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Is A 5.5 A1c Good?

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 >>

A1c Level And Future Risk Of Diabetes: A Systematic Review

A1c Level And Future Risk Of Diabetes: A Systematic Review

Go to: RESEARCH DESIGN AND METHODS Data sources We developed a systematic review protocol using the Cochrane Collaboration's methods (9). We formulated search strategies using an iterative process that involved medical subject headings and key search terms including hemoglobin A, glycated, predictive value of tests, prospective studies, and related terms (available from the authors on request). We searched the following databases between database establishment and August 2009: MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science (WOS), and The Cochrane Library. Systematic searches were performed for relevant reviews of A1C as a predictor of incident diabetes. Reference lists of all the included studies and relevant reviews were examined for additional citations. We attempted to contact authors of original studies if their data were unclear or missing. Study selection and data abstraction We searched for published, English language, prospective cohort studies that used A1C to predict the progression to diabetes among those aged ≥18 years. We included studies with any design that measured A1C—whether using a cutoff point or categories—and incident diabetes. Titles and abstracts were screened for studies that potentially met inclusion criteria, and relevant full text articles were retrieved. X.Z. and W.T. reviewed each article for inclusion and abstracted, reviewed, and verified the data using a standardized abstraction template. If A1C measurement was standardized by the National Glycohemoglobin Standardization Program (NGSP) and both standardized and unstandardized A1C values were reported, standardized values were used in the analyses. A sensitivity analysis, however, was conducted using both standardized and unsta 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 Identifies Diabetes, Heart Risk

A1c Test Identifies Diabetes, Heart Risk

March 3, 2010 - You don't have to fast before taking the newly recommended A1c test to screen for diabetes -- and it spots early diabetes and heart disease better than the older test, researchers find. Late last year, the American Diabetes Association recommended using the A1c test to screen for diabetes. The test had been around for decades, but recent standardization made it useful as a screening tool. And now there's convincing evidence that A1c outperforms the older test, which measured blood sugar (glucose) in people who had fasted for eight hours. It comes from a study in which Johns Hopkins researcher Elizabeth Selvin, PhD, MPH, and colleagues compared results of both tests in 11,000 adults screened with both tests. A1c "was similarly associated with a risk of diabetes and more strongly associated with risks of cardiovascular disease and death from any cause as compared with fasting glucose," Selvin and colleagues report. The ADA says that an A1c level at or above 6.5% means you have diabetes. Selvin's team showed that the risk of diabetes, heart disease, and death rises with A1c. Compared to people with a normal A1c level of 5.0% to 5.5%, they found that: An A1c level of less than 5.0% means a 48% lower risk of diabetes and about the same risk of heart disease. An A1c level of 5.5% to 6.0% means an 86% higher risk of diabetes and a 23% higher risk of heart disease. An A1c level of 6.0% to 6.5% means a 4.5-fold higher risk of diabetes and a 78% higher risk of heart disease. An A1c level of 6.5% or more means a 16.5-fold higher risk of diabetes and a twofold higher risk of heart disease. A1c stands for glycated hemoglobin. The A1c percentage measures how much sugar is attached to the blood's hemoglobin protein. The A1c test result gives a measure of how well your 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 >>

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 >>

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 >>

Dr. Jacqueline Gerhart: If You Have Prediabetes, Will You Get Diabetes?

Dr. Jacqueline Gerhart: If You Have Prediabetes, Will You Get Diabetes?

Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission. Dear Dr. Gerhart: I was just told I have prediabetes. What are the chances I'm going to get full-blown diabetes? Dear Reader: I'm sorry to hear you have prediabetes, also known as impaired fasting glucose or impaired glucose tolerance. It is diagnosed in patients with elevated blood sugars that are not yet high enough to be considered diabetes. There are a few ways to test for diabetes. Fasting blood sugar: This can be done either by a traditional blood draw or by a finger prick. If the value is from 100 to 125 mg/dL (milligrams per deciliter), you are considered to have impaired fasting glucose. If it is greater than 126 mg/dL on two different occasions, you are diagnosed with diabetes. Two-hour oral glucose tolerance test: This test is done less frequently because you have to drink a sugary drink, then wait two hours before your blood is drawn. On this test, if your blood sugar is 140 to 199 mg/dL, you have impaired glucose tolerance. Greater than 200 mg/dL means diabetes. Hemoglobin A1C: This test is often used for both the diagnosis and the ongoing management of diabetes. If your value is 5.7 to 6.4 percent, you have prediabetes. Greater than 6.5 percent is diabetes. Having prediabetes does place you at a high risk of developing diabetes. For example, people with hemoglobin A1C values of 5.5 to 6.0 have a 9 to 25 percent chance of developing diabetes in five years. Those with values from 6.0 to 6.4 have a 25 to 50 percent chance, and they are 20 times more likely to develop diabetes than those with a normal hemoglobin A1C. Prediabetes is associated with card Continue reading >>

Does 5.5 A1c Predict Retinopathy?

Does 5.5 A1c Predict Retinopathy?

A new, high quality study which I cited in my Updates to Blood Sugar 101 blog found a steep increase in the incidence of retinopathy in people not diagnosed with diabetes whose A1cs were 5.5% or more. The study found that the predictive value of the A1c was much stronger than the predictive value of fasting blood sugars in the same population. At first glance this might be a very disturbing finding to those of us who find it difficult if not impossible to lower our A1cs below 5.5%. I have not been able to do this even when eating a very low carb diet. My A1cs are almost always between 5.7% and 5.8%. I've discussed why some of us have higher than expected A1cs in another blog post. But I want to raise another point here, one that is often lost when researchers use A1c: The A1c reflects average blood sugar values over time, but there are many ways to attain an average. In fact, what the A1c really measures the amount of glucose that has gotten bonded onto red blood cells over a period of time. The more exposure red blood cells have to high blood sugars, the more glucose they accumulate. Since these red blood cells live about 3 months, the A1c is supposed to reflect three month's worth of blood sugar exposure. In reality, though, the A1c reflects the several weeks right before the test, much more than it does the whole three month period. Studies that compare CGMS readings with A1cs conclude that that A1c gives a close approximation to average blood sugars for a population as a whole, and much rougher approximations for the average blood sugar of the individuals in a population. Note, however, that people with unusually high or low concentrations of red blood cells will get A1c readings that do not reflect the actual concentration of glucose in their blood. So will people Continue reading >>

The Normal A1c Level

The Normal A1c Level

Wow Richard, 70 lbs? I have lost 24 lbs from low carb diet due to SIBO. It also helped my AC1 go down three points from 6.2 and my cholesterol is lower, which surprised me. I can’t afford to lose anymore weight because I was small to begin with. I had noticed much bigger people in the UK over the last 5 years compared to 15-20. Was quite shocking. I thought we had the patent on obesity! I am not diabetic that I know of but I had weird symptoms… Thirst that continued all day and night. My husband called me a camel. Dry eyes, rashes, strange dark discolouration on arm, under the arm to the side, some circulation issues and blurred vision. Eye specialist could not figure out why. Sores in the mouth also. I had observed about three weeks into super low carbs (30 Gms carb/day) that athlete’s foot symptom, sores in mouth and rashes were clearing up. So, lowering carbs for SIBO actually turned out for the best. By the way, I love your final paragraph. Research is what led me to SIBO diagnosis, and I then told the GI what to look for! He was barking up the wrong tree for months. Said I needed to eat more carbs so I don’t lose weight. Well, carbs fed the bacterial overgrowth!!! Dang fool. On Saturday, June 23, 2012, Diabetes Developments wrote: There is a new comment on the post “The Normal A1C Level”. Author: Richard Comment: I think part of the problem is that doctors are trained over many years to treat with pills, not with food. We continue to do what we are trained to do no matter what. I do believe they want to help us but don’t have the nutritional knowledge because that is not their expertise. When you have a hammer, etc. Nutritionist are no better unless they are those involved in research. They just peddle the messages they are told to. Then again, why wo Continue reading >>

A1c Diabetes Test Is A Better Indicator Of Risk

A1c Diabetes Test Is A Better Indicator Of Risk

WASHINGTON (Reuters) - A test that shows blood sugar levels over a span of several weeks is not only the best way to diagnose diabetes but also may be better at identifying who is at risk of getting diabetes than standard blood sugar tests, researchers said on Wednesday. In a study involving more than 11,000 people with no history of diabetes, the hemoglobin A1c test more accurately identified people who later developed diabetes than the glucose fasting test, which measures blood sugar levels at one point in time. The A1c test was also a better predictor of risk for stroke, heart disease and death from diabetes, the researchers reported in the New England Journal of Medicine. They found that people who had A1c levels at 6 percent or greater were at higher risk for developing diabetes. “A1c has significant advantages over fasting glucose,” Dr. Elizabeth Selvin of Johns Hopkins University in Baltimore, who led the study, said in a statement. Blood sugar levels can vary from day to day and hour to hour. The A1c test is more reliable, repeatable and allows doctors to track average glucose levels over time. Levels are not as affected by stress and illness, and patients do not have to fast before the test, the researchers said. ADA RECOMMENDATION In January, the American Diabetes Association recommended the A1c test for diabetes screening and to identify people who may be at risk of developing the disease. Fasting glucose had been the standard measure in the United States for decades. In the study, Selvin and colleagues examined stored blood samples from 11,092 black and white middle-aged adults without diabetes. The samples were collected between 1990 and 1992. They compared the A1c test to the fasting glucose test to identify people at high risk for diabetes, heart dise Continue reading >>

Hemoglobin A1c And Diabetes; What’s Your Number?

Hemoglobin A1c And Diabetes; What’s Your Number?

1 of every 10 people over the age of 20 years in the United States has Diabetes. More than 30 percent of all people over the age of 65 have Diabetes. These numbers keep climbing! Adult onset diabetes is preventable. If your fasting blood glucose (tested on your annual physical exam) is between 100 and 125, and you are not currently being treated to lower your blood glucose, now is the time to see your doctor and talk about preventing it from rising further and preventing a long term chronic illness. If you haven’t been tested within the past year or don’t know what your fasting blood glucose levels are, ask your doctor about getting either a fasting blood glucose, or a hemoglobin A1C test. The Old Standard Levels of glucose in your blood have been measured for many years as the gold standard to screen for the presence of diabetes. Fasting blood glucose testing is influenced by daily diet changes and can fluctuate quite a bit over time. In With the New In 2009, the Hemoglobin A1C test became the new gold standard for diabetes diagnosis. The hemoglobin A1C test doesn’t measure the amount of glucose floating loose in your blood, it measures glycosylated hemoglobin. As blood glucose levels rise and remain elevated, increasing levels of glycosylated hemoglobin appear. The added benefit to this test, unlike other methods, is that you don’t have to be fasting to get it tested. The Test of Time Red blood cells remain in the blood for 120 days, or 4 months. The A1C test looks at levels over time, not just the snap shot of a single fasting test. Consequently, the hemoglobin A1C is much more effective as a diagnostic screening and treatment response assessment tool, because the the levels remain stable over a much longer period of time, eliminating the day-to-day variation Continue reading >>

What Is The Best A1c Level?

What Is The Best A1c Level?

Most of us living with diabetes as well as the doctors who treat us have always assumed that lower blood glucose levels would protect us better from the complications of diabetes. In the past two decades several studies showed a linear relationship between blood glucose, as measured by A1C levels, and worsened health. But now, several recent A1C studies have shown a J-shaped relationships, in which at the lower end some bad things happen, at the center things are better, and at the top end things are terrible. While linear relationships are the rule in observational studies, U-shaped and J-shaped curves aren’t uncommon, and some authors lump both of these shapes as U-shaped. All of the studies relating A1C levels and ill health – the earlier ones and the recent ones alike – are observational. They study correlations, which aren’t proof, because other confounding factors that the researchers didn’t take into account could have been the problem. 5.4-5.6 Seems Safest The first of these newer studies showing that a very low A1C level is unhealthier than a higher one came out in the February 2015 issue of Diabetes Care. This analysis of the German National Health Interview and Examination Survey 1998 that studied about 6,300 people for about 12 years indicated that people with an A1C level of 5.4 to 5.6 had the lowest risk of excess mortality. Because this result puzzled me so much, I asked Dr. Richard K. Bernstein for his reaction. “These A1c measurements were made years ago in Germany,” he replied, “before international agreement on how it would be measured. The modern elution method would likely give considerably different results. It is even possible that several different methods were being used at different sites during the study.” A1C and Dementia Ev 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 >>

What Is A Good Score On The A1c Diabetes Test?

What Is A Good Score On The A1c Diabetes Test?

Normal A1C level can range from 4.5 to 6 percent. Someone who's had uncontrolled diabetes for a long time can have an A1C level above 9 percent. A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate dates indicates diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which is high risk of developing diabetes. For most people who have previously diagnosed diabetes, an A1C level of 7 percent or less is a common treatment target. Higher targets may be chosen in some individuals. If your A1C level is above your target, your doctor may recommend a change in your diabetes treatment plan. Remember, the higher your A1C level, the higher your risk of diabetes complications. A good score on the A1C test depends on whether you’ve been diagnosed with diabetes. For those who do not have diabetes, a score of less than 5.7% is considered normal, while 5.7% to 6.4% indicates prediabetes and 6.5% or higher means you have diabetes. If you already have diabetes, a score of 7% or lower is desired. You and your doctor can decide what score is best for you. The A1C diabetes test is a way to get an average of how well your blood sugar has been controlled for the past three months. The standard A1C goal for most people with diabetes is less than 7%. However, the goal may be individualized or may be different for some people, especially older adults, people with heart disease or those who are prone to frequent low blood glucose. It's a good idea to find out what your A1C goal should be from your healthcare provider and then use that as a benchmark for your A1C results. No one quite agrees on where your A1C score should be, but we all agree on where it shouldn’t be. The scale does not look anything like the BGL numbers you are used Continue reading >>

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