Hemoglobin A1c Blood Test Isn't Perfect
The hemoglobin A1C is a great blood test for type 2 diabetics, but not for diagnosing diabetes. Don't misunderstand. I love the hemoglobin A1C blood test. It doesn't require fasting. It can be done in the doctor's office with a fingerstick just like your glucose monitor, and you can know the results before you leave the office. And it lets you know how your blood sugar has been doing over the past two or three months. It sounds perfect. But it isn't. For diabetes management you and I need to know what our blood sugar is doing all the time, not just every three months. A great HGA1C reading does not mean there have been no hyperglycemic or hypoglycemic episodes over that time. So the hemoglobin A1C cannot replace daily checks with a glucose monitor and log book records. Taken together with daily readings, the hemoglobin A1C gives an accurate picture of whether you are keeping your blood sugar in the ranges that will keep away the complications. There is more and more evidence that an HGA1C between 6.5 and 7 will do just that. And here's an encouraging fact. If your A1C was 9 and you lower it to 8, there is a 20% reduction in risk of complications even though you aren't in the target range yet. That's good to know. You should also know that the American Diabetic Association says to get the test done every three months if your are diabetic. Here's how it works. Hemoglobin is the medical term for red blood cells, and glycated hemoglobin is the term for red blood cells with sugar stuck to them. Over the life of a red blood cell, which is 120 days if all goes well, more and more sugar sticks to it as it travels through your bloodstream. The amount can be measured accurately, and doctors know how much should be on each normal cell. If the level is high, that signals diabetes. Continue reading >>
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 >>
One-third Of Slim American Adults Have Pre-diabetes
Among normal-weight individuals, those who were inactive were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic Among all the normal-weight inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent Inactivity increases your risk of pre-diabetes even if you’re not overweight or obese By Dr. Mercola It's often assumed that in order to develop type 2 diabetes, you have to be overweight. While it's true that excess weight is clearly associated with insulin resistance and diabetes, it's the insulin resistance — not necessarily the weight gain — that drives the disease. As such, many people with a healthy weight are not metabolically healthy, putting them at risk of diseases like type 2 diabetes — even without being overweight or obese. One of the greatest risk factors, according to University of Florida researchers, is actually inactivity, which drives up your risk of pre-diabetes regardless of your weight. Inactivity Is Associated With Pre-Diabetes, Even if You're a Healthy Weight If you were looking for motivation to get moving, this study, published in the American Journal of Preventive Medicine, is as good as it gets.1 In a survey of more than 1,100 healthy-weight individuals, those who were inactive (physically active for less than 30 minutes per week) were more likely to have an A1C level of 5.7 or higher, which is considered to be pre-diabetic. Among all the inactive participants (aged 20 and over), about one-quarter were either pre-diabetic or diabetic. When only those inactive people aged 40 and over were analyzed, the percentage rose to 40 percent. The researchers suggested that peop Continue reading >>
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 >>
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 >>
A1c 14.1 To 5.9 In 4 Months
I was Diagnosed Type 2 on 26 Feb. 2009. My fasting blood sugar was 366, A1C was 14.1, cholesterol was 300. Blood Pressure 145/95. The doctors put me on 500mg Metformin twice a day, 10mg Lisinopril, 40mg Simvastatin and 81mg Aspirin once a day. On March 1st I purchased a meter and started testing before and two hours after each meal. I now test approximately 1 hour after each meal and stopped eating foods that spike my blood sugar more than 30-40 points. I stopped eating sugar, using salt, drinking coffee, soda, beer and wine right away. I started eating salads, broccoli, cauliflower, cucumbers, pickles, sauerkraut and homemade coleslaw. Lots of coleslaw. I also started to drink at least 8 cups of water per day. I drink 2 cups after the protein drink, 2 ½ cups while driving to work, 2 ½ cups at lunch, 2 ½ cups on the way home, will drink 2 cups after supper and will sometimes drink 2 cups before going to bed. Over the next several weeks I stopped eating bread, crackers, noodles and anything that contained any kind of grains. No flour at all. I check the labels on everything I buy and will not purchase any product with more than 5 or 6 net carbs per serving with the exception of chana dal. When I wake up in the morning I test my blood sugar and drink a low carb protein powder drink mix. I used to use homemade soymilk to mix with the protein powder. I now use homemade almond or walnut milk. The nut milks are a lot easier to make. I only stopped using soymilk because of the time it takes to make it. Nut milks can be made a lot quicker and you don’t need to boil a lot of water. Just soak ½ cup of nuts in a bowl of water for several hours. Drain, rinse, and blend with 3 ½ -4 cups of water in a blender. Strain and drink. Makes about a quart. Last for 3-5 days. I eat abo Continue reading >>
Understanding The New Hba1c Units For The Diagnosis Of Type 2 Diabetes
In the absence of overt symptoms of hyperglycaemia, the diagnosis of diabetes has been based on plasma glucose concentrations that are associated with an increased risk of its specific microvascular complications, in particular retinopathy.1,2 The precise criteria have always been determined by consensus among experts and are based principally on several large observational cohort studies. The criteria have been repeatedly modified over time as more high quality data have become available. Most recently many international diabetes societies have adopted the measurement of glycated haemoglobin (HbA1c) as a legitimate diagnostic test for the diagnosis of diabetes using a “cut point” for the diagnosis of ≥6.5%.3–5 Recently there has been a change in the reporting units for HbA1c from percent to mmol/mol that has been driven by the International Federation of Clinical Chemistry (IFCC) and is linked to the standardisation of routine assays for HbA1c to a new reference method.6 The validity of the process has been accepted by many international diabetes societies (American Diabetes Association, Canadian Diabetes Society, European Association for the Study of Diabetes and International Diabetes Federation) as well as by the New Zealand Society for the Study of Diabetes (NZSSD).7 A NZSSD Working Party, made up of members representing clinicians, academics, laboratory staff, general practitioners and population health experts, has developed and now published a new position statement for the diagnosis of diabetes.7 This article explains the changes in use of HbA1c recommended in that statement and expands on the evidence behind these modifications. New units All methods used to measure HbA1c in New Zealand are now standardised through traceability to the IFCC reference me Continue reading >>
Five Things You Should Know About Prediabetes
After announcing the expansion of Diabetes Stops Here and asking you which topics you’d like covered, we received a specific request for more information about prediabetes. A staggering 79 million Americans deal with this condition, and while it can lead to crippling health consequences, it can be avoided. Here are five things you should know about prediabetes: 1. What is prediabetes? Before people develop type 2 diabetes, they almost always have prediabetes, a health condition where your blood glucose is higher than normal but not as high as if you had diabetes. 2. How can I find out if I have it? Your doctor can give you a blood test to tell if you have prediabetes (the same test that’s used to test for diabetes). At your next doctor visit, ask if you should be tested for prediabetes. 3. What can I do if I have prediabetes? If you have prediabetes, there are important steps you can, and should, take. Early intervention can turn back the clock and return elevated blood glucose levels to the normal range. Losing weight is an important step for most people with prediabetes, and the amount doesn’t have to be huge to make a difference. A weight loss of just 10 to 15 pounds can really stack the odds in your favor. Coupled with 30 minutes of exercise each day and healthy food choices, you’ll be on your way. Talk with your doctor and visit our website to learn more about other ways you can prevent or reverse the condition. 4. Does this mean I’m going to develop type 2 diabetes? Prediabetes can lead to type 2 diabetes…but it doesn’t have to. Scientific studies show taking the above steps can often halt or at least slow down the progression of prediabetes so it doesn’t take a turn for the worse. 5. Where can I find help? You are not alone. It’s never too late Continue reading >>
Racial And Ethnic Differences In Mean Plasma Glucose, Hemoglobin A1c, And 1,5-anhydroglucitol In Over 2000 Patients With Type 2 Diabetes
Racial and Ethnic Differences in Mean Plasma Glucose, Hemoglobin A1c, and 1,5-Anhydroglucitol in Over 2000 Patients with Type 2 Diabetes Internal Medicine and Epidemiology (W.H.H.), University of Michigan, Ann Arbor, Michigan 48109 Address all correspondence and requests for reprints to: William H. Herman, M.D., M.P.H., University of Michigan Health System, 1500 E. Medical Center Drive, 3920 Taubman Center, SPC 5354, Ann Arbor, Michigan 48109. Search for other works by this author on: Ohio State University (K.M.D.), Columbus, Ohio 43210 Search for other works by this author on: Department of Endocrinology and Metabolism (B.H.R.W.), University Medical Center Groningen, and University of Groningen, 9700 RB Groningen, The Netherlands Search for other works by this author on: Division of Endocrinology (J.B.B.), University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599 Search for other works by this author on: U.S. Medical Division (J.L.F., H.J., S.M.), Lilly USA, LLC, Indianapolis, Indiana 46285 Search for other works by this author on: U.S. Medical Division (J.L.F., H.J., S.M.), Lilly USA, LLC, Indianapolis, Indiana 46285 Search for other works by this author on: U.S. Medical Division (J.L.F., H.J., S.M.), Lilly USA, LLC, Indianapolis, Indiana 46285 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 94, Issue 5, 1 May 2009, Pages 16891694, William H. Herman, Kathleen M. Dungan, Bruce H. R. Wolffenbuttel, John B. Buse, Jessie L. Fahrbach, Honghua Jiang, Sherry Martin; Racial and Ethnic Differences in Mean Plasma Glucose, Hemoglobin A1c, and 1,5-Anhydroglucitol in Over 2000 Patients with Type 2 Diabetes, The Journal of Clinical Endocrinology & Metabolism, Volume 94, Issue 5, 1 May 2009, Pages 1689169 Continue reading >>
- Major Study Confirms Racial Disparities Related to Key Diabetes Indicator, Hemoglobin A1c
- Understudied racial minority groups show alarmingly high rates of obesity and diabetes
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
What’s Normal Blood Sugar?
Thank you for dropping in! If you need help lowering your blood sugar level, check out my books at Amazon or Smashwords. If you’re outside of the U.S., Smashwords may be the best source. —Steve Parker, M.D * * * Physicians focus so much on disease that we sometimes lose sight of what’s healthy and normal. For instance, the American Diabetes Association defines “tight” control of diabetes to include sugar levels as high as 179 mg/dl (9.9 mmol/l) when measured two hours after a meal. In contrast, young adults without diabetes two hours after a meal are usually in the range of 90 to 110 mg/dl (5.0–6.1 mmol/l). What Is a Normal Blood Sugar Level? The following numbers refer to average blood sugar (glucose) levels in venous plasma, as measured in a lab. Portable home glucose meters measure sugar in capillary whole blood. Many, but not all, meters in 2011 are calibrated to compare directly to venous plasma levels. Fasting blood sugar after a night of sleep and before breakfast: 85 mg/dl (4.7 mmol/l) One hour after a meal: 110 mg/dl (6.1 mmol/l) Two hours after a meal: 95 mg/dl (5.3 mmol/l) Five hours after a meal: 85 mg/dl (4.7 mmol/l) (The aforementioned meal derives 50–55% of its energy from carbohydrate) ♦ ♦ ♦ Ranges of blood sugar for young healthy non-diabetic adults: Fasting blood sugar: 70–90 mg/dl (3.9–5.0 mmol/l) One hour after a typical meal: 90–125 mg/dl (5.00–6.9 mmol/l) Two hours after a typical meal: 90–110 mg/dl (5.00–6.1 mmol/l) Five hours after a typical meal: 70–90 mg/dl (3.9–5.00 mmol/l) Blood sugars tend to be a bit lower in pregnant women. ♦ ♦ ♦ What Level of Blood Sugar Defines Diabetes and Prediabetes? According to the 2007 guidelines issued by the American Association of Clinical Endocrinologists: Prediabetes: Continue reading >>
Da - The Effects Of Uncontrolled Diabetes And More.
Diabetes In America The number of Americans with diabetes continues to increase, according to CDC's most recent National Diabetes Fact Sheet. So does the number of Americans with prediabetes, a condition that increases their risk of type 2 diabetes, heart disease, stroke, kidney disease, foot complications or Neuropathy, eye complications, skin complications, depression and gingivitis disease or tooth and bone loss. States with the largest increases over the 16-year period were Oklahoma, up 226 percent; Kentucky, up 158 percent; Georgia, up 145 percent; Alabama, up 140 percent, Washington, up 135 percent, and West Virginia, up 131 percent, according to the study published in CDC's Morbidity and Mortality Weekly Report. Beta cells, which are found in the pancreas within tiny cell clusters called islets, are the body’s sole source of the essential hormone insulin. Diabetes is characterized by the bodies in ability to produce and/ or respond appropriately to insulin, and results in the inability of the body to absorb and use glucose as a cellular fuel. These defects result in a persistent elevation of blood glucose levels and other metabolic abnormalities, which, in turn, lead to the development of disease complications. The most common forms of diabetes are Type I diabetes, in which the immune system launches a misguided attack, destroying the beta cells of the pancreas, and Type 2 diabetes, in which the body becomes resistant to insulin signaling, with subsequent impaired insulin production. While the causes of beta cell loss or failure differ, all major forms of diabetes share a common bond in the pancreatic beta cell. This is particularly important in light of studies that show that adverse changes in both the micro- and macro vascular environments can occur up to 10 Continue reading >>
Normal Fasting Glucose With High Hba1c
Jonathan's fasting glucose: 85 mg/dl Jonathan's high HbA1c reflects blood glucose fluctuations over the preceding 60-90 days and can be used to calculate an estimated average glucose (eAG) with the following equation: (For glucose in mmol/L, the equation is eAG = 1.59 × A1C - 2.59) Jonathan's HbA1c therefore equates to an eAG of 145.59 mg/dl--yet his fasting glucose value is 85 mg/dl. This is a common situation: Normal fasting glucose, high HbA1c. It comes from high postprandial glucose values, high values after meals. It suggests that, despite having normal glucose while fasting, Jonathan experiences high postprandial glucose values after many or most of his meals. After a breakfast of oatmeal, for instance, he likely has a blood glucose of 150 mg/dl or greater. After breakfast cereal, blood glucose likely exceeds 180 mg/dl. With two slices of whole wheat bread, glucose likewise likely runs 150-180 mg/dl. The best measure of all is a postprandial glucose one hour after the completion of a meal, a measure you can easily obtain yourself with a home glucose meter. Second best: fasting glucose with HbA1c. Gain control over this phenomenon and you 1) reduce fasting blood sugar, 2) reduce expression of small LDL particles, and 3) lose weight. Continue reading >>
- Diabetic by HbA1c, Normal by OGTT: A Frequent Finding in the Mexico City Diabetes Study
- Fasting blood sugar: Normal levels and testing
- 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
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 >>
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 Is The A1c Test?
The A1C (“A-one-C”) is a blood test that checks your average blood sugar over the past 3 months. This average is different from your day to day blood sugar. There are 3 reasons to check your A1C: · To diagnose prediabetes · To diagnose diabetes · To see how well you are controlling your blood sugar Sugar absorbed from your food goes into the bloodstream. The sugar sticks to the hemoglobin protein in red blood cells, forming hemoglobin A1C. The A1C stays in the blood for the life of the red blood cell, which is 90 to 120 days. This means that the amount of A1C in your blood reflects how high your blood sugar has been over the past 3 months. Another name for this test is hemoglobin A1C test. It is different from a regular blood sugar or blood glucose test. WHY IS THIS TEST DONE? A1C is an excellent way to check how well you are controlling your blood sugar over a 3-month period. A1C tests are important because: · They can check the accuracy of the blood sugar results you get at home. · They help predict your risk of diabetic complications. The higher the A1C percentage, the greater your risk of serious problems from diabetes, like eye, kidney, blood vessel, or nerve damage. If your A1C is high, your diabetes plan will need to be changed. HOW DO I PREPARE FOR THIS TEST? You don’t need to do anything to prepare for this test. One of the advantages of this test is that you do not have to fast before you take it. HOW IS THE TEST DONE? A small amount of blood is taken from a vein in your arm with a needle. The blood is collected in tubes and sent to a lab. Having this test will take just a few minutes of your time. At some pharmacies you may be able to buy a device that allows you to test A1C at home. You may find that the results of the home test are not the same a Continue reading >>
