Type 1 Diabetes High A1c

The A1c Test & Diabetes

What is the A1C test? The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, or glycohemoglobin test. The A1C test is the primary test used for diabetes management and diabetes research. How does the A1C test work? The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent. Can the A1C test be used to diagnose type 2 diabetes and prediabetes? Yes. In 2009, an international expert committee recommended the A1C test as one of the tests available to help diagnose type 2 diabetes and prediabetes.1 Previously, only the traditional blood glucose tests were used to diagnose diabetes and prediabetes. Because the A1C test does not require fasting and blood can be drawn for the test at any time of day, experts are hoping its convenience will allow more people to get tested—thus, decreasing the number of people with undiagnosed diabetes. However, some medical organizations continue to recommend using blood glucose tests for diagnosis. Why should a person be tested for diabetes? Testing is especially important because early in the disease diabetes has no symptoms. Although no test is perfect, the A1C and blood glucose tests are the best tools available to diagnose diabetes—a serious and li Continue reading >>

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 >>

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 >>

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 >>

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 >>

Type 1 Diabetes

Print Diagnosis Diagnostic tests include: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It 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. An A1C level of 6.5 percent or higher on two separate tests indicates diabetes. If the A1C test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as pregnancy or an uncommon form of hemoglobin (hemoglobin variant) — your doctor may use these tests: Random blood sugar test. A blood sample will be taken at a random time and may be confirmed by repeat testing. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. If you're diagnosed with diabetes, your doctor may also run blood tests to check for autoantibodies that are common in type 1 diabetes. These tests help your doctor distinguish between type 1 and type 2 diabetes when the diagnosis is uncertain. The presence of ketones — byproducts from the breakdown of fat — in your urine also suggests type 1 diab Continue reading >>

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 >>

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 >>

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 >>

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 >>

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 >>

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 >>

My Son’s A1c Was 6.1, But The Doctor Said He Had Highs And Lows And That Wasn’t Good. Isn’t A1c The Important Thing?

Q: My son is type 1 and 23 years old. His A1c was 6.1, but the doctor said he had highs and lows and that wasn't good. I thought your A1c was important? You are right in thinking that your son’s A1c is important, but it is not the whole story. A good way to think of an A1c reading is a three-month average of blood sugar levels. If your average blood sugar level is 120-130mg/dl (which is what an A1c of 6.1 usually represents), that's a good thing. However, if your blood sugar fluctuates from 40mg/dL (which is dangerously low) to 500mg/dL (which is dangerously high) and those extreme highs and lows average out to a blood sugar level of 125mg/dl, that's not a good thing. Basically, big swings in blood sugar levels means that they are not well controlled. The good thing is that your son is checking his blood sugar levels, and that can be helpful in developing a plan to get your son's blood sugar under control. One other thing your son may want to consider is to have his doctor or another member of his diabetes care team evaluate his blood sugar monitoring technique to make sure the fluctuations are not due to a problem with the testing procedure. Or if your son uses a continuous blood glucose monitor (CGM), he may want to check with his trainer (or whoever helps him manage his CGM) to make sure there is no problem with it. Originally answered by Kirk Spero, RPh 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 medical advice, diagnosis o Continue reading >>

How To Lower Your A1c Levels: A Healthful Guide

An A1C blood test measures average blood sugar levels over the past 2 to 3 months. The American Diabetes Association (ADA) recommend the use of A1C tests to help diagnose cases of prediabetes, type 1, and type 2 diabetes. A1C tests are also used to monitor diabetes treatment plans. What is an A1C test? An A1C test measures how well the body is maintaining blood glucose levels. To do this, an A1C test averages the percentage of sugar-bound hemoglobin in a blood sample. When glucose enters the blood, it binds to a red blood cell protein called hemoglobin. The higher blood glucose levels are, the more hemoglobin is bound. Red blood cells live for around 4 months, so A1C results reflect long-term blood glucose levels. A1C tests are done using blood obtained by a finger prick or blood draw. Physicians will usually repeat A1C tests before diagnosing diabetes. Initial A1C tests help physicians work out an individual's baseline A1C level for later comparison. How often A1C tests are required after diagnosis varies depending on the type of diabetes and management factors. Lowering A1C levels Many studies have shown that lowering A1C levels can help reduce the risk or intensity of diabetes complications. With type 1 diabetes, more controlled blood glucose levels are associated with reduced rates of disease progression. With type 2 diabetes, more controlled A1C levels have also been shown to reduce symptoms affecting the small arteries and nerves in the body. This influences eyesight and pain while decreasing complications. Long-term studies have also shown that early and intensive blood glucose control can reduce cardiovascular complications in people with type 1 or 2 diabetes. Even small changes in A1C levels can have big effects. The ADA recommend that maintaining fair control Continue reading >>

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 >>