David’s Guide To Getting Our A1c Under 6.0
The A1C test is our best scorecard to show how well we are controlling our diabetes. It measures how much glucose has been sticking to our red blood cells for the previous two or three months. Since our bodies replace each red blood cell with a new one every four months, this test tells us the average of how high our glucose levels have been during the life of the cells. The experts recommend that we should get our A1C level tested at least twice a year. People who take insulin need to get it about four times a year. If the test shows that our blood glucose level is high, it means that we have a greater risk of having diabetes problems. Think of the A1C as an early warning system for the insidious complications that we can get down the road when we don’t control our condition. But what do we mean by a “high” A1C level? Here the experts disagree. The American Diabetes Association says that we need to keep our A1C results below 7.0 percent. The American Association of Clinical Endocrinologists sets the target at 6.5 percent. The International Diabetes Federation, or IDF, also recommends that most people with diabetes keep their levels below 6.5 percent. The more our A1C level is higher than normal, the greater the likelihood that we will suffer from one or more of the complications of diabetes. And here too the experts disagree with how they define “normal.” People who don’t have diabetes have A1C levels below 6.0 percent. That’s the gist of what I wrote here recently in “The Normal A1C Level.” The IDF agrees. But more aggressive endocrinologists say that a truly normal A1C ranges from 4.2 percent to 4.6 percent. That’s what Dr. Richard K. Bernstein wrote in Dr. Bernstein’s Diabetes Solution. No matter what our level is, we can be sure that lower is Continue reading >>
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 >>
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 >>
I Was Diagnosed At 6.6 A1c. Why Is The Line Of Prediabetes At 6.4? I Was Told That I Would Always Be Diabetic. Has Anyone Gone Back To Normal At 6.6 Range? Ive Heard Some Have, But I Dont Know.
I was diagnosed at 6.6 A1C. Why is the line of prediabetes at 6.4? I was told that I would always be diabetic. Has anyone gone back to normal at 6.6 range? Ive heard some have, but I dont know. I was diagnosed at 6.6 A1C. Why is the line of prediabetes at 6.4? I was told that I would always be diabetic. Has anyone gone back to normal at 6.6 range? Ive heard some have, but I dont know. Q:I was diagnosed at 6.6 A1C. Why is the line of prediabetes at 6.4? I was told that I would always be diabetic. Has anyone gone back to normal at 6.6 range? I've heard some have, but I don't know. Although the upper limit for prediabetes diagnosis is an A1c of 6.4%, many experts believe that this indicates blood sugar is frequently above levels considered healthy. Rather than focusing on whether you are classified as having prediabetes or diabetes, it's important to try to keep your blood sugar as well controlled as possible to prevent progression of the disease. In addition, it is possible to lower your A1c and achieve normal blood sugar levels after being diagnosed with diabetes, but this depends on many factors, including how much pancreatic function you have remaining. However, following a nutrient-dense low-carb diet, losing weight if you need to, exercising regularly, and engaging in stress-relieving activities can increase your odds of achieving and maintaining blood sugar levels in the normal range. Answered By dLife Expert: Franziska Spritzler, RD, CDE Certified diabetes educator and registered dietitian living in Southern California. The content of this website, such as text, graphics, images, and other material on the site (collectively, Content) are for informational purposes only. The Content is not intended to be a substitute for, and dLife does not provide, professional me Continue reading >>
Failing The Hemoglobin A1c Test
I feel like a failure. I got my latest blood test results yesterday and I was so disappointed with my hemoglobin A1C that I just can’t get over it. After holding steady at 6.4% for the two previous blood tests, my latest result is up to 7%. I know this is not a horrible result, and that many doctors consider a hemoglobin A1C of 7% to be in the norm for people with type 1 diabetes, but to me this feels like a huge personal failure. And it wasn’t the only disappointing result I got. Against my doctor’s advice, I stopped taking my statin. The result was not what I had hoped for. Without a statin my LDL cholesterol is up to 150 – fine if you don’t have diabetes, but far from the 100 result people with diabetes should have. Had it only been my cholesterol that was high, I could have dealt with it. It was my decision not to take the statins. But I feel like when it comes to the A1c, I do everything I’m supposed to do. I work ALL the time. I’m totally responsible. So seeing a significant jump in A1c put me in a bad mood, so bad I only started to get over it after a good run this morning. I’ve been told many times and have told myself (and others) that I should not judge myself according to my blood test results. During my morning run I tried to convince myself of this repeating it in my head over and over again – you are not your A1c. It didn’t convince me of anything but the heat and hills did the job and at a certain point I just forgot all about my A1c and was left with my run. I have to be honest and say that this result – despite my efforts – didn’t come as a total surprise. I had blood sugar control issues after my last marathon. Some had to do with not running and some with problems I had with my insulin pump and infusion sets, which resulted i Continue reading >>
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 >>
- Home blood glucose test: How to test for diabetes at home
- Diabetes and the A1C Test: What Does It Tell You?
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
Diabetes Experts Share Ways To Lower Your A1c Levels
Diabetes management at home is an important way of controlling your blood sugar levels without the help of an expert. In that sense, you are in control of your diabetes on a daily basis. However, the American Diabetes Associations’ recommends that a person with diabetes should get their A1C tested by a doctor at least two times a year. The test will give you a picture of your journey with diabetes as a whole. Now, once you do get the numbers, what do you do with that information? If you are on the right track, you will continue doing whatever it is that has been working so far. you feel encouraged! However, if the numbers are not what you and your health care provider were expecting, it is imperative that you embark on the path to lowering them so you can avoid any diabetes related complications in the future. The task can be daunting and overwhelming. We have rounded up 37 experts to share tips and ways that will help you in lowering your A1C levels and keeping them that way. The wisdom they share with us today will help you take those little steps towards a healthier lifestyle. 1. Sharon Castillo In a recent study published by the University of Toronto, it was shown that cinnamon has properties which can reduce blood pressure, especially for those who have prediabetes or type 2-diabetes. Hypertension or high blood pressure is common among those who have prediabetes and type-2 diabetics. High blood glucose levels create oxidative radicals which can damage the arteries. I recommend reading the following articles: The damage to the arteries can result into the scarring of the blood vessels. The scarring builds up plaque which reduces the size of the blood vessel. The reduction in the size of the diameter increases blood pressure. While not all of cinnamon’s mechanism Continue reading >>
Understanding Your A1c
The A1C is a blood test that helps determine if your diabetes management plan is working well. (Both Type 1 and Type 2 take this test.) It’s done every 2-3 months to find out what your average blood sugar has been. (You may also hear this test called glycosylated hemoglobin, glycohemoglobin, hemoglobin A1c, and HbA1c.) A1c is the most common name for it though. How the test works Essentially, the test can tell how much sugar is in the blood stream by looking for proteins (hemoglobins). When glucose (sugar) enters the blood, it binds to the protein in the red blood cells. This binding creates “glycated hemoglobin”. The more sugar in the blood, the more glycated hemoglobin. It’s important to test your blood sugar levels (BGLs) throughout the day; however, an A1C test gives you a bigger picture with a long-term average of those blood sugar levels. What do these numbers mean? The A1c is an average of what your blood sugar levels have been over the 3-month period. In general, the higher your A1C number, the higher your likelihood of diabetes complications. (You don’t want a high A1C; it means there is too much sugar in your blood and your body isn’t absorbing it.) A1C number 4.6 – 6.0 Normal (does not have diabetes) 5.7 – 6.4 Pre-diabetes (warning that someone may develop Type 2 or have the beginning onset of Type 1) 6.7+ Diabetes (someone diagnosed with diabetes) <7.0 – 7.5 Target range (for adults diagnosed with diabetes – children diagnosed with diabetes) This target range varies between individuals, some people naturally run a little higher, some lower. It is important to note that especially in children a higher A1C (of 7.5) is recommended. The A1C number will help you and your doctor determine though if your diabetes management plan is working well. Continue reading >>
Hba1c 6.4 Is It Curable?
by Wendy QUESTION: Hi Dr. Alba, No Charge Glucose Meter - OneTouch Verio Flex® Meter Ad Compact Design to Track Your Glucose On-the-Go. Get It At No Charge. OneTouch Learn more I'm Wendy from the Philippines. I was told by my Doctor that i have Hba1c of 6.4% does it mean that i have a diabetes? She gave me medication and she gave me metformin hydrochloride 500mg. Does it mean that i have diabetes? Can this still be cured? Because she told me that if my Hba1c falls down to normal then i will stop taking medications & i have no diabetes. Is my HBa1c curable? im 33 yrs. old and my dad has diabetes when he was 55. I would appreciate if u would answer my questions thanks From Wendy ANSWER: Hi Wendy, I have to inform you that no one is able to confirm or exclude diabetes as diagnose based only to the result of HbA1c test. Other tests are necessary to be carried out to determine this diagnose. For example, oral glucose tolerance test, fasting blood glucose test and others are needed and you haven’t mentioned if you have run these test or not. In addition, I will mention that normal ranges of HbA1c result is less than 6.5% and your result is 6.4. This means that you have normal amount of glycated hemoglobin in your organism. 2. Second thing is that metformin is really an effective drug and it is used on patients with confirmed diabetes and not on those, who have elevated HbA1c result. Other thing is that patients, who were recently diagnosed with diabetes, are trying to keep their blood glucose concentration within the normal ranges by diet and exercises. If these manners are not effective, drug treatment starts and in most cases metformin is the drug of choice, commonly used. However, my advice for you is to start following a healthy diabetic diet and begin to do some exerc Continue reading >>
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 >>
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 Between 5.7 And 6.4% As A Marker For Identifying Pre-diabetes, Insulin Sensitivity And Secretion, And Cardiovascular Risk Factors
OBJECTIVE A1C is an optional method for diagnosing diabetes and also for detecting individuals at increased risk of the disease. However, how A1C compares with fasting (FPG) and 2-h plasma glucose for detecting at-risk individuals is not well known. RESEARCH DESIGN AND METHODS A 2-h glucose tolerance test, frequently sampled intravenous glucose tolerance test, and A1C were obtained at the follow-up examination in 855 participants in the Insulin Resistance Atherosclerosis Study (IRAS). For this report, 385 individuals were at increased risk of diabetes as defined by A1C between 5.7 and 6.4%, impaired glucose tolerance (IGT), and/or impaired fasting glucose (IFG). RESULTS IFG and IGT identified 69.1 and 59.5% of all individuals at increased risk of diabetes, respectively. A1C 5.7–6.4% detected 23.6% of all at-risk individuals, although more African Americans (31.4%) and Hispanics (35.2%) than non-Hispanic whites (9.9%). Relative to A1C, FPG was more strongly related to fasting insulin (r = 0.38 vs. 0.26; P < 0.01), acute insulin response (r = – 0.20 vs. – 0.09; P < 0.01), and waist circumference (r = 0.43 vs. 0.25; P < 0.001) by the Spearman correlation test. Similarly, 2-h plasma glucose was more strongly related to Si (r = – 0.40 vs. – 0.27; P < 0.01) and triglycerides (r = 0.30 vs. 0.08; P < 0.001). CONCLUSIONS A1C 5.7–6.4% is less sensitive for detecting at-risk individuals than IFG and IGT, particularly among non-Hispanic whites. Single determinations of FPG and 2-h plasma glucose seem to be more precise correlates of insulin resistance and secretion than A1C and, in general, better for other metabolic disorders. A1C has been proposed by the American Diabetes Association (ADA) as an optional assay for diagnosing diabetes and also for detecting individuals Continue reading >>
Hba1c And Diabetes – Glycated Hemoglobin (a1c) Explained
Diabetes and its complications remain a major cause of early disease and death worldwide. The diagnosis of diabetes is to a large extent based on detecting elevated levels of sugar (glucose) in the blood. Hemoglobin A1c (HbA1c) is a laboratory measure frequently used for this purpose. The test is also useful to monitor treatment in patients with established diabetes. Approximately 8 percent of the US populations suffer from type 2 diabetes, with as many as 40 percent of those undiagnosed (1). Worldwide, the prevalence of type 2 diabetes is estimated at 6.4 percent in adults but varies somewhat among countries with the rate of undetected diabetes as high as 50 percent in some areas (2). The term diabetes describes several disorders of abnormal carbohydrate metabolism that are characterized by high levels of blood glucose (hyperglycemia). Diabetes is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin (3). The Difference Between Type 1 and Type 2 Diabetes The prevalence of both type 1 and type 2 diabetes continues to increase worldwide, with type 2 diabetes much more common and accounting for over 90 percent of patients with diabetes. Type 1 diabetes used to be called juvenile onset or insulin-dependent diabetes because it often presents in childhood and it is characterized by the inability of the pancreas to produce the insulin. Insulin is necessary for the cells of the body to be able to utilize glucose for energy production. Without insulin, glucose accumulates in the blood leading to hyperglycemia. Due to the absence of insulin, most patients with type 1 diabetes need to be treated with insulin. Conversely, type 2 diabetes, formerly called adult-onset or non-insulin-depend Continue reading >>
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 >>
A1c Between 5.7 And 6.4% As A Marker For Identifying Pre-diabetes, Insulin Sensitivity And Secretion, And Cardiovascular Risk Factors
A1C has been proposed by the American Diabetes Association (ADA) as an optional assay for diagnosing diabetes and also for detecting individuals at increased risk of the disease (1). A1C has been shown to predict future onset of diabetes (2–4) and is better than fasting plasma glucose (FPG) for predicting microvascular complications (1). A1C may be superior to FPG in predicting mortality and cardiovascular risk in nondiabetic individuals (5) but inferior to 2-h glucose concentration (2-h plasma glucose) in most studies (6–8), albeit not all (9). The A1C assay has advantages over the measurement of plasma glucose including convenience (not requiring fasting samples) and superior technical attributes (1). Conversely, the number of individuals diagnosed with diabetes by the 6.5% A1C threshold is significantly smaller than the number of those diagnosed by the 2003 American Diabetes Association (ADA) criteria (10–13). A1C, FPG, and 2-h plasma glucose assess different aspects of glucose metabolism (1), but differences in the relation of these three glycemic measures to insulin resistance, insulin secretion, and other metabolic abnormalities have not been described. A1C between 5.7 and 6.4% (A1C 5.7–6.4%) is now considered a category of increased risk for diabetes in addition to impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) (1). However, studies that compare A1C 5.7–6.4% with IFG and IGT are lacking. Therefore, our aim was twofold: 1) to analyze A1C, FPG, and 2-h plasma glucose for their ability to identify individuals at increased risk of diabetes; and 2) to examine the relation of these glycemic measures to other metabolic abnormalities, particularly measured insulin resistance and secretion in nondiabetic subjects. Continue reading >>