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How Accurate Is A1c Testing?

A1c Home Test Kits For Diabetes

A1c Home Test Kits For Diabetes

Hemoglobin A1C tests are used to screen for and diagnose prediabetes and diabetes. A1C home test kits are a good option if you want to testyour A1C at home in between visits to your doctor, whether you have type 1 or type 2 diabetes. An A1C test gives a picture of how well your diabetes treatment is working by showing your average blood sugar level for the past two or three months. This can be very helpful in your diabetes management plan. All A1C home test kits allow you to provide a small blood sample, about the same as your glucose meter ,in the convenience of your home. Depending on the type of kit you purchase, you either get immediate results at home or you send the sample to a lab for analysis. Home A1C tests are not approved for diagnosing diabetes. You need to see a doctor for a diagnosis. There are factors that will affect the accuracy of A1C tests, so discuss this with your doctor to ensure you know whether they're appropriate for you. A1C results are affected by hemoglobin variants (such as sickle cell), anemia, transfusion, blood loss, pregnancy, and rheumatoid factor. Portable consumer options for immediate results at home are now available at major retailers, with both name brand and house brand versions. A1CNow SELF CHECK was the original FDA-approved brand from Bayer Healthcare. PTS Diagnostics purchased the A1CNow business in 2014 and markets it under the original name, plus they license it for store brand devices. Walmart sells it as ReliOn Fast A1C Test and Walgreens and CVS as At Home A1C Test Kit. This technology received FDA approval and allows you to learn your A1C number in five minutes. It's similar in appearance to your daily glucose meter, but you don't use it on a continual basis. You purchase this A1C meter in a two-test kit. Once you have 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 >>

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 >>

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 Pros And Cons Of Diagnosing Diabetes With A1c

The Pros And Cons Of Diagnosing Diabetes With A1c

An International Expert Committee was convened in 2008 by the American Diabetes Association (ADA), the European Association for the Study of Diabetes, and the International Diabetes Federation to consider the means for diagnosing diabetes in nonpregnant individuals, with particular focus on the possibility to indicate A1C as an alternative if not a better tool (1). After reviewing the available literature and a thorough discussion on the advantages and the limits of previous diagnostic strategies (essentially based on fasting glucose assessment) and the considered alternative approach (based on A1C measurement), a consensus was reached that the latter (i.e., A1C) should be included among diagnostic tools for diabetes and, with the exception of a number of clinical conditions, should even be preferred in diabetes diagnosis in nonpregnant adults. The main conclusion of the International Expert Committee was implemented in the most recent clinical recommendations issued by the ADA. However, in these guidelines, A1C is indicated as a diagnostic tool alternative but not superior to blood glucose, leaving to the health care professional the decision about what test to use in an individual. The World Health Organization is currently examining the proposal made by the International Expert Committee and is carefully addressing the controversial issues still remaining, most of which have been the subject of letters to the editor and articles recently published in the literature. Nevertheless, the use of A1C for diagnosing diabetes is rapidly becoming a reality in many Western countries. In the text that follows, one of us (E.B.) will present the main points supporting A1C (pros) and the other (J.T.) will illustrate the main counterpoints challenging A1C (cons) as the primary tool Continue reading >>

At Home A1c Testing Systems & Kits: Review

At Home A1c Testing Systems & Kits: Review

The A1C, a Glycated hemoglobin, is a form of hemoglobin that is measured primarily to identify the three-month average blood glucose concentration. The A1C test is limited to a three-month average because the lifespan of a red blood cell is only four months. In other words, it’s the indication of your blood sugar level for a three-month period. Typically, your doctor will test your A1C levels every 90 to 180 days depending on how well your blood sugar levels have been managed. In basic terms, the A1C test checks to see how much glucose is attaching to your red blood cells. You can work to keep your A1C within your target range using a recommended diabetes management regimen along with a well-managed diet, exercise routine and other healthy lifestyle . Normal a1C Prediabetes a1C Diabetic a1c Under 5.7 5.7 to 6.4 6.5 and above A1C Test Features and Pricing While most hospital conducted A1C tests cost around $86 per test (depending on your co-pay), you can now buy the A1C self-check home kit for around $40. Each kit includes one test with two strips, but you can buy a double test kit as well. The kits are not reusable so once you use your two lancets, you must buy another kit. Use Most people use this test every 30 days instead of waiting 90 days to be seen by the doctor. This helps patients have a more accurate reading on where their levels fall throughout the month. Insurance Coverage Most insurances will cover 1 or 2 tests per year and some hospitals will have a sample take-home A1C test that you can ask for. However, not all hospitals do so you may still need to buy over the counter kits depending on how many results a year you want to have or how many your doctor requires. Pros and Cons of Home Testing The A1C at home kit needs four large drops of blood which is eas Continue reading >>

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

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

Want to learn more about A1C? Download our Guide to A1C here! So, for most people, BGmeter average doesntaccuratelyreflect 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 conversionequation is not perfect Most (if not all) average BG to A1C conversiontables 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 froma 2008 study of over 500 subjects (268 T1Ds, 159 T2Ds, and 80 non-diabetics)at 10 internationalcenters aroundthe world. The A1C values were all measured in a central laboratory, sodifferences in laboratory method or technique were not a factor. People were studied for 12 weeks, with two days of CGM and three days of 7-point glucose profiles each week. The BG meters used were carefully standardized and calibrated. The graph below shows the data used to derive the relationship between average glucose and A1C. As you can see, there is A LOTofscatter. A number ofdata points are offthe trend line by 1%. And for some A1C values,the spread is enormous Check out the range ofA1Cs for people with an average glucose of ~110 mg/dL it goesfrom below 4% to almost 9%! So, importantly, the study concluded that the equation could be used to convertA1C toaverage blood glucose values for most patients. Notallpatients, just most. Results of a study of 507 subjects. Published in Diabetes Care 31:1473-1478, 2008 . OK But whydo so many people have A1C values that dont follow the equation? As it turns out, the biological processesthat dictate A1C arenot exactly the same for everyone 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 >>

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 >>

What's A

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

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

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 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 >>

Why Hemoglobin A1c Is Not A Reliable Marker

Why Hemoglobin A1c Is Not A Reliable Marker

Over the last few years doctors are increasingly relying on a test called hemoglobin A1c to screen for insulin resistance and diabetes. It’s more practical (and significantly cheaper) than post-meal glucose testing, and it’s less likely to be skewed by day-to-day changes than fasting blood glucose. While this sounds good in theory, the reality is not so black and white. The main problem is that there is actually a wide variation in how long red blood cells survive in different people. What is hemoglobin A1c? Sugar has a tendency to stick to stuff. Anyone that has cooked with sugar can tell you that. In our bodies, sugar also sticks – especially to proteins. The theory behind the A1c test is that our red blood cells live an average of three months, so if we measure the amount of sugar stuck to these cells (which is what the hemoglobin A1c test does), it will give us an idea of how much sugar has been in the blood over the previous three months. The number reported in the A1c test result (i.e. 5.2) indicates the percentage of hemoglobin that has become glycated (stuck to sugar). Why is hemoglobin A1c unreliable? While this sounds good in theory, the reality is not so black and white. The main problem is that there is actually a wide variation in how long red blood cells survive in different people. This study, for example, shows that red blood cells live longer than average at normal blood sugars. Researchers found that the lifetime of hemoglobin cells of diabetics turned over in as few as 81 days, while they lived as long as 146 days in non-diabetics. This proves that the assumption that everyone’s red blood cells live for three months is false, and that hemoglobin A1c can’t be relied upon as a blood sugar marker. In a person with normal blood sugar, hemoglobin 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 >>

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 >>

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