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How Accurate Is The A1c Test

The A1c Blood Sugar Test May Be Less Accurate In African-americans

The A1c Blood Sugar Test May Be Less Accurate In African-americans

A widely used blood test to measure blood-sugar trends can give imprecise results, depending on a person's race and other factors. This test means diabetes can sometimes be misdiagnosed or managed poorly. Doctors have been cautioned before that results from the A1C test don't have pinpoint accuracy. A study published Tuesday underscores that shortcoming as it applies to people who carry the sickle cell trait. Glucose levels in the blood rise and fall all the time, so it can be tricky to look at a single exam to diagnose diabetes or manage the disease in people who have it. But one test gets around this problem. The A1C test measures sugar that binds to hemoglobin molecules in red blood cells. It provides an average of blood sugar over the past three months, "so this has turned out to be an incredibly powerful test, both for the diagnosis and treatment of diabetes," says Dr. Anthony Bleyer, a kidney specialist at the Wake Forest School of Medicine who was not involved in the study. The problem is that the test results can vary, depending on circumstance. For example, people with anemia may get inaccurate readings. So do people who carry unusual types of hemoglobin, the best known being sickle cell trait. Eight to 10 percent of African-Americans carry the sickle cell trait. But only people who inherit two copies of the sickle cell trait, one from each parent, develop the disease. And a few years ago, scientists realized that A1C readings for African-Americans typically don't match those from whites. They are generally higher. "The test was really standardized based on white individuals, and there were just a small number of African-American individuals in that study," Bleyer says. And while the difference isn't large, it can matter a lot, especially for people who are clo 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 >>

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 >>

Cvs Health At Home A1c Test Kit

Cvs Health At Home A1c Test Kit

Easy operation for at home A1C monitoring Monitors glycemic control in patients with diabetes Get the big picture' measurement of your blood glucose levels over the past 2-3 months, with CVS Health At Home A1C Test Kit. This small, easy-to-use test kit helps monitor glycemic control in patients with diabetes. Testing your long-term blood glucose level has never been more convenient. This test kit only requires a small blood sample and results are available in 5 minutes. Our kit includes the A1C analyzer, 2 cartridge pouches, 2 shaker pouches, a reference guide, and a helpful hints guide. For fast, reliable information about your blood glucose regulation, you can count on CVS Health At Home A1C Test Kit. A1C is an indication of your average blood glucose level over the past 2-3 months. For most people with diabetes, the American Diabetes Association (ADA) recommends that your A1C be under 7%.(1) A 1% point reduction in A1C may lower the risk of complications by up to 40%.(2)* Remember that your A1C is your "big picture" measurement. Don't use it for daily blood glucose measurement. 1. American Diabetes Association. Standards of medical care in diabetes-2011. Diabetes Care 2011; 34(1): S11-S61. 2. Startton IM. Adler Al, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405-412. *In non-pregnant adults with type 2 diabetes. CVS Health At Home A1C Test Kit is for home use monitoring of glycemic control in patients with diabetes. The following conditions may affect the accuracy of your A1C result: hemoglobin variants (HbS, HbC), elevated HbF, anemia, recent significant blood loss, a recent blood transfusion or high amounts of rheumatoid factor. Recommende 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 >>

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 >>

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 >>

Accuracy Of Fasting Plasma Glucose And Hemoglobin A1c Testing For The Early Detection Of Diabetes: A Pilot Study

Accuracy Of Fasting Plasma Glucose And Hemoglobin A1c Testing For The Early Detection Of Diabetes: A Pilot Study

Abstract Diabetes, often referred as diabetes mellitus, describes a group of metabolic disorders characterized by chronic hyperglycaemia with disturbances of fat, carbohydrate and protein metabolism because of the defects in insulin releasing, insulin action, or both. The most common form of diabetes mellitus is type 2 diabetes which is a worldwide chronic disease. The aim of this study was to investigate the accuracy of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) testing for the early detection of diabetes and to evaluate the correlation between FPG and HbA1c as a biomarker for diabetes in the general population in Hong Kong. This study also observed and assessed the risk of diabetes by comparing different genders and ages in Hong Kong. A retrospective study was undertaken and the data was collected in the database of a HOKLAS (The Hong Kong Laboratory Accreditation Scheme) clinical laboratory from 200 diabetic and non-diabetic patients (83 females and 117 males, age ranged from 20 to 90) who attended the laboratory during January 2016 to February 2016 for both FPG and HbA1c measurements. A significant correlation between HbA1c and FPG (r2 = 0.713, p < 0.05) was observed in this study. Moreover, patients detected as diabetes in age groups 45–64, 65–74 and ≥75 years old were 2.5, 3 and 6 times respectively higher than that of the diabetic individuals under 45 years old. In conclusion, FPG was significantly correlated with HbA1c and a significant increase in FPG and HbA1c in male was observed by comparing with female. Furthermore, the incidence rate of diabetes mellitus in male was 3 times higher than that in female in Hong Kong and it progressed with increasing age. Further longer term and large scale research in each age group is warranted. 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 >>

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 >>

Scientists Devise A More Accurate Way To Gauge Blood Sugar Averages In Diabetes

Scientists Devise A More Accurate Way To Gauge Blood Sugar Averages In Diabetes

Combining the power of advanced math with tests commonly used to measure blood sugar, scientists from Harvard Medical School and Massachusetts General Hospital have created a new model that more accurately accounts for long-term blood sugar fluctuations in people with diabetes. The disease affects more than 422 million people worldwide, according to the World Health Organization and more than 29 million Americans, according to the Centers for Disease Control and Prevention. By factoring in the age of each patient¹s red blood cells, the new method offers a more precise, individualized gauge of three-month blood sugar averages and reduces in half the error rate of the most commonly used ' but sometimes inaccurate ' test known as A1C. Findings of the study are described Oct. 5 in Science Translational Medicine. "What we currently deem the gold standard for estimating average blood glucose is nowhere as precise as it should be," said senior investigator John Higgins, an associate professor of systems biology at HMS and a clinical pathologist at Massachusetts General Hospital. "Our study not only pinpoints the root of the inaccuracy but also offers a way to get around it." The A1C test led to notable off-target estimates in about a third of more than 200 patients whose test results were analyzed as part of the research. The team found these inaccuracies stemmed entirely from individual variations in the life span of a person¹s red blood cells. In a final step, the scientists calculated new, age-adjusted estimates and tested their predictive accuracy by comparing them to actual blood sugar levels measured directly via continuous glucose monitors ' wearable devices that read a person¹s blood sugar every five minutes. Incorporating the new model into existing tests, the rese 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 >>

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 >>

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