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How Accurate Is A1c Blood Test

A1c Test

A1c Test

Print Overview The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c. The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Why it's done An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation, recommend that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes. After a diabetes diagnosis, the A1C test is used to monitor your diabetes treatment plan. Since the A1C test measures your average blood sugar level for the past two to three months instead of your blood sugar level at a specific point in time, it is a better reflection of how well your diabetes treatment plan is working overall. Your doctor will likely use the A1C test when you're first diagnosed with diabetes. This also helps establish a baseline A1C level. The test may then need to be repeated while you're learning to control your blood sugar. Later, how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you're managing your blood sugar. For example, the A1C test may be recommended: Once every year if you have prediabetes, which indicates a high risk of developing diabetes Twice a year if 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 >>

The A1c Test & Diabetes

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 >>

Hba1c Test Results Don't Tell The Full Story

Hba1c Test Results Don't Tell The Full Story

back to Overview When I was a teenager, the HbA1c test results cut straight through my lies and made-up paper logbook. It’s often viewed as the number to rule all numbers. But hemoglobin A1c (HbA1c) test results can be misleading and don’t tell the full story. As I learned in my teens, the HbA1c test shines a light on things I was trying to hide. Overall, It’s not good at getting to the details of blood sugars, but when used with other pieces of information it can draw attention to (sometimes unseen) problem areas in our diabetes management, and that’s a good thing. How do HbA1c test results work? Let’s take a quick look at the basics of the HbA1c test. A certain amount of sugar in your blood sticks to your red blood cells and can’t be unstuck. It’s there for the life of the cell, which is, on average, about 8-12 weeks. Those red blood cells in your body are constantly recycled, and by checking your HbA1c value every 8-12 weeks (or as often as recommended by your doctor – the ADA recommends at least twice a year), you get to see a fresh new grouping of them. So – A higher blood sugar for a longer time means more sugar on more cells – which means a higher HbA1c. Get it? Ideal HbA1c range HbA1c goals are very individual, which makes sense. We’re all different, right? Of course, there are reference values as a guide, and that’s a good place to start. The ADA suggests an HbA1c of 7%, but also say that “more or less stringent glycemic goals may be appropriate for each individual.” Why have different goals? Because, as you know, there’s a lot to consider with diabetes. Avoiding lows (hypoglycemia) while pushing for lower A1c’s is really important because low blood sugars are immediately dangerous. It’s simply not safe to push for a very low H Continue reading >>

Is A1c The Best Measure Of Success?

Is A1c The Best Measure Of Success?

HbA1c, known as the A1c test for short, is a blood test that gives an estimated average of blood sugar levels and of overall diabetes management. This is because when you have high blood sugar, some of that sugar sticks to the hemoglobin molecules in your red blood cells. The A1c test measures how much sugar is on those red blood cells, which live approximately 3 months. Many studies have been done regarding blood sugar management and have used target values of A1c levels as the clinical focus. In a paper published in the JAMA journal of medicine, Yale doctors Kasia Lipska and Harlan Krumholz wrote about how A1c levels may not be the best measure for scientists to use in diabetes studies.They wrote that the “goals of treatment of type 2 diabetes are to reduce the risk of diabetic complications and, as a result, improve the quality and, possibly, duration of life.” They explained how in the 1990s, the FDA started to approve drugs to treat diabetes based on how they affected a patient’s A1c level after treatment. Since then, a great focus has remained upon the idea that understanding risk for all sorts of related health complications due to diabetes could be had by a “clinical focus on reaching target values of HbA1c, agnostic to the strategies used.” Not all treatments have proven to reduce heart disease or improve odds of a longer life, yet a historical focus on how a treatment might have lowered A1c levels has bolstered those treatments to the forefront. If a drug lowers A1c levels but doesn’t make any improvement on the risk of heart disease or mortality, then should other primary factors or endpoints be considered in scientific trials? Why is an A1c Not Always Accurate? Unfortunately, there are various reasons why an A1c result may not be a good indicator 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 >>

A1c Test

A1c Test

Print Overview The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c. The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Why it's done An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation, recommend that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes. After a diabetes diagnosis, the A1C test is used to monitor your diabetes treatment plan. Since the A1C test measures your average blood sugar level for the past two to three months instead of your blood sugar level at a specific point in time, it is a better reflection of how well your diabetes treatment plan is working overall. Your doctor will likely use the A1C test when you're first diagnosed with diabetes. This also helps establish a baseline A1C level. The test may then need to be repeated while you're learning to control your blood sugar. Later, how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you're managing your blood sugar. For example, the A1C test may be recommended: Once every year if you have prediabetes, which indicates a high risk of developing diabetes Twice a year if Continue reading >>

Is The Hemoglobin A1c Test Always Accurate?

Is The Hemoglobin A1c Test Always Accurate?

Can you believe I’ve had patients show me a week’s worth of home glucose tests showing great numbers, tell me they’ve been that good for the last three months, and then I find a sky high Hemoglobin A1c test? How can that be? Hemglobin A1c (or HgbA1c) is a standard measure of glucose control, or lack thereof, over the three months preceding the blood test. It’s also used for diagnosis of diabetes and prediabetes. Levels between 5.7 and 6.4% suggest prediabetes. Levels of 6.5% of higher indicate diabetes. Hemoglobin is the oxygen-carrying protein in red blood cells. HgbA1c tells us if many sugar molecules are stuck to the hemoglobin, a process called glycosylation. HgbA1c is sometimes referred to as glycated hemoglobin. About half of the HgbA1c value is determined by blood sugar levels in the month before the blood draw. But the HgbA1c test is not always an accurate reflection of blood sugar levels. Many factors unrelated to serum glucose (sugar) levels can alter the HgbA1c value. Here they are: Pregnancy Pregnant women tend to have lower than average HgbA1c. Certain Types of Anemia Iron-deficiency anemia may yield falsely low or high HgbA1c, depending on whether it’s being treated or not. Acute bleeding and hemolytic anemia give falsely low HbA1c values. The unifying feature here is that young red blood cells, called reticulocytes, take some time to get glycosylated. Lack of a Spleen HgbA1c will be falsely high. Your spleen removes old red blood cells. Not having a spleen increases the life span of red blood cells, so they can accumulate more glucose molecules. Various Hemoglobin Types or Congenital Abnormalities Hemoglobin S and hemoglobin C may lead to deceptively low HgbA1c. Hemoglobin F tends to overestimate. Blood Transfusions Recent red blood cell transfu 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 >>

Is The Hemoglobin A1c Test Always Accurate?

Is The Hemoglobin A1c Test Always Accurate?

Can you believe I’ve had patients show me a week’s worth of home glucose tests showing great numbers, tell me they’ve been that good for the last three months, and then I find a sky high Hemoglobin A1c test? How can that be? Hemglobin A1c (or HgbA1c) is a standard measure of glucose control, or lack thereof, over the three months preceding the blood test. It’s also used for diagnosis of diabetes and prediabetes. Levels between 5.7 and 6.4% suggest prediabetes. Levels of 6.5% of higher indicate diabetes. Hemoglobin is the oxygen-carrying protein in red blood cells. HgbA1c tells us if many sugar molecules are stuck to the hemoglobin, a process called glycosylation. HgbA1c is sometimes referred to as glycated hemoglobin. About half of the HgbA1c value is determined by blood sugar levels in the month before the blood draw. But the HgbA1c test is not always an accurate reflection of blood sugar levels. Many factors unrelated to serum glucose (sugar) levels can alter the HgbA1c value. Here they are: Pregnancy Pregnant women tend to have lower than average HgbA1c. Certain Types of Anemia Iron-deficiency anemia may yield falsely low or high HgbA1c, depending on whether it’s being treated or not. Acute bleeding and hemolytic anemia give falsely low HbA1c values. The unifying feature here is that young red blood cells, called reticulocytes, take some time to get glycosylated. Lack of a Spleen HgbA1c will be falsely high. Your spleen removes old red blood cells. Not having a spleen increases the life span of red blood cells, so they can accumulate more glucose molecules. Various Hemoglobin Types or Congenital Abnormalities Hemoglobin S and hemoglobin C may lead to deceptively low HgbA1c. Hemoglobin F tends to overestimate. Blood Transfusions Recent red blood cell transfu Continue reading >>

A1c Accurate At Identifying Prediabetes

A1c Accurate At Identifying Prediabetes

A routine blood test may be able to identify people with prediabetes as well as the fasting plasma glucose (FPG) test, the method currently used by some doctors for screening, according to a recent study funded in part by the US Centers for Disease Control. An estimated 57 million adults in the United States have prediabetes (a condition in which blood glucose levels are elevated, but not enough for a diagnosis of diabetes) and the vast majority don’t know it. The FPG test screens for diabetes by measuring the level of glucose in a person’s blood plasma after a period of fasting (not eating or drinking anything other than water). The test is performed after a person has fasted for at least 8 hours; people with a fasting plasma glucose level less than 126 mg/dl but greater than or equal to 100 mg/dl are classified as having prediabetes. Because the FPG test sometimes requires a second doctor’s visit for retesting, and because people often forget to arrive with an empty stomach, obtaining accurate results by the method can be difficult. The A1C test, currently used to check the level of blood glucose control over the previous 2–3 months in people with diabetes, only requires a single visit and is accurate regardless of whether a person has eaten prior to the visit. Based on blood test results from the 1,750 people included in the study, the A1C test is effective at pinpointing people who have prediabetes, and who are therefore at increased risk of developing Type 2 diabetes. (In 2010, the American Diabetes Association began recommending that the A1C test be used to diagnose Type 1 or Type 2 diabetes.) According to Ronald T. Ackerman, MD, MPH, lead author of the study “If you have high blood pressure or heart disease, or multiple other risk factors such as obesit 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 >>

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 >>

How Accurate Is The Hemoglobin A1c Test?

How Accurate Is The Hemoglobin A1c Test?

The hemoglobin A1c is a very accurate test to quantify the average blood sugar over the previous three months. It is based on the amount of sugar to which red blood cells are exposed during their three-month lifespan. This is a reliable method to determine the severity of diabetes and is useful for making decisions about treating this disease. There are times that the hemoglobin A1c result does not accurately reflect a person’s average blood glucose readings. Hemoglobin A1c is created when glucose in the blood comes into contact with the hemoglobin inside a red blood cell. When a red blood cell is first created in the bone marrow, there is no hemoglobin A1c. As the cell circulates in the bloodstream over its life expectancy of about 4 months, hemoglobin A1c accumulates to a greater and greater degree. The oldest cells -- the ones that are closest to the end of their life cycle -- have the highest amount of hemoglobin A1c. Therefore, the amount of hemoglobin A1c in the blood varies depending not only on how much glucose there is in the system, but also on the rate of production of red blood cells, the rate of destruction of those cells, the average life span of a red blood cell, and factors that may affect the rate at which glucose attaches to the hemoglobin. The hemoglobin A1c usually underestimates the average glucose in the blood in settings in which red blood cells do not survive as long as they should in the blood. A simple example might be if someone has major blood loss, such as following an accident or surgery. Assume that the person has lost a fair amount of blood, but not enough to need a transfusion. In this case the bone marrow revs up to replace the lost blood at a faster rate than normal, and a higher percentage of the red cells are relatively young, with Continue reading >>

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

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

But before we get into that, let’s briefly go over why A1C is used to approximate average glucose over ~3 months : As glucose enters your blood, it attaches to a protein in your red blood cells called “hemoglobin.” Hemoglobin is the same protein that carries oxygen in your bloodstream, and it is what gives blood its red color A1C measures the total amount of glucose that has attached to your hemoglobin over the lifespan of your red blood cells (typically ~3 months). OK, now that we’ve got the science down, here’s why your average BG and lab-measured A1C values might not match up: 1. BG meter average does not usually reflect the average over a full 24 hours This reason is pretty obvious. If you are not on a CGM, it’s tough to get a full picture of your average blood glucose throughout the day. We generally test much more during the day than at night, and nighttime glucose values may be very different from daytime values. We also tend to test more often before eating (when glucose is typically lower), and less often after meals (when glucose is typically higher). So, for most people, BG meter average doesn’t accurately reflect average blood glucose over a full 24 hours. A1C, on the other hand, does. If you want your BG meter average to better reflect your A1C values, check more often! And make sure you check at various times throughout the day, including 1-3 hours after eating. 2. The Average BG to A1C conversion equation is not perfect Most (if not all) average BG to A1C conversion tables and calculators use the below equation to estimate A1C: Average BG (mg/dL) = 28.7 X A1C (%) – 46.7 This equation is based on data from a 2008 study of over 500 subjects (268 T1Ds, 159 T2Ds, and 80 non-diabetics) at 10 international centers around the Continue reading >>

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