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Type 1 Diabetes High A1c

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 >>

Ada: Teenagers With Type 1 Diabetes Not Even Close To Meeting Goals

Ada: Teenagers With Type 1 Diabetes Not Even Close To Meeting Goals

One in 5 kids with diabetes has an A1C above 10%…. According to results of the TEENs Registry Study, presented at the American Diabetes Association 2014 Scientific Sessions, 75 percent of young people living with type 1 diabetes are not meeting the recommended glycemic goals. The TEENs study, funded by Sanofi, was one of the largest studies to ever assess type 1 diabetes management and the factors that affect it. Commenting on the study was Dr. Lori M.B. Laffel, chief of the pediatric, adolescent and young adult section of the Joslin Diabetes Center and associate professor of pediatrics at Harvard Medical School in Boston, Massachusetts. Dr. Laffel said in her presentation of the results, "Despite modern advances in insulin replacement, the majority of young patients still fail to achieve recommended glycemic targets. In addition many continue to experience acute complications including both hypoglycemia and diabetic ketoacidosis." The data was collected from 5,960 participants between the ages of 8 and 25 seen at 219 diabetes centers in 20 developing and developed countries including Europe, the United States, Latin America, the Middle East, Africa and India. The patients had a mean age of 15 and a mean disease duration of 7 years. 75% of participants were white and between 26% and 29% were clinically overweight or obese. Average A1C levels were 8.3% for the 1724 children ranging in age from 8 to 12, 8.6% for the 2854 participants between the ages of 13 and 18 and 8.4% for the 1382 young adults aged 19 to 25. Overall 72% of participants were not meeting recommended A1C targets; less than 7.5% for those 18 or younger and less than 7% for diabetics between the ages of 19 and 25. Rates of DKA and severe hypoglycemia were higher among the young adults than either the tee 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 >>

What Does Your A1c Number Really Mean?

What Does Your A1c Number Really Mean?

We dFolk are bombarded with numbers, goals, and targets. We’re frequently told where we should be, but not how high our risk is when we can’t reach our targets. Here, we break down A1C numbers into a simple green-light, yellow-light, red-light format, to give you perspective on when (and how much) to worry, when to relax, when to call your doc, and when to call 911. Green-light A1C score For most people, the target for A1C, the green light, is between 6.0% and 6.9%. These numbers are commonly expressed simply as 6.0 and 6.9, without the % sign. If your A1C falls into this zone, you’re considered to be in control. For perspective, these numbers can be converted into “meter” numbers called estimated average glucose—eAG for short. The green light eAG range is 126 mg/dL (7 mmol/l) to 151 mg/dL (8.39 mmol/l). But what if your numbers are higher than target? Or lower than target? When are you actually in danger? Yellow-light A1C score If the light turns yellow as you approach the intersection, you need to either speed up or stop. Whichever is safe under the circumstances, right? If your A1C is between 7.0 and 8.9, you’ll be classified as “out of control.” But how much danger are you in? Frankly, it depends upon how close you are to either end of the spectrum. Yellow-light A1Cs are higher than is strictly healthy, but pose no immediate harm. However, the higher you are in this range, the closer you are to a red light. We’ll talk about just how serious that can be in a minute. I should point out that there are some special cases. If you’re a very young type 1, a yellow-light A1C score may be considered in-target for you until you get older. Similarly, if you’re an elderly type 2, or have a history of severe hypoglycemia, you doctor may choose to “green Continue reading >>

Type 1 Diabetes Through The Life Span: A Position Statement Of The American Diabetes Association

Type 1 Diabetes Through The Life Span: A Position Statement Of The American Diabetes Association

Incidence and Prevalence of Type 1 Diabetes The exact number of individuals with type 1 diabetes around the world is not known, but in the U.S., there are estimated to be up to 3 million (1). Although it has long been called “juvenile diabetes” due to the more frequent and relatively straightforward diagnosis in children, the majority of individuals with type 1 diabetes are adults. Most children are referred and treated in tertiary centers, where clinical data are more readily captured. The SEARCH for Diabetes in Youth study estimated that, in 2009, 18,436 U.S. youth were newly diagnosed with type 1 diabetes (12,945 non-Hispanic white, 3,098 Hispanic, 2,070 non-Hispanic black, 276 Asian-Pacific Islander, and 47 American Indian) (2). Worldwide, ∼78,000 youth are diagnosed with type 1 diabetes annually. Incidence varies tremendously among countries: East Asians and American Indians have the lowest incidence rates (0.1–8 per 100,000/year) as compared with the Finnish who have the highest rates (>64.2 per 100,000/year) (3). In the U.S., the number of youth with type 1 diabetes was estimated to be 166,984 (4). The precise incidence of new-onset type 1 diabetes in those over 20 years of age is unknown. This may be due to the prolonged phase of onset and the subtleties in distinguishing the different types of diabetes. In one European study of adults aged 30–70 years, ∼9% tested positive for GAD antibodies (GADA) within 5 years of a diabetes diagnosis, consistent with other studies (5). Adults with type 1 diabetes often receive care in primary care settings rather than with an endocrinologist. Unlike the consolidated care seen in pediatric diabetes management, the lack of consolidated care in adults makes incidence and prevalence rates difficult to characterize, an Continue reading >>

Hyperglycemia (high Blood Sugar)

Hyperglycemia (high Blood Sugar)

Hyperglycemia is a hallmark sign of diabetes (both type 1 diabetes and type 2 diabetes) and prediabetes. Other conditions that can cause hyperglycemia are pancreatitis, Cushing's syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses. The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNS, also referred to as hyperglycemic hyperosmolar state). Insulin is the treatment of choice for people with type 1 diabetes and for life-threatening increases in glucose levels. People with type 2 diabetes may be managed with a combination of different oral and injectable medications. Hyperglycemia due to medical conditions other than diabetes is generally treated by treating the underlying condition responsible for the elevated glucose. Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels A number of medical conditions can cause hyperglycemia, but the most common by far is diabetes mellitus. Diabetes affects over 8% of the total U.S. population. In diabetes, blood glucose levels rise either because there is an insufficient amount of insulin in the body or the body cannot use insulin well. Normally, the pancreas releases insulin after a meal so that the cells of the body can utilize glucose for fuel. This keeps blood glucose levels in the normal range. Type 1 diabetes is responsible for about 5% of all cases of diabetes and results from damage to the insulin-secreting cells of the pancreas. Type 2 diabetes is far more common and is related to the body's inability to effectively use insulin. In addition to type 1 and type 2, gestational diabe Continue reading >>

How To Lower Your A1c Levels: More Steps You Can Take

How To Lower Your A1c Levels: More Steps You Can Take

You may be familiar with the “ABCs” of diabetes: A1C, blood pressure, and cholesterol. This acronym is part of a larger diabetes campaign called “Know Your Numbers,” and hopefully you’re aware of all of your numbers — what they are, what they should be, and how often to get them checked. Obviously, knowing your A1C and knowing what you can do if it’s not at goal is a big part of diabetes management. The focus last week and this week has been on all things A1C: what it is, what the general goal is, why it matters, and ways to get it to where it needs to be. What else does it take to lower your A1C? Figuring out how to lower your A1C to whatever your personal goal is can sometimes seem like solving a puzzle. You try something and it may or may not help, or it helps but not enough. Then you try something else. Yes, it can be frustrating, but eventually you’ll hit on a strategy that works for you. Last week, we looked at how a healthy eating plan (including keeping carbs consistent and sticking to an eating schedule) and a physical activity program can help. Research shows that an eating plan can lower A1C levels by 1–2%; physical activity can lower A1C by 0.6–1%, according to various studies. But what if these two strategies aren’t enough? Then what? Time for medication? Diabetes medicines generally lower A1C levels anywhere from 0.5% to as much as 3.5%. The A1C-lowering effect of medicines can vary from person to person, however, and the effect is often dependent upon how high the A1C is to begin with. Insulin. We know that people who have Type 1 diabetes must take insulin. Insulin can be delivered using a syringe or an insulin pen; it can also be administered using an insulin pump. How you decide to take your insulin is a decision best made with you 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 >>

Symptoms, Diagnosis & Monitoring Of Diabetes

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 >>

Study Reveals Poor Disease Control Among Adolescents And Young Adults With Type 1 Diabetes

Study Reveals Poor Disease Control Among Adolescents And Young Adults With Type 1 Diabetes

T1D Exchange Clinic Registry data find a stagnant situation as little has changed in 25 years; underscores need for new technologies to help teens manage their disease BOSTON, May 22, 2015 – In a sweeping analysis assessing the current state of diabetes treatment in the U.S., T1D Exchange researchers conclude that there remains considerable room for improving treatment outcomes in type 1 diabetes across all age groups, but especially for adolescents and young adults. The analysis provides the most up-to-date picture of diabetes treatment, underscoring the need to address barriers to care and implement new therapies and technologies that can help type 1 patients achieve optimal metabolic control. The findings, published today in a special issue of Diabetes Care, come from data collected by the T1D Exchange Clinic Registry. Researchers from the Exchange evaluated data from more than 16,000 patients ages two to 95. Data were collected twice: between September 2010 to August 2012 and again, from September 2013 to December 2014. A key area of study was glycemic control across the age spectrum, determined by examining Hemoglobin A1c (HbA1c) levels, a standard test of average blood sugar levels over two to three months. According to the American Diabetes Association, the recommended target A1c level is less than 7 percent for adults with type 1 diabetes and less than 7.5 percent for youth under the age of 19. Researchers found that while 8.4 percent remains the average A1c level across the Registry, A1c levels are notably worse among 13 to 25-year olds. In fact, A1c levels for 13 to 17-year olds have barely changed since the initial Diabetes Control and Complications Trial (DCCT) results published in 1992. Specifically: Adolescents in the Registry averaged a 9.0 percent A1c Continue reading >>

The A1c – Cholesterol Connection In Children With Type 1 Diabetes: One Size Doesn’t Fit All

The A1c – Cholesterol Connection In Children With Type 1 Diabetes: One Size Doesn’t Fit All

This concern was the trigger for a new study led by Michelle Katz, M.D., M.P.H., a Pediatric Endocrinologist at Joslin Diabetes Center. Published in the American Diabetes Association journal Diabetes Care (October, 2016), it stemmed from the concern that more children with type 1 diabetes are at risk for dyslipidemia, putting them at greater risk for cardiovascular disease in adulthood. After collecting medical records from children and teens with type 1 diabetes Dr. Katz and her team examined the relationship between A1c and lipid levels as well as between body mass index (BMI, a measure of weight status) and lipids (LDL cholesterol, the so-called bad cholesterol; HDL cholesterol, the so-called good cholesterol; and non-HDL cholesterol). The investigation involved 572 youth with type 1 diabetes who had their A1c, BMI and lipid levels measured between the ages of six and 18 and rechecked again over a 10-year period on average. “What we saw was that changes in A1c do have a significant impact on changes in LDL and non-HDL cholesterol,” says Dr. Katz. “And those changes are more substantial as youth age into their young adult years.” The study showed that every 1 percent increase in A1c was associated with approximately a 2 to 6 mg/dl point increase in harmful LDLs, with a greater increase in LDLs as study participants progressed from pre-adolescence to young adulthood. Additionally, one standard deviation in BMI was associated with an LDL increase of about 2 mg/dl when study participants were 10 years old, and increased to about 8 mg/dl when study participants were 19 years old. The association between changes in A1c and BMI with changes in non-HDL as children and teens entered adulthood were similar to the associations found with LDL. “Addressing elevations in Continue reading >>

Understanding Your A1c

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 >>

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 >>

Type 1 Diabetes Stroke Risk And What A1c Levels To Aim For

Type 1 Diabetes Stroke Risk And What A1c Levels To Aim For

A study finds that those with type 1 diabetes have a higher risk for ischemic and hemorrhagic stroke, particularly in those with poor blood sugar management. Researchers in Sweden set out to estimate the elevated risk of stroke in relation to blood sugar management in patients with type 1 diabetes. The prospective, matched cohort study identified 33,453 patients with type 1 diabetes age 18 or older who were registered in the Swedish National Diabetes Register from 1998-2011 plus five control subjects per case from the general population which were matched for age, gender, and county of residence. Risk for any kind of stroke including ischemic and hemorrhagic stroke were estimated by Cox hazard regression. Does Poor Diabetes Management Increase Risk of Stroke in Type 1 Patients? Of the 33,453 patients with type 1 diabetes (mean age 35 and mean duration of diabetes 20 years), 762 were diagnosed with stroke compared with 1122 of 159,924 control subjects.The risk for ischemic and hemorrhagic stroke rose with A1c levels. Risk for ischemic stroke increased significantly with A1c levels at or above 6.9% (≤52 mmol mol-1). Risk for both ischemic and hemorrhagic stroke also increased significantly in A1c levels at or above 9.7% (≥83 mmol mol-1).Researchers in their study abstract concluded that the risk for ischemic and hemorrhagic stroke rose alongside poorer blood sugar management. How Low Should A1c Levels Be in Patients with Type 1 Diabetes? While it varies depending on personal circumstances, the American Diabetes Association recommends that A1c levels in people with type 1 diabetes be below 7%. The Association’s magazine Diabetes Forecast states in an article that a higher or lower goal may be best for the individual. “For example, an older adult with a limited life Continue reading >>

Your A1c Results: What Do They Mean?

Your A1c Results: What Do They Mean?

If you have diabetes, you should have an A1C test at least twice each year to find out your long-term blood glucose control. The A1C test measures your average blood glucose during the previous 2-3 months, but especially during the previous month. For people without diabetes, the normal A1C range is 4-6%. For people with diabetes, the lower the A1C value, the better the diabetes control and the lower the risk of developing complications such as eye, heart, and kidney disease. Your goal should be to have A1C values less than 7%. That may be a hard target to hit, but it is important to try because the lower your A1C, the lower your health risk. The table on this page shows what your A1C results say about your blood glucose control during the past few months. Some people are surprised when they have a high A1C result because when they check their blood glucose with their meter, they have relatively low numbers. But remember that checking your blood glucose gives you only a momentary sample of your blood glucose control. The A1C test measures your blood glucose control at all times during the previous 2-3 months, even times such as after meals or when you are asleep, when you don't usually check your blood glucose. Think of the A1C test as feedback to help you better control your diabetes and improve your diabetes care habits. By giving you important information about your long-term control, the A1C test can help you stay motivated to do your best on diabetes self care. Talk with your doctor and other members of the health care team about your A1C results and how you can use them to better manage diabetes. Within the next few months, the federal government will implement the first major reorganization of the Medicare system for many years: the Medicare Prescription Drug Imp Continue reading >>

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