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Is A1c 5.9 Normal?

Hemoglobin A1c Test (hba1c, A1c, Hb1c)

Hemoglobin A1c Test (hba1c, A1c, Hb1c)

Hemoglobin A1c definition and facts Hemoglobin A1c is a protein on the surface of red blood cells that sugar molecules stick to, usually for the life of the red blood cell (about three months). The higher the level of glucose in the blood, the higher the level of hemoglobin A1c is detectable on red blood cells. Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time period. Normal ranges for hemoglobin A1c in people without diabetes is about 4% to 5.9%. People with diabetes with poor glucose control have hemoglobin A1c levels above 7%. Hemoglobin A1c levels are routinely used to determine blood sugar control over time in people with diabetes. Decreasing hemoglobin A1c levels by 1% may decrease the risk of microvascular complications (for example, diabetic eye, nerve, or kidney disease) by 10%. Hemoglobin A1c levels should be checked, according to the American Diabetic Association, every six months in individuals with stable blood sugar control, and every three months if the person is trying to establish stable blood sugar control. Hemoglobin A1c has many other names such as glycohemoglobin, glycated hemoglobin, glycosylated hemoglobin, and HbA1c. To explain what hemoglobin A1c is, think in simple terms. Sugar sticks to things, and when it has been stuck to something for a long time it's harder to the get sugar (glucose) off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die. When sugar (glucose) sticks to these red blood cells by binding to hemoglobin A1c, it gives us an idea of how much glucose has been around in the blood for the preceding three months. Hemoglobin A1c is a minor component of hemoglobin to which gl 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 >>

Your Average Blood Sugar: Why It Really Matters

Your Average Blood Sugar: Why It Really Matters

If there was a blood test that could give you valuable information about a major, yet reversible risk factor for Alzheimer’s disease and age related dementia, would you want to take it? What if that same blood test could also give you information about your risk of heart disease, high blood pressure, diabetes, vision loss, cancer and how fast you can expect your body to age? What if the test was really cheap? Now, what if you knew that what you were going to have to do to reverse your risk of all these conditions was going to be personally challenging, maybe even really hard, would you still want to take the test? Something to think about, isn’t it? The test I’m talking about does exist. It’s a simple little test that’s run all the time. It’s full implications are rarely considered, however. The test It’s called “hemoglobin A1c” and is sometimes referred to simply as the “A1c” test. In essence, it measures the amount of sugar that has become stuck to the hemoglobin in your red blood cells (hemoglobin is the component in blood that carries oxygen). Because red blood cells live for about 3 to 4 months, the test is usually used to estimate an “average blood sugar” for the previous 3 months. The more sugar floating around in your blood on a daily basis, the higher you A1c value will be. In conventional medicine the test is used to diagnose and monitor treatment goals for diabetics. The implications of a person’s A1c value run much deeper, however. Sugar within the body doesn’t just stick to hemoglobin. It sticks to many tissues that are made of proteins and fats (this accounts for most tissues in your body by the way) and can bind directly to DNA. The compounds formed by this process are called advanced glycation end products or “AGEs” for Continue reading >>

Diagnosis

Diagnosis

Print The American Diabetes Association (ADA) recommends that blood glucose screening for adults begin at age 45, or sooner if you are overweight and have additional risk factors for prediabetes or type 2 diabetes. There are several blood tests for prediabetes. Glycated hemoglobin (A1C) test This test indicates your average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. In general: An A1C level below 5.7 percent is considered normal An A1C level between 5.7 and 6.4 percent is considered prediabetes An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (hemoglobin variant). Fasting blood sugar test A blood sample is taken after you fast for at least eight hours or overnight. In general: A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes. Oral glucose tolerance test This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours. In general: A blood sugar level less than 140 mg/dL (7.8 mmo Continue reading >>

To Your Good Health: A1c Is Better Screening Test For Diabetes

To Your Good Health: A1c Is Better Screening Test For Diabetes

Q: My A1c test on blood sugar is always higher (prediabetes) than my fasting glucose test (normal) on the same visit to the doctor. Which result should I believe? My latest test at a doctor’s office showed that my A1c is 6.2 percent, and fasting glucose is 88 mg/dL. The A1c pretty much remained at 6.2 percent level, while the fasting glucose varied between 81 and 88 in the past two years. The test is drawing a blood sample after a 12-hour overnight fast. I am not taking any diabetes medication. Previously, my A1c results were 5.9 percent in August 2016 and 5.5 percent in December 2016. A: Both the A1c test and the glucose tests are blood tests for diabetes. The blood glucose test is a snapshot of an instant in time, while the A1c is a measure of the average value over the past two or three months or so. The A1c looks at the amount of sugar molecules on the large hemoglobin protein of the blood. In general, the A1c is a better screening test for diabetes than a fasting glucose test, because fasting blood sugar is normal for a long time (potentially years) before one shows overt diabetes. In early Type 2 diabetes, the only time the blood sugar gets above normal is after eating (the blood sugar is supposed to go up a bit after eating, but in the early stages of diabetes, it goes higher than it should). The most sensitive test for Type 2 diabetes is a glucose tolerance test, where a fixed amount of sugar is given, and the blood is tested after two hours. An elevated level at two hours is prediabetes or diabetes. However, the A1c, which is affected by both fasting blood glucose levels and those after eating, is nearly as sensitive, and is much easier to do. Both the glucose tolerance test and the A1c usually will diagnose prediabetes and diabetes before the fasting glucose Continue reading >>

A1c Is Better Screening Test For Diabetes

A1c Is Better Screening Test For Diabetes

Dear Dr. Roach • My A1c test on blood sugar is always higher (prediabetes) than my fasting glucose test (normal) on the same visit to the doctor. Which result should I believe? My latest test at a doctor’s office showed that my A1c is 6.2 percent, and fasting glucose is 88 mg/dL. The A1c pretty much remained at 6.2 percent level, while the fasting glucose varied between 81 and 88 in the past two years. The test is drawing a blood sample after a 12-hour overnight fast. I am not taking any diabetes medication. Previously, my A1c results were 5.9 percent in August 2016 and 5.5 percent in December 2016. — K.H. Answer • Both the A1c test and the glucose tests are blood tests for diabetes. The blood glucose test is a snapshot of an instant in time, while the A1c is a measure of the average value over the past two or three months or so. The A1c looks at the amount of sugar molecules on the large hemoglobin protein of the blood. In general, the A1c is a better screening test for diabetes than a fasting glucose test, because fasting blood sugar is normal for a long time (potentially years) before one shows overt diabetes. In early Type 2 diabetes, the only time the blood sugar gets above normal is after eating (the blood sugar is supposed to go up a bit after eating, but in the early stages of diabetes, it goes higher than it should). The most sensitive test for Type 2 diabetes is a glucose tolerance test, where a fixed amount of sugar is given, and the blood is tested after two hours. An elevated level at two hours is prediabetes or diabetes. However, the A1c, which is affected by both fasting blood glucose levels and those after eating, is nearly as sensitive, and is much easier to do. Both the glucose tolerance test and the A1c usually will diagnose prediabetes and di 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 >>

The Hemoglobin A1c Blood Test For Type 2 Diabetes

The Hemoglobin A1c Blood Test For Type 2 Diabetes

The hemoglobin A1C is a great blood test for a diabetic. You can know how well your blood sugar control has been over a few months. But this test will not replace daily glucose monitors. It has other limitations too. Still, the HbA1C blood test is my favorite of all type 2 diabetic tests. For one thing, it does not require fasting. For another, it can be done in the doctor's office with a single fingerstick just like a glucose monitor test. You get results in six minutes. Best of all, it lets you know how your blood sugar has been doing over the past two or three months. The test sounds perfect, but it is not. For diabetes management you need to know what your blood sugar levels are every day. Daily blood testing is still necessary, because a type 2 diabetic on insulin needs to know his glucose levels several times a day, not just every three months. A great HBA1C reading does not mean there have been no hyperglycemic (high blood sugar) or hypoglycemic (low blood sugar) episodes over the last few months. So the hemoglobin A1C cannot replace daily checks with your glucose monitor and good log book records. Your doctor always asks what your last daily reading was, and he likes to see your log book too. Daily readings along with the A1C give a complete picture of what is going on with your diabetes treatment. Taken together with daily readings, the hemoglobin A1C tells you if your blood sugar is staying in the range that will keep away the complications. There is more and more evidence that an A1C between 6.5 and 7 will do just that. And here's an encouraging fact. If your A1C was 9 and you lowered it to 8, there is a 20% reduction in your risk of complications. That means you do not have to be in the best range yet to see benefits from better blood sugar control. Hemoglob Continue reading >>

6 Ways To Lower Your A1c Level

6 Ways To Lower Your A1c Level

Diabetes is a serious, chronic disease that can lead to many complications. When managed properly, diabetes does not have to control your life or ruin your health. Getting tested, especially if you are at risk for developing type 2 diabetes, is a proactive measure you can take for yourself and your future. In the early stages of diabetes, there are no symptoms. An early diagnosis helps you get treatment before complications occur. The A1C test is a blood test that checks for type 2 diabetes. It is also used to see how well you are managing your diabetes if you have already been diagnosed. The test provides information about a person’s average levels of blood sugar over a two- to three-month period. The number is reported in the form of a percentage. The higher the percentage, the higher your average blood glucose levels are, and the higher your risk for either diabetes or related complications. A1C is one of the primary tests used for diabetes diagnosis and management. It can test for type 1 and type 2 diabetes, but it can’t test for gestational diabetes. It can also be used to predict the likelihood that someone will get diabetes. The A1C test measures how much glucose, or sugar, is attached to hemoglobin, the protein in red blood cells. The more glucose attached, the higher the A1C. This test is groundbreaking, as it 1) doesn’t require fasting, 2) gives a picture of blood sugar levels over a period of days and weeks instead of at just one point in time like fasting sugars, and 3) can be done at any time of day. This makes it easier to administer and easier to make accurate diagnoses. According to the National Institutes of Health, a normal A1C is below 5.7 percent. If your score is between 5.7 and 6.4 percent, the diagnosis is prediabetes. Having prediabetes put Continue reading >>

When “normal” Blood Sugar Isn’t Normal (part 2)

When “normal” Blood Sugar Isn’t Normal (part 2)

In the last article I explained the three primary markers we use to track blood sugar: fasting blood glucose (FBG), oral glucose tolerance test (OGTT) and hemoglobin A1c (A1c). We also looked at what the medical establishment considers as normal for these markers. The table below summarizes those values. In this article, we’re going to look at just how “normal” those normal levels are — according to the scientific literature. We’ll also consider which of these three markers is most important in preventing diabetes and cardiovascular disease. Marker Normal Pre-diabetes Diabetes Fasting blood glucose (mg/dL) <99 100-125 >126 OGGT / post-meal (mg/dL after 2 hours) <140 140-199 >200 Hemoglobin A1c (%) <6 6-6.4 >6.4 But before we do that, I’d like to make an important point: context is everything. In my work with patients, I never use any single marker alone to determine whether someone has a blood sugar issue. I run a full blood panel that includes fasting glucose, A1c, fructosamine, uric acid and triglycerides (along with other lipids), and I also have them do post-meal testing at home over a period of 3 days with a range of foods. If they have a few post-meal spikes and all other markers or normal, I’m not concerned. If their fasting BG, A1c and fructosamine are all elevated, and they’re having spikes, then I’m concerned and I will investigate further. On a similar note, I’ve written that A1c is not a reliable marker for individuals because of context: there are many non-blood sugar-related conditions that can make A1c appear high or low. So if someone is normal on all of the other blood sugar markers, but has high A1c, I’m usually not concerned. With all of that said, let’s take a look at some of the research. Fasting blood sugar According to cont 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 >>

Hemoglobin A1c (hba1c) Test For Diabetes

Hemoglobin A1c (hba1c) Test For Diabetes

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes. Hemoglobin is a protein found in red blood cells. It gives blood its red color, and it’s job is to carry oxygen throughout your body. The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher change of getting of diabetes. Levels of 6.5% or higher mean you have diabetes. The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. A combination of diet, exercise, and medication can bring your levels down. People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year. People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can 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 >>

Metformin For Prediabetes

Metformin For Prediabetes

Prediabetes is, for many people, a confusing condition. It’s not quite Type 2 diabetes — but it’s not quite nothing, either. So how concerned should you be about it? For years, the jargon-filled names given to this condition — impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) — may have made the task of taking it seriously more difficult. But in 2002, the American Diabetes Association (ADA), along with the U.S. Department of Health and Human Services, inaugurated the term “prediabetes” to convey the likely result of not making diet or lifestyle changes in response to this diagnosis. In 2003, the threshold for prediabetes was lowered from a fasting glucose level of 110 mg/dl to one of 100 mg/dl. Then, in 2008, the American Diabetes Association (ADA) began recommending the drug metformin for some cases of prediabetes — specifically, for people under age 60 with a very high risk of developing diabetes, for people who are very obese (with a body-mass index, or BMI, of 35 or higher), and for women with a history of gestational diabetes. The ADA also said that health-care professionals could consider metformin for anyone with prediabetes or an HbA1c level (a measure of long-term blood glucose control) between 5.7% and 6.4%. But according to a recent study, metformin is still rarely prescribed for prediabetes. The study, published in April in the journal Annals of Internal Medicine, found that only 3.7% of people with prediabetes were prescribed metformin over a three-year period, based on data from a large national sample of adults ages 19 to 58. According to a Medscape article on the study, 7.8% of people with prediabetes with a BMI of 35 or higher or a history of gestational diabetes were prescribed metformin — still a very low rate for t Continue reading >>

What Are The Normal A1c Levels For Children?

What Are The Normal A1c Levels For Children?

The A1c blood test is one of the laboratory tests used to diagnose diabetes and an important measure of average blood sugar levels in someone who has diabetes. This test determines the amount of glucose or sugar that has attached to the blood's hemoglobin -- the oxygen-carrying protein in red blood cells -- during the 3-month lifespan of these cells. Target A1c levels have been established to help healthcare providers, as well as children with diabetes and their families, understand the blood sugar goals needed to reduce the risk of the long-term complications of diabetes. While there are some situations where the A1c result may not be reliable, as a rule this test is accurate and an essential part of a child's diabetes management program. Video of the Day Normal A1c Levels Diagnostic criteria for children is similar to the guidelines used in adults, and the A1c is one of the tests used to diagnose diabetes. A1c levels are reported as a percentage, and often the estimated average glucose (eAG) -- a number calculated from the A1c reading -- is also included with the results. Using the same units as a blood glucose meter, the eAG makes understanding the A1c result a bit easier by comparing the A1c to average blood sugar levels. A normal, nondiabetic A1c level is below 5.7 percent, which reflects an eAG below 117 mg/dL. The level used to diagnose diabetes is 6.5 percent and above, which reflects an eAG of 140 mg/dL or higher. A1c levels above normal but below the diabetes range fit into a prediabetes range. Target A1c Levels Along with its role in diagnosing diabetes, the A1c test is performed between 2 and 4 times per year to estimate average blood sugar levels over the previous 3 months. This test is used to monitor the effectiveness of diabetes treatment and to determin Continue reading >>

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