A1c To Detect Diabetes In Healthy Adults: When Should We Recheck?
1. Diabetes Care. 2010 Sep;33(9):2016-7. doi: 10.2337/dc10-0588. Epub 2010 Jun 21. A1C to detect diabetes in healthy adults: when should we recheck? Takahashi O(1), Farmer AJ, Shimbo T, Fukui T, Glasziou PP. (1)Department of Primary Health Care, University of Oxford, Oxford, U.K. [email protected] OBJECTIVE: To evaluate the optimal interval for rechecking A1C levels below thediagnostic threshold of 6.5% for healthy adults.RESEARCH DESIGN AND METHODS: This was a retrospective cohort study. Participants were 16,313 apparently healthy Japanese adults not taking glucose-loweringmedications at baseline. Annual A1C measures from 2005 to 2008 at the Center for Preventive Medicine, a community teaching hospital in Japan, estimated cumulativeincidence of diabetes.RESULTS: Mean age (+/-SD) of participants was 49.7 +/- 12.3 years, and 53% weremale. Mean A1C at baseline was 5.4 +/- 0.5%. At 3 years, for those with A1C atbaseline of <5.0%, 5.0-5.4%, 5.5-5.9%, and 6.0-6.4%, cumulative incidence (95%CI) was 0.05% (0.001-0.3), 0.05% (0.01-0.11), 1.2% (0.9-1.6), and 20% (18-23),respectively.CONCLUSIONS: In those with an A1C <6.0%, rescreening at intervals shorter than 3 years identifies few individuals (approximately
How Often Should I Be Tested For Prediabetes?
Your healthcare provider will test for prediabetes using a hemoglobin A1c test, a blood test that measures your average blood glucose level over the last three months. If you fall into the prediabetes range of 5.8% to 6.4%, you will be tested every year. If your blood glucose levels are in the normal range, it is reasonable to be checked every 3 years. If you have prediabetes, you should be checked for type 2 diabetes every 1-2 years after your diagnosis. Continue Learning about Prediabetes Videos Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs. Continue reading >>
How Often Should People With Diabetes Check Their A1c?
A new study concludes that people who have diabetes should check their blood glucose level with A1C tests more often than the experts recommend. But even then the study doesn’t go far enough. The study looked at more than 400,000 tests by about 80,000 people whose doctors prescribed them between 2008 and 2011. It focused on the relationship between the retest interval and the percentage change in A1C level. The results of this massive analysis just appeared in the current issue of Diabetes Care. The abstract of the study is free online, and an endocrinologist friend of mine kindly gave me a copy of the full text. If you want to quickly reduce your A1C level, the best strategy is to get an A1C test every three months. That’s the main conclusion of the study. This is particularly true if you level is 7.0 or more. While Diabetes Care is a professional journal of the American Diabetes Association, this is more frequent than the ADA currently recommends. People who are “meeting their treatment goals” and who have stable blood glucose control should get A1C testing at least every six months, according to the ADA’s “Standards of Medical Care in Diabetes—2014.” Only when people recently change their treatment or aren’t achieving their blood sugar targets do they need to be tested every three months, the ADA’s recommendation continues. But what does “meeting their treatment goals” mean? While the ADA says that the goal can vary for different people, the general glycemic goal is an A1C level of less than 7.0. This goal is just a little less than the average A1C level that Americans with diabetes had in the most recent years for which data are available. An analysis by the U.S. Centers for Disease Control and Prevention found that the mean (average) A1C amo Continue reading >>
How Often Should You Check Hba1c
Diabetes Forum • The Global Diabetes Community Find support, ask questions and share your experiences. Join the community » Ideally, how often should we check HbA1C? The cost for this test is quite expensive so I always think twice before drawing my blood to lab. I am in Canada and I get tested every 3 months. I think it would depend on your control of blood glucose and your medication. I will have my next A1c in February after a gap of six months. This suits me. There is no point in testing more often than once every three months but if your control is good then six months or annually can be sufficient. My first follow up was three months, the next is six - we don't have to pay for ours, so I have to take my guidance from a GP that refuses to advise his T2 diabetic patients to test themselves to see how they are doing... so... who knows if that's a decent gap or not! I do think every six months unless uncontrolled. Given HbA1C measures an average over the last 3 months, there does not seem to be much reason to get it measured any more often. After that, it depends on why you are getting it measured - to confirm you are still doing ok, to make you feel good about improvements or because you have concerns things are getting worse. I believe in the UK, it is typically taken every 6 or 12 months. If you have a glucometer you can track bg using a method that @Bluetit1802 uses, I think this method gives a predicted A1c value but personally I know little about it. Perhaps Blue can help? Rachox Type 2 (in remission!) · Well-Known Member I had my first two tests after diagnosis at two months intervals, my next will be at three. I use the app MySugr, which gives a predicted estimate of my HbA1c. At my last HbA1c check at the Drs MySugr was suggesting 34.4 when my lab result Continue reading >>
How Often To Check A1c
All of us who have diabetes regularly get our A1C checked. Few of us check it often enough. The A1C is the best way we have to show how well we are managing our disease. It’s a simple test that we can perform at home or at a doctor’s office or lab. Just like the fingerstick tests that we use for spot checking our blood sugar levels before or after meals, the A1C test uses a small drop of blood. But the A1C measures our sugar level over a lot longer time. How much longer is the question. The answer to that question can tell us how often that we need to check our A1C level. The A1C test measures the percentage of glycated hemoglobin, also known as HbA1C, in our blood. We need to check our A1C level "twice a year at a minimum or more frequently when necessary," is the advice that the American Diabetes Association offers in its "A1C" article. That’s because "the A1C test measures your average blood glucose control for the past 2 or 3 months." For a long time I’ve wondered why the ADA isn’t more specific about the time period that the A1C test measures. When I started using the A1CNow SelfCheck that finally became available three years ago so we can now check our A1C at home, I started to research this question. The patient insert that comes with it led me to a big book generally considered to be the definitive reference for clinical chemistry, which explains what’s going on with the A1C. The book is Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, 5th edition, 2011, edited by Carl A. Burtis et al. This massive volume has 2,238 pages and weighs 10 pounds. I could have bought it for about $250, but instead I borrowed it from my local library on interlibrary loan. In seven of those pages, 1141-1147, the book explains the A1C. How much glycated hemogl Continue reading >>
Screening And Monitoring Of Prediabetes
Screening for Prediabetes AACE recommends that individuals who meet any of the clinical risk criteria noted below should be screened for prediabetes or type 2 diabetes (T2D) (1). Age ≥45 years without other risk factors CVD or family history of T2D Overweight or obese Sedentary lifestyle Member of an at-risk racial or ethnic group: Asian African American Hispanic Native American (Alaska Natives and American Indians) Pacific Islander High-density lipoprotein cholesterol (HDL-C) <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L) Impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and/or metabolic syndrome Polycystic ovary syndrome (PCOS), acanthosis nigricans, or nonalcoholic fatty liver disease (NAFLD) Hypertension (blood pressure >140/90 mm Hg or on antihypertensive therapy) History of gestational diabetes or delivery of a baby weighing more than 4 kg (9 lb) Antipsychotic therapy for schizophrenia and/or severe bipolar disease Chronic glucocorticoid exposure Sleep disorders in the presence of glucose intolerance (A1C >5.7%, IGT, or IFG on previous testing), including obstructive sleep apnea (OSA), chronic sleep deprivation, and night-shift occupation In the event of normal results, repeat testing at least every 3 years. Clinicians may consider annual screening for patients with 2 or more risk factors (1). Medications and Prediabetes Risk Specific medications that increase prediabetes risk include: Antidepressants: The ongoing use of antidepressant medications may modestly increase the risk of developing prediabetes or T2D, although the elevation in absolute risk is modest (2). Psychotropic agents: Certain treatments for schizophrenia or bipolar disease may increase prediabetes, T2D, and/or CVD risk. Substantial weight gain has b Continue reading >>
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Shorthand for hemoglobin A1C or glycosylated hemoglobin, an indicator of blood glucose control over the previous two to three months. Hemoglobin, a protein found in red blood cells, carries oxygen from the lungs to tissues throughout the body. Some of the glucose in the bloodstream can also bind to hemoglobin molecules for the life of the red blood cell, which is about four months. Throughout the life of the red blood cell, the higher the blood glucose level, the more glucose that becomes bound to the hemoglobin in that cell. The percentage of hemoglobin in a blood sample that is glycosylated (has glucose attached to it) indicates how well blood glucose has been controlled over the previous two to three months. Typically, people who do not have diabetes have an HbA1c value of less than 6%. Based on the results of studies such as the Diabetes Control and Complications Trial, which showed that tight blood glucose control could reduce the risk of diabetic eye, kidney, and nerve disease, the American Diabetes Association (ADA) recommends an HbA1c goal of less than 7% for people with diabetes in general. How often should people with diabetes have their HbA1c level tested? According to the ADA, people who are meeting their treatment goals and who have stable blood glucose control should get HbA1c testing at least twice a year. People whose treatment has been changed recently or who are not achieving their blood glucose targets should be tested four times a year. Continue reading >>
How Often Should You Check Your A1c Measures If You Have Diabetes?
ANSWER If you have diabetes, you should check your blood sugar often to make sure your levels are in check. A hemoglobin A1c test is a blood test that measures your average blood sugar level over the past 2 to 3 months. It's a way to check how well you control your blood sugar over time. A1c measures how much glucose has been "sticking" to your red blood cells. If your treatment changes or your blood sugar control is not on target, then you should repeat the test every 3 months. Continue reading >>
When To Retest Ac1?
A1c shows blood sugar control over time. Most docs recheck it every 3 months unless it is within the reference range of their lab. If you want to check it more often walmart sells a home test kit containing materials for 2 tests for about $23. The A1c test shows the percent of glycated hemoglobin (glucose permanently bonded to hemoglobin). As red blood cells live about 3-4 months it gives an approximation of blood sugar over that period. It will be weighted toward more recent blood sugars as the older cells will have died off and been removed from your blood. So monthly testing might give you some idea if you're heading in the right direction. More frequent than that would probably not tell you much as it is dependent on the die-off of red blood cells. Your best method of knowing how well you are controlling your blood sugar remains "eat-to-your-meter." Hope this helps. Just guessing the glyb is causing the lower numbers in the afternoon. It causes your beta cells to excrete insulin, needed or not. I have no idea about the timing of it working in relationship to taking it. first. And that is the whole problem with insulin stimulating drugs - no-one can say when and how much insulin (if any) will be delivered! But on the A1c test, about once a quarter, just as MaJoie says, and she's also right about the testing. Unless you do a lot more checks than is realistic, you don't really have a true overall average. What you've got is an average of snapshots taken when you felt there might be something interesting going on. The calculation is missing, for instance, your overnight pattern and the full impact of the drugs. A quote from first. And that is the whole problem with insulin stimulating drugs - no-one can say when and how much insulin (if any) will be delivered! But on t Continue reading >>
Diabetes Mellitus: Screening And Diagnosis
Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease. Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment, but may not reduce rates of end-organ damage. Randomized trials show that screening for type 2 diabetes does not reduce mortality after 10 years, although some data suggest mortality benefits after 23 to 30 years. Lifestyle and pharmacologic interventions decrease progression to diabetes in patients with impaired fasting glucose or impaired glucose tolerance. Screening for type 1 diabetes is not recommended. The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and type 2 diabetes in adults 40 to 70 years of age who are overweight or obese, and repeating testing every three years if results are normal. Individuals at higher risk should be considered for earlier and more frequent screening. The American Diabetes Association recommends screening for type 2 diabetes annually in patients 45 years and older, or in patients younger than 45 years with major risk factors. The diagnosis can be made with a fasting plasma glucose level of 126 mg per dL or greater; an A1C level of 6.5% or greater; a random plasma glucose level of 200 mg per dL or greater; or a 75-g two-hour oral glucose tolerance test with a plasma glucose level of 200 mg per dL or greater. Results should be confirmed with repeat testing on a subsequent day; however, a single random plasma glucose level of 200 mg per dL or greater with typical signs and symptoms of hyperglycemia likely indicates diabetes. Additional testing to determine the etiology of diabetes is not routinely recommended. Clinical r Continue reading >>
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Diabetes - Tests And Checkups
See your diabetes doctor for an exam every 3 to 6 months. During this exam, your doctor should check your: Blood pressure Weight Feet See your dentist every 6 months, also. Your doctor should check the pulses in your feet and your reflexes at least once a year. Your doctor should also look for: If you have had foot ulcers before, see your doctor every 3 to 6 months. It is always a good idea to ask your doctor to check your feet. An A1c lab test shows how well you are controlling your blood sugar levels over a 3-month period. The normal level is less than 5.7%. Most people with diabetes should aim for an A1C of less than 7%. Some people have a higher target. Your doctor will help decide what your target should be. Higher A1C numbers mean that your blood sugar is higher and that you may be more likely to have complications from your diabetes. Continue reading >>
When To Test Blood Sugar | Accu-chek
Before physical activity, to see if you need a snack If you think your blood sugar might be too high, too low or falling Short-term, structured testing means checking your blood sugar at specific times over a few days. It can help you recognize patterns and problem-solve around how the things you do are connected to your blood sugar. You may want to consider structured testing, in addition to your routine or daily testing, if you: Begin a new medication unrelated to diabetes Change your activity level, meal plan or schedule There are different ways to perform structured testing, depending on your goals. The Accu-Chek 360 View tool is a simple paper tool that helps you track your blood sugar over 3 days, so you and your doctor can quickly identify patterns that can guide adjustments to your treatment plan. The Accu-Chek Testing in Pairs tool is an easy-to-use, printable tool that helps you see changes in your blood glucose with before-and-after testing. In just 7 days, you can see the effect of a specific meal, exercise or other event has on your blood sugar. Take your completed tool to your next appointment so your healthcare professional can help you fine-tune your diabetes management. Combining routine blood sugar testing and structured testing can give you a better view and a clearer picture of how your self-care program is working. You can then take one step at a time toward meeting your goals. 1American Diabetes Association. Standards of medical care in diabetes2016; Abridged for primary care providers [position statement]. Diabetes Care. 2016;34(1): 3-21. Available at: . Accessed March 11, 2016. 2Joslin Diabetes Center. Monitoring your blood glucose. Available at: . Accessed March 11, 2016. 3Mayo Clinic. Exercise is an important part of any diabetes treatment pla Continue reading >>
How Often Should People With Diabetes Check Their A1c?
A new study concludes that people who have diabetes should check their blood glucose level with A1C tests more often than the experts recommend. But even then, the study doesn’t go far enough. The study looked at more than 400,000 tests by about 80,000 people whose doctors prescribed them between 2008 and 2011. It focused on the relationship between the retest interval and the percentage change in A1C level. The results of this massive analysis just appeared in the current issue of Diabetes Care. The abstract of the study is free online, and an endocrinologist friend of mine kindly gave me a copy of the full text. If you want to quickly reduce your A1C level, the best strategy is to get an A1C test every three months. That’s the main conclusion of the study. This is particularly true if you level is 7.0 or more. While Diabetes Care is a professional journal of the American Diabetes Association, this is more frequent than the ADA currently recommends. People who are "meeting their treatment goals" and who have stable blood glucose control should get their A1C tested at least every six months, according to the ADA’s "Standards of Medical Care in Diabetes 2014." Only when people recently change their treatment or aren’t achieving their blood sugar targets do they need to be tested every three months, the ADA’s recommendation continues. But what does "meeting their treatment goals" mean? While the ADA says that the goal can vary for different people, the general glycemic goal is an A1C level of less than 7.0. This goal is just a little less than the average A1C level of Americans with diabetes in the most recent years for which data are available. An analysis by the U.S. Centers for Disease Control and Prevention found that the mean (average) A1C among adults with Continue reading >>
Symptoms, Diagnosis & Monitoring Of Diabetes
According to the latest American Heart Association's Heart Disease and Stroke Statistics, about 8 million people 18 years and older in the United States have type 2 diabetes and do not know it. Often type 1 diabetes remains undiagnosed until symptoms become severe and hospitalization is required. Left untreated, diabetes can cause a number of health complications. That's why it's so important to both know what warning signs to look for and to see a health care provider regularly for routine wellness screenings. Symptoms In incidences of prediabetes, there are no symptoms. People may not be aware that they have type 1 or type 2 diabetes because they have no symptoms or because the symptoms are so mild that they go unnoticed for quite some time. However, some individuals do experience warning signs, so it's important to be familiar with them. Prediabetes Type 1 Diabetes Type 2 Diabetes No symptoms Increased or extreme thirst Increased thirst Increased appetite Increased appetite Increased fatigue Fatigue Increased or frequent urination Increased urination, especially at night Unusual weight loss Weight loss Blurred vision Blurred vision Fruity odor or breath Sores that do not heal In some cases, no symptoms In some cases, no symptoms If you have any of these symptoms, see your health care provider right away. Diabetes can only be diagnosed by your healthcare provider. Who should be tested for prediabetes and diabetes? The U.S. Department of Health and Human Services recommends that you should be tested if you are: If your blood glucose levels are in normal range, testing should be done about every three years. If you have prediabetes, you should be checked for diabetes every one to two years after diagnosis. Tests for Diagnosing Prediabetes and Diabetes There are three ty Continue reading >>
Diabetes And Exercise: When To Monitor Your Blood Sugar
Exercise is an important part of any diabetes treatment plan. To avoid potential problems, check your blood sugar before, during and after exercise. Diabetes and exercise go hand in hand, at least when it comes to managing your diabetes. Exercise can help you improve your blood sugar control, boost your overall fitness, and reduce your risk of heart disease and stroke. But diabetes and exercise pose unique challenges, too. To exercise safely, it's crucial to track your blood sugar before, during and after physical activity. You'll learn how your body responds to exercise, which can help you prevent potentially dangerous blood sugar fluctuations. Before exercise: Check your blood sugar before your workout Before jumping into a fitness program, get your doctor's OK to exercise — especially if you've been inactive. Talk to your doctor about any activities you're contemplating, the best time to exercise and the potential impact of medications on your blood sugar as you become more active. For the best health benefits, experts recommend at least 150 minutes a week of moderately intense physical activities such as: Fast walking Lap swimming Bicycling If you're taking insulin or medications that can cause low blood sugar (hypoglycemia), test your blood sugar 30 minutes before exercising. Consider these general guidelines relative to your blood sugar level — measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Lower than 100 mg/dL (5.6 mmol/L). Your blood sugar may be too low to exercise safely. Eat a small snack containing 15 to 30 grams of carbohydrates, such as fruit juice, fruit, crackers or even glucose tablets before you begin your workout. 100 to 250 mg/dL (5.6 to 13.9 mmol/L). You're good to go. For most people, this is a safe pre-exercise Continue reading >>