Dr. Jacqueline Gerhart: If You Have Prediabetes, Will You Get Diabetes?
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission. Dear Dr. Gerhart: I was just told I have prediabetes. What are the chances I'm going to get full-blown diabetes? Dear Reader: I'm sorry to hear you have prediabetes, also known as impaired fasting glucose or impaired glucose tolerance. It is diagnosed in patients with elevated blood sugars that are not yet high enough to be considered diabetes. There are a few ways to test for diabetes. Fasting blood sugar: This can be done either by a traditional blood draw or by a finger prick. If the value is from 100 to 125 mg/dL (milligrams per deciliter), you are considered to have impaired fasting glucose. If it is greater than 126 mg/dL on two different occasions, you are diagnosed with diabetes. Two-hour oral glucose tolerance test: This test is done less frequently because you have to drink a sugary drink, then wait two hours before your blood is drawn. On this test, if your blood sugar is 140 to 199 mg/dL, you have impaired glucose tolerance. Greater than 200 mg/dL means diabetes. Hemoglobin A1C: This test is often used for both the diagnosis and the ongoing management of diabetes. If your value is 5.7 to 6.4 percent, you have prediabetes. Greater than 6.5 percent is diabetes. Having prediabetes does place you at a high risk of developing diabetes. For example, people with hemoglobin A1C values of 5.5 to 6.0 have a 9 to 25 percent chance of developing diabetes in five years. Those with values from 6.0 to 6.4 have a 25 to 50 percent chance, and they are 20 times more likely to develop diabetes than those with a normal hemoglobin A1C. Prediabetes is associated with card Continue reading >>
Diabetes Experts Share Ways To Lower Your A1c Levels
Diabetes management at home is an important way of controlling your blood sugar levels without the help of an expert. In that sense, you are in control of your diabetes on a daily basis. However, the American Diabetes Associations’ recommends that a person with diabetes should get their A1C tested by a doctor at least two times a year. The test will give you a picture of your journey with diabetes as a whole. Now, once you do get the numbers, what do you do with that information? If you are on the right track, you will continue doing whatever it is that has been working so far. you feel encouraged! However, if the numbers are not what you and your health care provider were expecting, it is imperative that you embark on the path to lowering them so you can avoid any diabetes related complications in the future. The task can be daunting and overwhelming. We have rounded up 37 experts to share tips and ways that will help you in lowering your A1C levels and keeping them that way. The wisdom they share with us today will help you take those little steps towards a healthier lifestyle. 1. Sharon Castillo In a recent study published by the University of Toronto, it was shown that cinnamon has properties which can reduce blood pressure, especially for those who have prediabetes or type 2-diabetes. Hypertension or high blood pressure is common among those who have prediabetes and type-2 diabetics. High blood glucose levels create oxidative radicals which can damage the arteries. I recommend reading the following articles: The damage to the arteries can result into the scarring of the blood vessels. The scarring builds up plaque which reduces the size of the blood vessel. The reduction in the size of the diameter increases blood pressure. While not all of cinnamon’s mechanism Continue reading >>
Diabetes Simplified: A1c Testing
By Wil Dubois “Mirror, mirror, on the wall, who’s the best-controlled of all?” —what the Wicked Queen would have asked if she’d had diabetes instead of vanity issues If you’ve had diabetes for any time at all, you’ve probably heard of the A1C test. Sometimes, it’s also called the HbA1c test, the Hemoglobin A1c test, or the glycated hemoglobin test. They’re all the same thing. This is a lab test that allows your doctor, by consulting with a magic mirror, to determine how well your diabetes has been controlled, night and day, for the last three months. If that’s not black magic, I don’t know what is. Of course, as sci-fi writer Arthur C. Clarke famously said, “Any sufficiently advanced technology is indistinguishable from magic.” The A1C has become the widely accepted benchmark for diabetes control. It’s used to classify who is in control and who is not, and to quantify the risk levels of those not in-target. The higher the A1C, the greater the risk of complications. The A1C is now also used diagnostically, with A1C scores actually used to diagnose new-onset diabetes. The A1C Test: How Does It Work? Well, like I said, it’s magic: in this case, the magic of biochemistry. The test measures the average blood sugar level for the past three months. It can do this because glucose sticks to red blood cells, just like powdered sugar sticks to freshly-fried doughnut holes. The result of the test is expressed as a percentage: 6.2 percent…7.8 percent…8.3 percent…9.6 percent…12.4 percent…and so on. Most A1C scores are only expressed in tenths of a percent, but some labs report twentieths, as well, so you might see an A1C of 6.79 percent or 8.32 percent. Wait a sec. A percentage of what, exactly? The percentage of hemoglobin in the sample of red Continue reading >>
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 >>
Patient Comments: Hemoglobin A1c Test - High Results
I have been doing a lot of research on CIN1. I was 26 when my doctor told me I have cervical dysplasia (CIN1), January of 20017. I didn't think anything of it. But then she told me I have HPV high risk E6/E7 mRNA. One day I was looking through my medical records online and discovered I had CIN1 3 years ago July of 2014 and my doctor never told me. Now I am stressing over it because my periods are irregular and when I do have them they are strange. Also the year of 2014 I told my doctor I was having clots the size of 2 half dollars put together and she didn't say anything either. I get pelvic pain sometimes. She did a biopsy and I was positive for CIN1 and high risk HPV and ascus. I don't know what I should do, maybe I should get a new doctor. In May 2015 I was really tired, lethargic and bloated all the time. I was so constipated and miserable. I had been gluten free for 4 years by self-diagnosis. Finally, I went to a gastroenterologist. My blood work came back positive for Helicobacter pylori. The doctor said that H. pylori causes similar symptoms as gluten allergies. I had an endoscopy and colonoscopy which showed all of the internal inflammation and prior damage from the bacteria. It seemed to be dormant so there was no need for eradication, however the prescription acid reflux pills made me sick so I stopped that. Now I take probiotics and manuka honey and feel great. Try to avoid the prescription drugs. I have to go back for a check up to see if the bacteria is gone. I just had a laparoscopy 2 days ago and other than feeling full and bloated from the gas and a soreness around the incisions, I feel pretty good. The day of the surgery when I came home, I was very sleepy and slept for almost 2 days with getting up, except here and there to use the bathroom and eat. My Continue reading >>
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 >>
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 >>
- What Is a Normal Blood Sugar Level?
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
Diagnosis
Print The American Diabetes Association (ADA) recommends that blood glucose screening for adults begin at age 45, or sooner if you are overweight and have additional risk factors for prediabetes or type 2 diabetes. There are several blood tests for prediabetes. Glycated hemoglobin (A1C) test This test indicates your average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. In general: An A1C level below 5.7 percent is considered normal An A1C level between 5.7 and 6.4 percent is considered prediabetes An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (hemoglobin variant). Fasting blood sugar test A blood sample is taken after you fast for at least eight hours or overnight. In general: A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes. Oral glucose tolerance test This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours. In general: A blood sugar level less than 140 mg/dL (7.8 mmo Continue reading >>
5 Simple Ways To Lower Your A1c This Week
The A1C blood test is a simple test that analyzes your glucose (blood sugar) levels by measuring the amount of glycated hemoglobin in your blood. Hemoglobin is a protein in your red blood cells; when glucose enters the blood, it attaches to the hemoglobin. The result is glycated hemoglobin. The more glucose in your blood, the higher your glycated hemoglobin. The A1C is a valuable indicator of how well your diabetes management plan is working. While your individual A1C goal will depend on factors including your age and your personal medical profile, most people with diabetes aim to keep their A1C below 7 percent. By keeping your A1C number within your target range, you can reduce the risk of diabetes complications. While it is important to develop a long-term diabetes management plan with your physician, there are several steps you can take right away to help reduce your A1C. Small changes add up, so consider trying some of these strategies to lower your A1C this week. 1. Try Short Sessions of High Intensity Exercise According to research presented at the American Heart Association's Scientific Sessions 2015, type 2 diabetes patients who did 10 minutes of exercise three times a day, five days a week at 85 percent of their target heart rate had a twofold improvement in A1C levels compared to patients who exercised for 30 minutes a day at 65 percent of their target heart rate. Be sure to check with your doctor before trying high intensity exercise, and wear a heart rate monitor so you don’t overdo it. 2. Shrink Your Dinner Plate Instead of a large dinner plate for your meals, use a smaller salad plate. This simple swap can trick your eyes and brain into thinking you’re eating more than you really are, and you’ll feel satisfied with less food. It’s especially helpfu Continue reading >>
What Does A 6.2% Hemoglobin A1c Mean?
My recent blood test result indicated that my Hemoglobin A1c is labeled as "high" at 6.2% because the normal range is 3.0-6.0%. What does it... show more My recent blood test result indicated that my Hemoglobin A1c is labeled as "high" at 6.2% because the normal range is 3.0-6.0%. What does it mean? Does it mean I may have lung problem or some kind of tumor? Everything else on the report is normal except this. Thanks!!! The glycated (glyco- and glycosylated are incorrect terms according to the International Journal of Biomedical Nomenclature) hemoglobin A1C is the mean (average) glucose over approximately a ninety day period (the typical lifespan of an erythrocyte also known as a red blood cell). An A1C of 6.2% approximates a mean ninety day glucose of 132 mg/dL (7.3 mmol/L for those not in the US). No single blood test is diagnostic but if your A1C is reproducibly above 6.0% then you would have early diabetes. Terms such as abnormal glucose tolerance, pre-diabetic, and borderline diabetic are out of date. There is about a ten year period of damage prior to the glucose becoming elevated. Thus there is a strong push today for early diagnosis with prompt and decisive treatment. The non-diabetic's glucose ranges (independent of what, when, or how much you eat) from 70 to 140 mg/dL (3.9 to 7.8 mmol/L). An A1C of 6.0% approximates a ninety day mean glucose of 126 mg/dL (7.0 mmol/L). Numbers above this - if reproducible - indicate diabetes. Remember that the diagnosis should not be based upon a single reading. If I may be of further assistance please let me know. I wish you the very best of health and may God bless. Continue reading >>
The A1c Test & Diabetes
What is the A1C test? The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, or glycohemoglobin test. The A1C test is the primary test used for diabetes management and diabetes research. How does the A1C test work? The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent. Can the A1C test be used to diagnose type 2 diabetes and prediabetes? Yes. In 2009, an international expert committee recommended the A1C test as one of the tests available to help diagnose type 2 diabetes and prediabetes.1 Previously, only the traditional blood glucose tests were used to diagnose diabetes and prediabetes. Because the A1C test does not require fasting and blood can be drawn for the test at any time of day, experts are hoping its convenience will allow more people to get tested—thus, decreasing the number of people with undiagnosed diabetes. However, some medical organizations continue to recommend using blood glucose tests for diagnosis. Why should a person be tested for diabetes? Testing is especially important because early in the disease diabetes has no symptoms. Although no test is perfect, the A1C and blood glucose tests are the best tools available to diagnose diabetes—a serious and li Continue reading >>
10 Facts About The Hba1c (a1c) Blood Test
If you are a diabetic or have recently been diagnosed, then you will be familiar with the HbA1C test. It is one of the most effective methods of monitoring glucose control in diabetes management. Insurance companies may also request this test before covering a diabetic and there is good reason that it is the test of choice these days. It is not a snapshot of your blood glucose levels at the time of taking the blood sample. Rather it gives you an idea of your blood glucose levels over a period of a few months. Measures glucose in blood cells Most other glucose tests measure the amount of glucose circulating in your blood or being passed out in the urine at the time when the sample was collected. It can change within hours. However, an A1c measures the changes in your red blood cells that arises with high blood glucose levels. It measures what is known as glycated hemoglobin which is within red blood cells. Hemoglobin is the important compound in red blood cells that carries oxygen through the bloodstream. When the glucose levels are high, it combines with the hemoglobin over time to form glycated hemoglobin. No fasting before test necessary Eating or drinking before most glucose tests can affect the results. For this reason these tests are done early in the morning before a person has their first meal. However, fasting is not necessary for an HbA1c. It can be done anytime during the day, before or after a meal, and still give an accurate result. The HbA1c test indicates the glucose levels over weeks and months, and does not change over hours and days. Even drinking a sugary drink before the test will not affect the result. No other preparation is required prior to the test. Nevertheless it is important to follow your doctor’s orders. Shows levels between 2 to 3 months Continue reading >>
My Hba1c Has Raised To 6. 2 With High Cholesterol. Please Help.
iCliniq Ask a doctor online Medical Forum Diabetology Cholesterol My HbA1c has raised to 6. 2 with high cholesterol. Please help. Q. My HbA1c has raised to 6. 2 with high cholesterol. Please help. My age is 38 years and my HbA1c has gone to 6.2 with high cholesterol and lipids. My fasting and post fasting blood sugar is however in range and no health complications yet. I am attaching my report. Please suggest whether I need to take any preventive measures. Based upon the report, I have already started morning walk (earlier I used to only walk after dinner). I have low back pain also. So, instead of any heavy exercise, I only do around 15-20 minutes of yoga to strengthen my back. My father is a diabetic (68 years) and also has blood pressure problem. I feel lethargic sometimes, but I have craving for sweets. Please guide. From the history you have told, your blood sugar levels are under control with high cholesterol. There is family history of diabetes which makes you prone for diabetes in future. So, you have to make dietary modifications. Physical activity is also important here. Avoid sweets, non-vegetarian diet, fried foods and outside food. You can start on tablet Lipitor (Atorvastatin calcium) 10 mg once daily for 15 days. This will keep your cholesterol levels under control. Diet modification and physical activity are the best preventive measures for diabetes . Please follow the advice and report to me after 15 days. Revert back with the reports after 15 days to a diabetologist online --> Thank you for your advice. I am uploading the reports. Following are some out of range values:HbA1c 6.2 (fasting blood sugar as 97), total cholesterol 242 (triglyceride 127 and HDL 63.1), VLDL 25.40,LDL 153.50,SGOT 45.30 andSGPT 81.80.Can I start using BGR 34, which is an approv Continue reading >>
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 >>
The Normal A1c Level
You want to control your diabetes as much as possible. You wouldn’t be reading this if you didn’t. So you regularly check your A1C level. This is the best measurement of our blood glucose control that we have now. It tells us what percentage of our hemoglobin – the protein in our red blood cells that carry oxygen – has glucose sticking to it. The less glucose that remains in our bloodstream rather than going to work in the cells that need it the better we feel now and the better our health will continue to be. Less glucose in the bloodstream over time leads to lower A1C values. As we are able to control our diabetes better and better, the reasonable goal is to bring our A1C levels down to normal – the A1C level that people who don’t have diabetes have. But before we can even set that goal, we have to know what the target is. The trouble with setting that target is that different experts tell us that quite different A1C levels are “normal.” They tell us that different levels are normal – but I have never heard of actual studies of normal A1C levels among people without diabetes – until now. The major laboratories that test our levels often say that the normal range is 4.0 to 6.0. They base that range on an old standard chemistry text, Tietz Fundamentals of Clinical Chemistry. The Diabetes Control and Complications Trial or DCCT, one of the two largest and most important studies of people with diabetes, said that 6.0 was a normal level. But the other key study, the United Kingdom Prospective Diabetes Study or UKPDS, which compared conventional and intensive therapy in more than 5,000 newly diagnosed people with type 2 diabetes, said that 6.2 is the normal level. Those levels, while unsubstantiated, are close. But then comes along one of my heroes, Dr. Continue reading >>
- What Is a Normal Blood Sugar Level?
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
