treated by giving a readily absorbed source of sugar, including soft drinks, juice, or foods containing sugar. If the hypoglycemia has progressed to the point at which the patient cannot take anything by mouth, an injection of glucagon may be given. Glucagon is a hormone that causes a fast release of glucose from the liver. Hypoglycemia or low blood sugar is syndrome that results from low blood sugar. The severity and symptoms of hypoglycemia can vary from person to person. Blood tests can diagnose low blood sugar, and symptoms resolve when the levels of sugar in the blood return to the normal range. The medical term for blood sugar is blood glucose. What can cause low blood sugar? Despite advances in the treatment of diabetes, low blood sugar episodes occur as a side effect of many treatments for diabetes. In fact, these episodes are often the limiting factor in achieving optimal blood sugar control, because many medications that are effective in treating diabetes carry the risk of lowering the blood sugar level too much, causing symptoms. In large scale studies looking at tight control in both type 1 and type 2 diabetes, low blood sugars occurred more often in the patients who were managed most intensively. This is important for patients and physicians to recognize, especially as the goal for treating patients with diabetes becomes tighter control of blood sugar. While peopl Continue reading >>

Hemoglobin A1c Levels And Risk Of Severe Hypoglycemia In Children And Young Adults With Type 1 Diabetes From Germany And Austria: A Trend Analysis In A Cohort Of 37,539 Patients Between 1995 And 2012

Hemoglobin A1c Levels And Risk Of Severe Hypoglycemia In Children And Young Adults With Type 1 Diabetes From Germany And Austria: A Trend Analysis In A Cohort Of 37,539 Patients Between 1995 And 2012

Abstract Severe hypoglycemia is a major complication of insulin treatment in patients with type 1 diabetes, limiting full realization of glycemic control. It has been shown in the past that low levels of hemoglobin A1c (HbA1c), a marker of average plasma glucose, predict a high risk of severe hypoglycemia, but it is uncertain whether this association still exists. Based on advances in diabetes technology and pharmacotherapy, we hypothesized that the inverse association between severe hypoglycemia and HbA1c has decreased in recent years. Methods and Findings We analyzed data of 37,539 patients with type 1 diabetes (mean age ± standard deviation 14.4±3.8 y, range 1–20 y) from the DPV (Diabetes Patienten Verlaufsdokumentation) Initiative diabetes cohort prospectively documented between January 1, 1995, and December 31, 2012. The DPV cohort covers an estimated proportion of >80% of all pediatric diabetes patients in Germany and Austria. Associations of severe hypoglycemia, hypoglycemic coma, and HbA1c levels were assessed by multivariable regression analysis. From 1995 to 2012, the relative risk (RR) for severe hypoglycemia and coma per 1% HbA1c decrease declined from 1.28 (95% CI 1.19–1.37) to 1.05 (1.00–1.09) and from 1.39 (1.23–1.56) to 1.01 (0.93–1.10), respectively, corresponding to a risk reduction of 1.2% (95% CI 0.6–1.7, p<0.001) and 1.9% (0.8–2.9, p<0.001) each year, respectively. Risk reduction of severe hypoglycemia and coma was strongest in patients with HbA1c levels of 6.0%–6.9% (RR 0.96 and 0.90 each year) and 7.0%–7.9% (RR 0.96 and 0.89 each year). From 1995 to 2012, glucose monitoring frequency and the use of insulin analogs and insulin pumps increased (p<0.001). Our study was not designed to investigate the effects of different treatment Continue reading >>

How Effective Is An A1c Test In Determining Hypoglycemia - Things You Didn't Know

How Effective Is An A1c Test In Determining Hypoglycemia - Things You Didn't Know

How effective is an A1c test in determining hypoglycemia? Ineffective: Hemoglobin A1c level has been utilized to monitor how well hyperglycemia (as in diabetics) has been controlled. ...Read more Poor:Hba1c is fair at detecting chronically high bgs, but very poor at detecting low bgs. Fortunately, true low bgs are very rare and almost never sustained or recurrent. The sensation of "hypoglycemia", when related to sugar at all in people not treated with diabetes medications, is usually the normal response to low-ish sugars, which corrects them and keeps the body well. ...Read more Needs evaluation:The hba1c is mildly high and could indicate pre-diabetes. You need a fasting glucose and lipid profile to see more. The cortisol level appears high, you need to do an overnight Dexamethasone suppression test to evaluate. Most people who feel shaky after meals do not have low sugars causing it. You should check your sugar with a glucose monitor when you have symptoms. ...Read more Borderline sugar:A hemoglobin a1c of 5.9 indicates borderline high blood sugar. Normal is <5.7, and over 6.5 is diabetes . ...Read more Not good at all:Hgb a1c should not be used to assess for hypoglycemic episodes or trends. It indicates only average blood sugars over months, and if there is concern or symptoms of hypoglycemia, then fingerstick blood sugar levels should be checked. Do some random ones, especially at night, and after high demand glucose things like exercise. Also check if having any symptoms - don't drive if you are low! ...Read more Most of it is bunk:Miss a few meals and your body will produce epinephrine to keep your blood sugar normal. That's why you shake. Please forgive me -- if you're so worried about "hypoglycemia", please adopt more sensible eating habits. Think about getting Continue reading >>

Association Between Hypoglycemia Risk And Hemoglobin A1c In Patients With Type 2 Diabetes Mellitus.

Association Between Hypoglycemia Risk And Hemoglobin A1c In Patients With Type 2 Diabetes Mellitus.

Association between hypoglycemia risk and hemoglobin A1C in patients with type 2 diabetes mellitus. a Abbott Diabetes Care, Inc. , Alameda , CA , USA. ; b Georgetown University Medical Center , Washington , DC , U.S.A. Curr Med Res Opin. 2016 Aug;32(8):1409-16. doi: 10.1080/03007995.2016.1176017. Epub 2016 May 5. OBJECTIVE: To better manage type 2 diabetes mellitus (T2DM), the tradeoff between improved glycemic control and hypoglycemia should be evaluated. The purpose of this study was to assess the relationship between hypoglycemia and hemoglobin A1c (HbA1c) in a real-world population. RESEARCH DESIGN AND METHODS: Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) was a multi-center, observational study. Patients 30 years old using any oral anti-hyperglycemic agent were recruited from seven European and five Asian countries between 2006 and 2007. Hypoglycemia events were collected through patient-reported questionnaires. HbA1c data was collected through chart review. Logistic regression was performed to assess the relationship between hypoglycemia and the most proximate HbA1c levels adjusting for potential confounders (demographics, clinical variables, other medication use, and comorbid conditions). RESULTS: A total of 4399 patients were recruited and analyzed. Mean age was 60 years, 52% were male, and 75% were on sulfonylureas (S.U.s). Respectively, 37% or 42% of patients reported hypoglycemia in the past 6 (Asia) or 12 months (Europe) before recruitment. Prevalence of hypoglycemia increased significantly (33% to 40%) as HbA1c decreased (p = 0.035). The same trend was also observed among S.U.-treated patients (p < 0.01). After adjusting for confounders, hypoglycemia prevalence was significantly higher for HbA1c <7.0% (odds ratio [O.R.] = 1.66 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 >>

What's A

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

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

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