Cardiometabolic Risk Profiles In Patients With Impaired Fasting Glucose And/or Hemoglobin A1c 5.7% To 6.4%: Evidence For A Gradient According To Diagnostic Criteria
Go to: Abstract It has been suggested that the early detection of individuals with prediabetes can help prevent cardiovascular diseases. The purpose of the current study was to examine the cardiometabolic risk profile in patients with prediabetes according to fasting plasma glucose (FPG) and/or hemoglobin A1c (HbA1c) criteria. Cross-sectional analysis from the 2022 patients in the Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS Study) was developed. Four glycemic status groups were defined based on American Diabetes Association criteria. Information about cardiovascular risk factors–body mass index, waist circumference, blood pressure, cholesterol, triglycerides, uric acid, gamma-glutamyltransferase, glomerular filtration–and metabolic syndrome components were analyzed. Mean values of clinical and biochemical characteristics and frequencies of metabolic syndrome were estimated adjusting by age, sex, educational level, and family history of diabetes. A linear trend (P<0.001) was observed in most of the cardiovascular risk factors and in all components of metabolic syndrome. Normoglycemic individuals had the best values, individuals with both criteria of prediabetes had the worst, and individuals with only one–HbA1c or FPG–criterion had an intermediate position. Metabolic syndrome was present in 15.0% (95% confidence interval: 12.6–17.4), 59.5% (54.0–64.9), 62.0% (56.0–68.0), and 76.2% (72.8–79.6) of individuals classified in normoglycemia, isolated HbA1c, isolated FPG, and both criteria groups, respectively. In conclusion, individuals with prediabetes, especially those with both criteria, have worse cardiometabolic risk profile than normoglycemic individuals. These results suggest the need to use both criteria in Continue reading >>
Hba1c And Diabetes – Glycated Hemoglobin (a1c) Explained
Diabetes and its complications remain a major cause of early disease and death worldwide. The diagnosis of diabetes is to a large extent based on detecting elevated levels of sugar (glucose) in the blood. Hemoglobin A1c (HbA1c) is a laboratory measure frequently used for this purpose. The test is also useful to monitor treatment in patients with established diabetes. Approximately 8 percent of the US populations suffer from type 2 diabetes, with as many as 40 percent of those undiagnosed (1). Worldwide, the prevalence of type 2 diabetes is estimated at 6.4 percent in adults but varies somewhat among countries with the rate of undetected diabetes as high as 50 percent in some areas (2). The term diabetes describes several disorders of abnormal carbohydrate metabolism that are characterized by high levels of blood glucose (hyperglycemia). Diabetes is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin (3). The Difference Between Type 1 and Type 2 Diabetes The prevalence of both type 1 and type 2 diabetes continues to increase worldwide, with type 2 diabetes much more common and accounting for over 90 percent of patients with diabetes. Type 1 diabetes used to be called juvenile onset or insulin-dependent diabetes because it often presents in childhood and it is characterized by the inability of the pancreas to produce the insulin. Insulin is necessary for the cells of the body to be able to utilize glucose for energy production. Without insulin, glucose accumulates in the blood leading to hyperglycemia. Due to the absence of insulin, most patients with type 1 diabetes need to be treated with insulin. Conversely, type 2 diabetes, formerly called adult-onset or non-insulin-depend Continue reading >>
Cardiometabolic Risk Profiles In Patients With Impaired Fasting Glucose And/or Hemoglobin A1c 5.7% To 6.4%: Evidence For A Gradient According To Diagnostic Criteria: The Predaps Study.
Giráldez-García C, Sangrós FJ, Díaz-Redondo A, Franch-Nadal J, Serrano R, Díez J. et al. Cardiometabolic risk profiles in patients with impaired fasting glucose and/or hemoglobin A1c 5.7% to 6.4%: evidence for a gradient according to diagnostic criteria: The PREDAPS Study. Medicine (Baltimore). 2015 Nov;94(44):e1935. doi: 10.1097/MD.0000000000001935. It has been suggested that the early detection of individuals with prediabetes can help prevent cardiovascular diseases. The purpose of the current study was to examine the cardiometabolic risk profile in patients with prediabetes according to fasting plasma glucose (FPG) and/or hemoglobin A1c (HbA1c) criteria.Cross-sectional analysis from the 2022 patients in the Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS Study) was developed. Four glycemic status ... + Continue reading >>
Clinical Science Glucoregulatory Function Among African Americans And European Americans With Normal Or Pre-diabetic Hemoglobin A1c Levels
Abstract A hemoglobin (Hb) A1c range of 5.7%–6.4% has been recommended for the diagnosis of prediabetes. To determine the significance of such “prediabetic” HbA1c levels, we compared glucoregulatory function in persons with HbA1c levels of 5.7%–6.4% and those with HbA1c < 5.7%. We studied 280 nondiabetic adults (142 black, 138 white; mean (± SD) age 44.2 ± 10.6 years). Each subject underwent clinical assessment, blood sampling for HbA1c measurement, and a 75-g oral glucose tolerance test at baseline. Additional assessments during subsequent outpatient visits included insulin sensitivity, using homeostasis model assessment (HOMA)-IR and the hyperinsulinemic euglycemic clamp; insulin secretion, using HOMA-B and frequently samples intravenous glucose tolerance test (FSIVGTT) and disposition index (DI); and measurement of fat mass, using DXA. Compared to subjects with HbA1c < 5.7%, persons with HbA1c levels of 5.7%–6.4% were older, and had higher body mass index (BMI) and insulin secretion but similar insulin sensitivity. When the two groups were matched in age and BMI, persons with HbA1c 5.7%–6.4% were indistinguishable from those with HbA1c < 5.7% with regard to all measures of glycemia and glucoregulatory function. Unlike glucose-defined prediabetes status, an HbA1c range of 5.7%–6.4% does not reliably identify individuals with impaired insulin action or secretion, the classical defects underlying the pathophysiology of prediabetes. Thus, HbA1c cannot validly replace blood glucose measurement in the diagnosis of prediabetes. If utilized as a screening test due to convenience, aberrant HbA1c values should be corroborated with blood glucose measurement before therapeutic intervention. Continue reading >>
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 >>
Feedback Patient Preparation Collect Specimen Preparation Storage/Transport Temperature Unacceptable Conditions Remarks Stability Ambient: 24 hours; Refrigerated: 1 month; Frozen: 1 year (avoid repeated freeze/thaw cycles) Hemoglobin A1c values of 5.7-6.4 percent indicate an increased risk for developing diabetes mellitus. Hemoglobin A1c values greater than or equal to 6.5 percent are diagnostic of diabetes mellitus. Diagnosis should be confirmed by repeating the Hb A1c test. This boronate affinity Hb A1c method provides accurate analytical results in the presence of nearly all hemoglobin variants. Hb F higher than 10 percent of total Hb may yield falsely low results. Conditions that shorten red cell survival, such as the presence of unstable hemoglobins like Hb SS, Hb CC, and Hb SC, or other causes of hemolytic anemia may yield falsely low results. Iron deficiency anemia may yield falsely high results. A1C A1c Hemoglobin Glycated Hemoglobin Glyco HGB Glyco-Hb Glycosylated Hemoglobin HA1C HbA1c Hemoglobin A1C Hemoglobin A1c, Blood HgbA1c Continue reading >>
Do I Have Prediabetes Or Diabetes? Guide To The A1c, Fpg, And Ogtt Tests, Plus Tips For Prevention
If you’ve been diagnosed with prediabetes, you may wonder what that means. It’s a condition where your blood glucose levels are above normal, but not high enough for you to be diagnosed with diabetes. Many doctors consider prediabetes to be the first stage of type 2 diabetes. Studies show that 15 to 30 percent of people with prediabetes will develop diabetes in as little as five years without intervention, such as weight loss or increased physical activity. In fact, most people who get type 2 diabetes had prediabetes first. Prediabetes is serious in and of itself. People with this condition have a greater risk of developing cardiovascular disease than those without it. There are three tests that doctors can do in order to determine whether you have high blood sugar. A1C This blood test, which is also called hemoglobin A1c, HbA1c, or glycosylated hemoglobin, measures the percentage of sugar that is attached to your hemoglobin. Hemoglobin is a protein in your red blood cells. The higher the A1C, the higher your average blood sugar levels have been running over the past two or three months. A normal A1C is below 5.7 percent. An A1C between 5.7 percent and 6.4 percent suggests prediabetes. An A1C of 6.5 or more indicates type 2 diabetes if the test is confirmed. If your results are questionable, your doctor will retest your A1C on another day to confirm the diagnosis. Fasting plasma glucose The fasting plasma glucose (FPG) test is a blood test that’s done after you’ve been fasting overnight. It measures the sugar in your blood. A normal fasting glucose test is lower than 100 milligrams per deciliter (mg/dL). A result between 100 and 125 mg/dL is diagnostic for prediabetes. One that is 126 mg/dL or above is indicative of diabetes. It’s recommended to retest this an Continue reading >>
Research On Type 2 Diabetes/ Prediabetes
Below you will find a growing collection of dietary research on type 2 diabetes treatment. JUMP TO: Overview | Blood sugar & A1c | Diet Recommendations | Low Carb vs. Low Fat | Weight Loss & A1C Diet Comparison | Carbohydrates | Fat & Cholesterol | Protein | DMP Blog Overview Most people think that when people get diagnosed with diabetes, that’s it, they’re destined to get progressively worse, take more meds and suffer bad health. That’s simply not the case! While type 2 diabetes is not reversible from a diagnostic standpoint (once a person has it, they have it), diabetes can be reversible from a physiological standpoint in many. That is, a person can work to gain excellent control of their blood sugar levels, keeping them within a normal healthy range so that they are functioning like a non-diabetic person. Research shows this is true and in our experience with members and subscribers, people are achieving this everyday, even if they’ve had diabetes for 20 years! NOTE: The majority of the research that follows is around type 2 diabetes treatment. It's important to differentiate ‘reduction of diabetes risk' from ‘diabetes treatment.' These are often lumped into the same category but they are two very different concepts. Here our main focus of research is on diabetes treatment, along with prediabetes diet and lifetsyle interventions. Blood Sugar & A1C BLOOD SUGAR: Blood sugar is a measure of glucose/ sugar in the blood at any one time. Throughout the day blood sugar can fluctuate in response to numerous factors, mainly food but also exercise, stress, sleep, medications and so forth. The body is designed to maintain blood sugar levels in a healthy range. And it is well established that diabetics and prediabetics should work toward the goal of having blood suga Continue reading >>
For A 65 Year Old Male In Good Health Is 118 Glucose Level And 6.4 A1c Ok?
No. Higher A1C's are strongly correlated with increased heart disease, for A1C's above 4.6. A summary: A1c and High Post-Meal Blood Sugars Predict Heart Attack One study: Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study. In nondiabetic adults, HbA1c level was not related to CHD risk below a level of 4.6% but was significantly related to risk above that level (P<.001). In diabetic adults, the risk of CHD increased throughout the range of HbA1c levels. In the adjusted model, the Risk Ratio of CHD for a 1 percentage point increase in HbA1c level was 2.36 (95% CI, 1.43-3.90) in persons without diabetes but with an HbA1c level greater than 4.6%. In diabetic adults, the Risk Ratio was 1.14 (95% CI, 1.07-1.21) per 1 percentage point increase in HbA1c across the full range of HbA1c values. Continue reading >>
5 Ways To Lower Your A1c
For some, home blood sugar testing can be an important and useful tool for managing your blood sugar on a day-to-day basis. Still, it only provides a snapshot of what’s happening in the moment, not long-term information, says Gregory Dodell, MD, assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai Health System in New York City. For this reason, your doctor may occasionally administer a blood test that measures your average blood sugar level over the past two to three months. Called the A1C test, or the hemoglobin A1C test, this provides a more accurate picture of how well your type 2 diabetes management plan is working. Taking the A1C Test If your diabetes is well controlled and your blood sugar levels have remained stable, the American Diabetes Association recommends that you have the A1C test two times each year. This simple blood draw can be done in your doctor's office. Some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes. The A1C test results provide insight into how your treatment plan is working, and how it might be modified to better control the condition. Your doctor may want to run the test as often as every three months if your A1C is not within your target range. What the A1C Results Mean The A1C test measures the glucose (blood sugar) in your blood by assessing the amount of what’s called glycated hemoglobin. “Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin, or glycates. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin,” Dr. Dodell says. An A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 perce Continue reading >>
How Is A Hemoglobin A1c Performed?
The hemoglobin A1C laboratory test is an essential lab value for tracking blood sugar control. Typically, primary care providers like to monitor this test every three months. It is a test that is often used for patients with diabetes to determine if their treatment plan is working effectively It is a good screening tool to evaluate if someone is developing diabetes A hemoglobin A1C test is performed by drawing blood. It can be taken with a non-fasting blood draw, which means that if you eat immediately before the test, it will not change the value. The hemoglobin A1C test reveals the average blood sugar over the course of the last three months. This test is also called a glycated hemoglobin because it looks at red blood cells. As red blood cells circulate through the blood stream, they become coated with excess sugar, or glucose, that is also floating around in the blood. When a blood sample is taken, a test can be run to determine how much sugar has attached to the red blood cells during circulation. Increased amounts of glucose in the blood will result in a higher hemoglobin A1C value. Red blood cells live an average of three months, so they can show the average of the last three months of an individual’s blood sugars. Understanding Hemoglobin A1C Results The normal range for a hemoglobin A1c is less than 5.7 percent. This indicates that the average blood sugar levels were within an acceptable range and do not suggest that a person has diabetes. Hemoglobin A1C values of 5.7 to 6.4 percent are considered to be pre-diabetic values. This means that the patient has had higher than normal blood sugar levels over the previous three months and could be developing diabetes. Many health care providers recommend dietary and lifestyle changes to reduce the risk of developing d Continue reading >>
What Is A Good Score On The A1c Diabetes Test?
Normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time can have an A1C level above 9 percent. A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate dates indicates diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which is high risk of developing diabetes. For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan. Remember, the higher your A1C level, the higher your risk of diabetes complications. A good score on the A1C test depends on whether you’ve been diagnosed with diabetes. For those who do not have diabetes, a score of less than 5.7% is considered normal, while 5.7% to 6.4% indicates prediabetes and 6.5% or higher means you have diabetes. If you already have diabetes, a score of 7% or lower is desired. You and your doctor can decide what score is best for you. The A1C diabetes test is a way to get an average of how well your blood sugar has been controlled for the past three months. The standard A1C goal for most people with diabetes is less than 7%. However, the goal may be individualized or may be different for some people, especially older adults, people with heart disease or those who are prone to frequent low blood glucose. It's a good idea to find out what your A1C goal should be from your healthcare provider and then use that as a benchmark for your A1C results. No one quite agrees on where your A1C score should be, but we all agree on where it shouldn’t be. The scale does not look anything like the BGL numbers you are used Continue reading >>
Have You Gotten Your Hemoglobin A1c Checked?
There are numerous amount of information online about diabetes, its complications, signs and symptoms. However, how does one know if they are at risk of diabetes? The hemoglobin A1C test for diabetes The hemoglobin A1C test is an important blood test that determines the amount of sugar in the blood or how well your diabetes is controlled. This test gives an average of your blood sugar level between a 6-12 week period. Hemoglobin is a substance within the red blood cells that carried oxygen throughout the bloodstream. When your blood sugar level is high, then the sugar builds up in the blood and then combines with the hemoglobin, hence being “glycated”. Therefore the average amount of sugar in the blood can be determined by measuring the hemoglobin A1C level. The amount of hemoglobin A1C will reflect the last several weeks of blood sugar levels for a period of approximately 120 days; if your sugar level has been high over the recent weeks, then your hemoglobin A1C test will be high. What is normal and what is not? For people who are not diagnosed with diabetes, the normal range for your hemoglobin A1C test is between 4% and 5.6%. If your hemoglobin A1C level is between 5.7% and 6.4% then you may be at risk for diabetes and should visit your physician for consultation. If your hemoglobin A1C level is above 6.5%, this indicated diabetes and you should go to see a physician as soon as possible. The higher the hemoglobin A1C level, the higher the risk of developing complications associated with diabetes. If you have uncontrolled diabetes, then you are familiar with the hemoglobin A1C test and this test is usually recommended to be done every 12 weeks/3 months to maintain stability of the blood sugar level. If your diabetes is controlled, then doing a hemoglobin A1C test Continue reading >>
Hemoglobin A1c Overview
Hemoglobin (A1c) is a blood test that checks the amount of sugar (given as a percent) bound to the hemoglobin in the red blood cells. This test gives an average blood sugar level over the past 2 to 3 months. Hemoglobin (A1c) is measured as a percentage. The normal level is less than 7% in a diabetic adult. The normal level is less than 5% in a non diabetic adult. Continue reading >>
What Is It? In pre-diabetes, blood sugar levels are slightly higher than normal, but still not as high as in diabetes. If diabetes is "runaway blood sugar" think of pre-diabetes as blood sugar that is "halfway out the door." People almost always develop pre-diabetes before they get type 2 diabetes. The rise in blood sugar levels that is seen in pre-diabetes starts when the body begins to develop a problem called "insulin resistance." Insulin is an important hormone that helps you to process glucose (blood sugar). If usual amounts of insulin can't trigger the body to move glucose out of the bloodstream and into your cells, then you have insulin resistance. Once insulin resistance begins, it can worsen over time. When you have pre-diabetes, you make extra insulin to keep your sugar levels near to normal. Insulin resistance can worsen as you age, and it worsens with weight gain. If your insulin resistance progresses, eventually you can't compensate well enough by making extra insulin. When this occurs, your sugar levels will increase, and you will have diabetes. Depending on what a blood sugar test finds, pre-diabetes can be more specifically called "impaired glucose (sugar) tolerance" or "impaired fasting glucose." Impaired fasting glucose means that blood sugar increase after you haven't eaten for a while – for example, in the morning, before breakfast. Impaired glucose tolerance means that blood sugar levels reach a surprisingly high level after you eat sugar. To diagnose impaired glucose tolerance, doctors usually use what is called a "glucose tolerance test." For this test you drink a sugary solution, and then you have blood drawn after a short time. Having pre-diabetes does not automatically mean you will get diabetes, but it does put you at an increased risk. Pre- Continue reading >>