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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 >>

Guide To Hba1c

Guide To Hba1c

Tweet HbA1c is a term commonly used in relation to diabetes. This guide explains what HbA1c is, how it differs from blood glucose levels and how it's used for diagnosing diabetes. What is HbA1c? The term HbA1c refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout your body, joins with glucose in the blood, becoming 'glycated'. By measuring glycated haemoglobin (HbA1c), clinicians are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months. For people with diabetes this is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications. HbA1c is also referred to as haemoglobin A1c or simply A1c. HbA1c refers to glycated haemoglobin (A1c), which identifies average plasma glucose concentration. How does HBA1c return an accurate average measurement of average blood glucose? When the body processes sugar, glucose in the bloodstream naturally attaches to haemoglobin. The amount of glucose that combines with this protein is directly proportional to the total amount of sugar that is in your system at that time. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why peop Continue reading >>

The Hemoglobin A1c Blood Test For Type 2 Diabetes

The Hemoglobin A1c Blood Test For Type 2 Diabetes

The hemoglobin A1C is a great blood test for a diabetic. You can know how well your blood sugar control has been over a few months. But this test will not replace daily glucose monitors. It has other limitations too. Still, the HbA1C blood test is my favorite of all type 2 diabetic tests. For one thing, it does not require fasting. For another, it can be done in the doctor's office with a single fingerstick just like a glucose monitor test. You get results in six minutes. Best of all, it lets you know how your blood sugar has been doing over the past two or three months. The test sounds perfect, but it is not. For diabetes management you need to know what your blood sugar levels are every day. Daily blood testing is still necessary, because a type 2 diabetic on insulin needs to know his glucose levels several times a day, not just every three months. A great HBA1C reading does not mean there have been no hyperglycemic (high blood sugar) or hypoglycemic (low blood sugar) episodes over the last few months. So the hemoglobin A1C cannot replace daily checks with your glucose monitor and good log book records. Your doctor always asks what your last daily reading was, and he likes to see your log book too. Daily readings along with the A1C give a complete picture of what is going on with your diabetes treatment. Taken together with daily readings, the hemoglobin A1C tells you if your blood sugar is staying in the range that will keep away the complications. There is more and more evidence that an A1C between 6.5 and 7 will do just that. And here's an encouraging fact. If your A1C was 9 and you lowered it to 8, there is a 20% reduction in your risk of complications. That means you do not have to be in the best range yet to see benefits from better blood sugar control. Hemoglob Continue reading >>

Metformin For Prediabetes

Metformin For Prediabetes

Prediabetes is, for many people, a confusing condition. It’s not quite Type 2 diabetes — but it’s not quite nothing, either. So how concerned should you be about it? For years, the jargon-filled names given to this condition — impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) — may have made the task of taking it seriously more difficult. But in 2002, the American Diabetes Association (ADA), along with the U.S. Department of Health and Human Services, inaugurated the term “prediabetes” to convey the likely result of not making diet or lifestyle changes in response to this diagnosis. In 2003, the threshold for prediabetes was lowered from a fasting glucose level of 110 mg/dl to one of 100 mg/dl. Then, in 2008, the American Diabetes Association (ADA) began recommending the drug metformin for some cases of prediabetes — specifically, for people under age 60 with a very high risk of developing diabetes, for people who are very obese (with a body-mass index, or BMI, of 35 or higher), and for women with a history of gestational diabetes. The ADA also said that health-care professionals could consider metformin for anyone with prediabetes or an HbA1c level (a measure of long-term blood glucose control) between 5.7% and 6.4%. But according to a recent study, metformin is still rarely prescribed for prediabetes. The study, published in April in the journal Annals of Internal Medicine, found that only 3.7% of people with prediabetes were prescribed metformin over a three-year period, based on data from a large national sample of adults ages 19 to 58. According to a Medscape article on the study, 7.8% of people with prediabetes with a BMI of 35 or higher or a history of gestational diabetes were prescribed metformin — still a very low rate for t Continue reading >>

Hemoglobin A1c Test (hba1c, A1c, Hb1c)

Hemoglobin A1c Test (hba1c, A1c, Hb1c)

Hemoglobin A1c definition and facts Hemoglobin A1c is a protein on the surface of red blood cells that sugar molecules stick to, usually for the life of the red blood cell (about three months). The higher the level of glucose in the blood, the higher the level of hemoglobin A1c is detectable on red blood cells. Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time period. Normal ranges for hemoglobin A1c in people without diabetes is about 4% to 5.9%. People with diabetes with poor glucose control have hemoglobin A1c levels above 7%. Hemoglobin A1c levels are routinely used to determine blood sugar control over time in people with diabetes. Decreasing hemoglobin A1c levels by 1% may decrease the risk of microvascular complications (for example, diabetic eye, nerve, or kidney disease) by 10%. Hemoglobin A1c levels should be checked, according to the American Diabetic Association, every six months in individuals with stable blood sugar control, and every three months if the person is trying to establish stable blood sugar control. Hemoglobin A1c has many other names such as glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin, and HbA1c. To explain what hemoglobin A1c is, think in simple terms. Sugar sticks to things, and when it has been stuck to something for a long time it's harder to the get sugar (glucose) off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die. When sugar (glucose) sticks to these red blood cells by binding to hemoglobin A1c, it gives us an idea of how much glucose has been around in the blood for the preceding three months. Hemoglobin A1c is a minor component of hemoglobin to which gl 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 >>

A1c Level And Future Risk Of Diabetes: A Systematic Review

A1c Level And Future Risk Of Diabetes: A Systematic Review

Go to: RESEARCH DESIGN AND METHODS Data sources We developed a systematic review protocol using the Cochrane Collaboration's methods (9). We formulated search strategies using an iterative process that involved medical subject headings and key search terms including hemoglobin A, glycated, predictive value of tests, prospective studies, and related terms (available from the authors on request). We searched the following databases between database establishment and August 2009: MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science (WOS), and The Cochrane Library. Systematic searches were performed for relevant reviews of A1C as a predictor of incident diabetes. Reference lists of all the included studies and relevant reviews were examined for additional citations. We attempted to contact authors of original studies if their data were unclear or missing. Study selection and data abstraction We searched for published, English language, prospective cohort studies that used A1C to predict the progression to diabetes among those aged ≥18 years. We included studies with any design that measured A1C—whether using a cutoff point or categories—and incident diabetes. Titles and abstracts were screened for studies that potentially met inclusion criteria, and relevant full text articles were retrieved. X.Z. and W.T. reviewed each article for inclusion and abstracted, reviewed, and verified the data using a standardized abstraction template. If A1C measurement was standardized by the National Glycohemoglobin Standardization Program (NGSP) and both standardized and unstandardized A1C values were reported, standardized values were used in the analyses. A sensitivity analysis, however, was conducted using both standardized and unsta 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 >>

6 Ways To Lower Your A1c Level

6 Ways To Lower Your A1c Level

Diabetes is a serious, chronic disease that can lead to many complications. When managed properly, diabetes does not have to control your life or ruin your health. Getting tested, especially if you are at risk for developing type 2 diabetes, is a proactive measure you can take for yourself and your future. In the early stages of diabetes, there are no symptoms. An early diagnosis helps you get treatment before complications occur. The A1C test is a blood test that checks for type 2 diabetes. It is also used to see how well you are managing your diabetes if you have already been diagnosed. The test provides information about a person’s average levels of blood sugar over a two- to three-month period. The number is reported in the form of a percentage. The higher the percentage, the higher your average blood glucose levels are, and the higher your risk for either diabetes or related complications. A1C is one of the primary tests used for diabetes diagnosis and management. It can test for type 1 and type 2 diabetes, but it can’t test for gestational diabetes. It can also be used to predict the likelihood that someone will get diabetes. The A1C test measures how much glucose, or sugar, is attached to hemoglobin, the protein in red blood cells. The more glucose attached, the higher the A1C. This test is groundbreaking, as it 1) doesn’t require fasting, 2) gives a picture of blood sugar levels over a period of days and weeks instead of at just one point in time like fasting sugars, and 3) can be done at any time of day. This makes it easier to administer and easier to make accurate diagnoses. According to the National Institutes of Health, a normal A1C is below 5.7 percent. If your score is between 5.7 and 6.4 percent, the diagnosis is prediabetes. Having prediabetes put Continue reading >>

A1c Is Better Screening Test For Diabetes

A1c Is Better Screening Test For Diabetes

Dear Dr. Roach • My A1c test on blood sugar is always higher (prediabetes) than my fasting glucose test (normal) on the same visit to the doctor. Which result should I believe? My latest test at a doctor’s office showed that my A1c is 6.2 percent, and fasting glucose is 88 mg/dL. The A1c pretty much remained at 6.2 percent level, while the fasting glucose varied between 81 and 88 in the past two years. The test is drawing a blood sample after a 12-hour overnight fast. I am not taking any diabetes medication. Previously, my A1c results were 5.9 percent in August 2016 and 5.5 percent in December 2016. — K.H. Answer • Both the A1c test and the glucose tests are blood tests for diabetes. The blood glucose test is a snapshot of an instant in time, while the A1c is a measure of the average value over the past two or three months or so. The A1c looks at the amount of sugar molecules on the large hemoglobin protein of the blood. In general, the A1c is a better screening test for diabetes than a fasting glucose test, because fasting blood sugar is normal for a long time (potentially years) before one shows overt diabetes. In early Type 2 diabetes, the only time the blood sugar gets above normal is after eating (the blood sugar is supposed to go up a bit after eating, but in the early stages of diabetes, it goes higher than it should). The most sensitive test for Type 2 diabetes is a glucose tolerance test, where a fixed amount of sugar is given, and the blood is tested after two hours. An elevated level at two hours is prediabetes or diabetes. However, the A1c, which is affected by both fasting blood glucose levels and those after eating, is nearly as sensitive, and is much easier to do. Both the glucose tolerance test and the A1c usually will diagnose prediabetes and di 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 >>

Hba1c Cutoff Of 5.9% Best For Detecting Diabetes In Pregnancy

Hba1c Cutoff Of 5.9% Best For Detecting Diabetes In Pregnancy

NEW YORK A1c level of 5.9% or higher is optimal for detecting diabetes and for identifying women at increased risk of adverse pregnancy outcomes, according to researchers from New Zealand. This is lower than the currently recommended 6.5% threshold, they note in Diabetes Care, online September 4. "HbA1c is predictive of pregnancy outcomes in women with known diabetes, so we weren't that surprised," Dr. Ruth C. E. Hughes from University of Otago in Christchurch told Reuters Health by email. "However, the rates of adverse pregnancy outcomes were higher than anticipated in women with an HbA1c 5.9%-6.4% (41-46 mmol/mol) who did not meet New Zealand criteria for gestational diabetes on an early pregnancy oral glucose tolerance test." Although several organizations recommend screening for diabetes in pregnancy at the first antenatal visit, the most appropriate test and threshold remain undefined. Dr. Hughes's team studied a prospective cohort study of more than 16,100 pregnant women, who had blood drawn at a median 47 days' gestation. The mean HbA1c among all women tested was 5.3%. Only 33 women (0.2%) had HbA1c of 6.5% or higher. Of the 974 women who had oral glucose tolerance tests (OGTTs) before 20 weeks' gestation, 15 met criteria for diabetes (median HbA1c, 6.5%) and 170 for gestational diabetes (GDM) (median HbA1c, 5.8%). On receiver operating curve (ROC) analysis, an HbA1c of 5.9% emerged as the optimal screening threshold for detecting diabetes. It yielded 100% sensitivity, 97.4% specificity, 18.8% positive predictive value, and 100% negative predictive value. The 5.9% cutoff was also highly specific (98.4%) for early GDM, with a positive predictive value of 52.9% and a negative predictive value of 92.8%. About three-quarters of women with early HbA1c of 5.9% or highe 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 >>

At What A1c Level Do Adverse Pregnancy Outcomes Begin?

At What A1c Level Do Adverse Pregnancy Outcomes Begin?

The results from a new study show that risk increased in women with an early HbA1c of at least 5.9% regardless of a gestational diabetes diagnosis later in pregnancy. Risk of obstetric complications increases linearly with rising maternal glycemia. Testing HbA1c is an effective option to detect hyperglycemia, but its association with adverse pregnancy outcomes remains unclear. Emerging data sustains that an early HbA1c≥5.9% could act as a pregnancy risk marker. The purpose of the study was to determine, in a multi-ethnic cohort, whether an early ≥5.9% HbA1c could be useful to identify women without diabetes mellitus at increased pregnancy risk. Primary outcome was macrosomia. Secondary outcomes were pre-eclampsia, preterm birth and Caesarean section rate. 1,228 pregnancies were included for outcome analysis. Women with HbA1c≥5.9% (n= 48) showed a higher rate of macrosomia (16.7% vs. 5.9%,p= 0.008) and a tendency towards a higher rate of preeclampsia (9.32% vs. 3.9% ,p= 0.092). There were no significant differences in other pregnancy outcomes. After adjusting for potential confounders, an HbA1c≥5.9% was independently associated with a three-fold increased risk of macrosomia (p= 0.028) and preeclampsia (p= 0.036). They evaluated data on 1,228 pregnant women from April 2013 to September 2015 to determine whether an early HbA1c of at least 5.9% can identify women at increased risk for adverse pregnancy outcomes. Participants were screened for gestational diabetes at 24 to 28 weeks’ gestation, and HbA1c measurement was added to first antenatal blood tests. The primary outcome of the study was macrosomia, and secondary outcomes included rates of preeclampsia, preterm birth and caesarean section. Compared with participants with an HbA1c less than 5.9% (n = 48), parti Continue reading >>

Hba1c Cutoff Of 5.9% Best For Detecting Diabetes In Pregnancy

Hba1c Cutoff Of 5.9% Best For Detecting Diabetes In Pregnancy

A hemoglobin (Hb) A1c level of 5.9% or higher is optimal for detecting diabetes and for identifying women at increased risk of adverse pregnancy outcomes, according to researchers from New Zealand. This is lower than the currently recommended 6.5% threshold, they note in Diabetes Care, online September 4. "HbA1c is predictive of pregnancy outcomes in women with known diabetes, so we weren't that surprised," Dr. Ruth C. E. Hughes from University of Otago in Christchurch told Reuters Health by email. "However, the rates of adverse pregnancy outcomes were higher than anticipated in women with an HbA1c 5.9%-6.4% (41-46 mmol/mol) who did not meet New Zealand criteria for gestational diabetes on an early pregnancy oral glucose tolerance test." Although several organizations recommend screening for diabetes in pregnancy at the first antenatal visit, the most appropriate test and threshold remain undefined. Dr. Hughes's team studied a prospective cohort study of more than 16,100 pregnant women, who had blood drawn at a median 47 days' gestation. The mean HbA1c among all women tested was 5.3%. Only 33 women (0.2%) had HbA1c of 6.5% or higher. Of the 974 women who had oral glucose tolerance tests (OGTTs) before 20 weeks' gestation, 15 met criteria for diabetes (median HbA1c, 6.5%) and 170 for gestational diabetes (GDM) (median HbA1c, 5.8%). On receiver operating curve (ROC) analysis, an HbA1c of 5.9% emerged as the optimal screening threshold for detecting diabetes. It yielded 100% sensitivity, 97.4% specificity, 18.8% positive predictive value, and 100% negative predictive value. The 5.9% cutoff was also highly specific (98.4%) for early GDM, with a positive predictive value of 52.9% and a negative predictive value of 92.8%. About three-quarters of women with early HbA1c of 5.9% Continue reading >>

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