Ask The Doctor: What's The Difference Between Blood Sugar And Hemoglobin A1c?
Ask the doctor Q. In your article on blood sugar control, you kept talking about hemoglobin A1c. I measure my blood sugar all the time, but my meter doesn't have a setting for a percentage reading. Is there a simple connection between blood sugar and hemoglobin A1c? A. I'm sorry we confused you. Blood sugar and hemoglobin A1c are connected, but they are different, too. Your blood sugar meter measures the concentration of glucose in the bloodstream at the instant you prick your finger. The reading is in milligrams of glucose per deciliter (a tenth of a liter) of blood, abbreviated as mg/dL. Blood sugar levels vary throughout the day. In people with diabetes, they can range from below 70 mg/dL to above 200. Continue reading >>
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- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- Hemoglobin A1c (HbA1c) Test for Diabetes
A1c Versus Glucose Testing: A Comparison
Go to: FPG Measurement of glucose in plasma of fasting subjects is widely accepted as a diagnostic criterion for diabetes (1,2). Advantages include inexpensive assays on automated instruments that are available in most laboratories worldwide (Table 1). Nevertheless, FPG is subject to some limitations. One report that analyzed repeated measurements from 685 fasting participants without diagnosed diabetes from the Third National Health and Nutrition Examination Survey (NHANES III) revealed that only 70.4% of people with FPG ≥126 mg/dL on the first test had FPG ≥126 mg/dL when analysis was repeated ∼2 weeks later (6). Numerous factors may contribute to this lack of reproducibility. These are elaborated below. Biological variation Fasting glucose concentrations vary considerably both in a single person from day to day and also between different subjects. Intraindividual variation in a healthy person is reported to be 5.7–8.3%, whereas interindividual variation of up to 12.5% has been observed (6,7). Based on a CV (coefficient of variation) of 5.7%, FPG can range from 112–140 mg/dL in an individual with an FPG of 126 mg/dL. (It is important to realize that these values encompass the 95% confidence interval, and 5% of values will be outside this range.) Preanalytical variation Numerous factors that occur before a sample is measured can influence results of blood tests. Examples include medications, venous stasis, posture, and sample handling. The concentration of glucose in the blood can be altered by food ingestion, prolonged fasting, or exercise (8). It is also important that measurements are performed in subjects in the absence of intercurrent illness, which frequently produces transient hyperglycemia (9). Similarly, acute stress (e.g., not being able to find par Continue reading >>
A Simple Blood Test Can Reveal Your Risk For Disease
It is well known that having diabetes increases the risk for several chronic degenerative diseases, such as heart disease, Alzheimer’s and cancer. A new study published in the British Journal of Cancer in March 2014, indicates that chronic hyperglycemia (increased blood sugar) correlates with the increased risk for cancer – and goes further to indicate that this risk is present, for those in the pre-diabetic state as well as for those people with “normal ranges” – for certain types of cancer. How Do We Track Blood Sugar? A simple blood test that is routinely given is fasting glucose. The result should be in the mid 90′s or below. This is a good test, but it only shows your blood sugar at that particular moment in time. Blood sugar rises and falls in response to what you eat, how often you eat and how you metabolize sugar and carbohydrates. If your blood sugar is running on the high side, this test will not necessarily show it. Luckily, there is a good, reliable blood test that shows your average blood sugar levels for the preceding 3 months. That test is Hemaglobin A1c and it is used to monitor the blood sugar of people with diabetes. If you have a doctor who is on the ball, they will also test you for it routinely – even if you do not have diabetes – at your yearly physical. It is currently considered normal in the range of 5.6 – 5.8. This study showed that even in these “normal” ranges, there was an increased risk for certain cancers (except prostate cancer) and, importantly, that risk is increased even in the “normal” ranges for several cancers. The researchers concluded that, These results merit urgent (my emphasis) investigation into the risks and advantages of updating recommendations for stricter glycaemic control in diabetic and non-dia Continue reading >>
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Diabetes And Anemia:
There are lots of articles about diabetes, as well as all kinds of information about anemia. But what if you have both? About 25 percent of people with diabetes have some level of anemia. This article explains how the two conditions interact. What Is Anemia, and Why Is It Linked to Diabetes? In anemia, there are fewer red blood cells than normal, resulting in less oxygen being carried to the body’s cells. People with anemia often feel tired or weak and may have difficulty getting through activities of daily living. Other symptoms include paleness, poor appetite, dizziness, lightheadedness, rapid heartbeat, and shortness of breath. Because these symptoms can also be associated with diabetes, they are sometimes not recognized as evidence of anemia. Anemia may occur with diabetes because the hormone that regulates red blood cell production, erythropoietin (EPO), is produced by the kidneys. Kidney damage at several levels is a complication of diabetes, and one problem often leads to the other. Changes in the kidneys that occur with diabetes range from diabetic nephropathy all the way to chronic kidney disease. Early detection and treatment is essential to prevent or delay disease progression. Information in greater detail can be found at www.kidney.niddk.nih.gov. Other causes of anemia are low levels of iron or other vitamins, as well as prolonged illness. Diagnosing Anemia A simple blood test done during a doctor visit, called a complete blood count or CBC, is used to check for anemia. The two elements of the test that reveal anemia are hemoglobin and hematocrit. Hemoglobin is the part of red blood cells that carries oxygen to the cells. Hematocrit indicates the percentage of red blood cells in the blood. How Does Anemia Affect Your Diabetes Care? If you have anemia, you Continue reading >>
Tests For Blood Sugar (glucose) And Hba1c
Blood sugar (glucose) measurements are used to diagnose diabetes. They are also used to monitor glucose control for those people who are already known to have diabetes. Play VideoPlayMute0:00/0:00Loaded: 0%Progress: 0%Stream TypeLIVE0:00Playback Rate1xChapters Chapters Descriptions descriptions off, selected Subtitles undefined settings, opens undefined settings dialog captions and subtitles off, selected Audio TrackFullscreen This is a modal window. Beginning of dialog window. Escape will cancel and close the window. TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal Dialog End of dialog window. If your glucose level remains high then you have diabetes. If the level goes too low then it is called hypoglycaemia. The main tests for measuring the amount of glucose in the blood are: Random blood glucose level. Fasting blood glucose level. The HbA1c blood test. Oral glucose tolerance test. Capillary blood glucose (home monitoring). Urine test for blood sugar (glucose). Blood tests for blood sugar (glucose) Random blood glucose level A sample of blood taken at any time can be a useful test if diabetes is suspected. A level of 11.1 mmol/L or more in the blood sample indicates that you have diabetes. A fasting blood glucose test may be done to confirm the diagnosis. Fasting blood glucose level Continue reading >>
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How To Lower Your A1c For Diabetes Control
Do you know what the AIC test measures? Learn about this blood test and get tips to help lower A1C and manage diabetes over time. The A1C test is an essential part of living well with type 2 diabetes: This simple blood test to measure hemoglobin A1C, or HbA1C, provides information about your blood sugar control over the previous few months. The results are like a grade for how well you've been managing diabetes. By making the most of your daily efforts, you can lower your A1C results and take pride in all of your hard work. A1C 101 Unlike blood glucose monitoring, which you do at home yourself at frequent intervals, A1C levels are measured periodically by your doctor or a nurse in a medical office. During this test, a health care worker will use a needle to draw a blood sample from a vein in your arm, or by pricking the tip of your finger with a small lancet. The sample is then sent to a medical laboratory for analysis. The A1C test lets your doctor know about your average level of blood sugar control for the past three months. It looks at the way glucose has attached to hemoglobin, a component of red blood cells. Red blood cells live for about three months, which is how the A1C test can provide this overview. The results of the test are given as a percentage. Normal A1C is below 5.7 percent, and the results of the test are accurate within 0.5 percent. In general, the goal of blood sugar control is a result below a 7 percent A1C because the risk for diabetes complications is lower below that point. But that number isn't realistic for everyone with diabetes, so your doctor might recommend a different target for you. Understanding Blood Sugar Control “I explain that a blood sugar test gives a snapshot, and A1C is the whole motion picture,” says Joyce Malaskovitz, RN, Continue reading >>
Diagnosis
While symptoms may be indicative of disease, definitive diagnosis requires one or more of the following blood tests: Plasma glucose levels: The American Diabetes Association reports that the fasting plasma glucose (FPG) for normal individuals should be <100 mg/dL. Here fasting is defined as no caloric intake for at least 8 hours (usually implying overnight fasting). Approximately 2 hours after a meal plasma glucose levels should be less than 140 mg/dL. The diagnosis of diabetes requires fasting glucose levels greater than 126 mg/dl on two occasions. Test Administration Risks Blood is drawn from the vein following overnight fasting (for fasting blood glucose levels) or at any random moment during the day (to measure random glucose levels). There may be some bruising, infection, and soreness at the site of puncture for drawing blood. The subject may also feel some dizziness. Oral Glucose Tolerance Test (OGTT) is an elaboration of the blood glucose test that reveals how the body metabolizes glucose ~2 hours after ingesting glucose. For pregnant mothers with high risk of diabetes, a glucose-screening test (OGTT) is usually performed between 24-28 weeks of pregnancy (or earlier) to identify gestational diabetes and manage the blood glucose levels for the health of mother and baby. Test Administration Risks After blood is drawn, the subject is asked to drink a liquid, which contains 50, 75, or 100 grams of glucose. Normally the absorption of glucose in the body occurs rapidly, and blood glucose levels rise within 30 to 60 minutes of fluid intake. Blood work is done an hour after drinking the solution. If the blood test shows abnormal blood glucose levels, then blood work must be repeated after three hours. The blood test may cause side effects such as moderate pain, nausea, a 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 >>
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5 Important Tests For Type 2 Diabetes
It takes more than just one abnormal blood test to diagnose diabetes.Istockphoto For centuries, diabetes testing mostly consisted of a physician dipping his pinkie into a urine sample and tasting it to pick up on abnormally high sugar. Thankfully, testing for type 2 diabetes is lot easier now—at least for doctors. Urine tests can still pick up diabetes. However, sugar levels need to be quite high (and diabetes more advanced) to be detected on a urine test, so this is not the test of choice for type 2 diabetes. Blood tests Almost all diabetes tests are now conducted on blood samples, which are collected in a visit to your physician or obstetrician (if you're pregnant). More about type 2 diabetes If you have an abnormal resultmeaning blood sugar is too high—on any of these tests, you'll need to have more testing. Many things can affect blood sugar (such as certain medications, illness, or stress). A diabetes diagnosis requires more than just one abnormal blood sugar result. The main types of diabetes blood tests include: Oral glucose-tolerance test. This test is most commonly performed during pregnancy. You typically have your blood drawn once, then drink a syrupy glucose solution and have your blood drawn at 30 to 60 minute intervals for up to three hours to see how your body is handling the glut of sugar. Normal result: Depends on how many grams of glucose are in the solution, which can vary. Fasting blood sugar. This is a common test because it's easy to perform. After fasting overnight, you have your blood drawn at an early morning doctor's visit and tested to see if your blood sugar is in the normal range. Normal result: 70-99 milligrams per deciliter (mg/dl) or less than 5.5 mmol/L Two-hour postprandial test. This blood test is done two hours after you have eate Continue reading >>
3 Diabetes Tests You Must Have
Mike Ellis was fly fishing when he first noticed a change in his vision. Ellis, an avid angler, had so much trouble focusing he struggled for 20 minutes before he was finally able to get a fly on his hook, something he'd done countless times over many years of fly fishing. Then, after casting his line, he was unable to see his lure on the water. "I thought I'd scorched my eyeballs from being out in the sun too much," says Ellis, 63, a retired mechanical engineer in Denver. An eye exam the following month revealed an equally unsettling reality: Ellis had type 2 diabetes, the most common type of the disease. Years of going undiagnosed had taken a toll on his eyesight. He had diabetic retinopathy. The blood vessels in the back of his eye were damaged, a problem that often comes with the condition. "Diabetes damages every blood vessel in your body, including the ones in your eyes," says Robert Rizza, MD, professor of medicine at the Mayo Clinic. "Similar damage can also occur in your heart, your head, and your kidneys. But if you take care of yourself -- if you control your blood sugar, blood cholesterol, and blood pressure -- the chances of bad things happening to you are very low." Certainly, that's the case with Ellis. With the help of three basic tests, he has his diabetes in check. These tests can help you, too. A simple blood test, the A1c (your doctor may call it "glycosylated hemoglobin") is done on a sample of blood taken from a finger-stick or from a small vial of it drawn from your arm. Not to be confused with the daily at-home monitoring that allows some people with diabetes to measure their blood sugars in the moment, the A1c test paints a picture of your average blood sugar level for the past 3 months. If you can keep your hemoglobin A1c in the range of about Continue reading >>
Understanding Your Lab Test Results
Diabetes is a chronic condition that requires an enormous amount of self-care and that can affect many parts of the body. Because of this, people who have diabetes are generally advised to visit their doctors multiple times a year and also to see various specialists (such as endocrinologists, podiatrists, and eye doctors) periodically to screen for potential problems and treat any complications that arise. Along with blood pressure readings and inspection of the feet and eyes, there are a number of laboratory tests recommended by the American Diabetes Association. These tests are used to track blood glucose control, kidney function, cardiovascular health, and other areas of health. Although you certainly can’t and won’t be expected to analyze the lab report when your test results come back, knowing a little bit about what your report says can be a way for you to more fully understand and take charge of your health. If it isn’t already your doctor’s regular practice to give you copies of your lab reports, ask for a copy the next time you have lab tests done. Use the information in this article to learn more about what lab reports show, and discuss your results with your doctor to learn what your results mean with regards to your health. Lab reports All lab reports share certain standard features, regardless of the test(s) they show. A Federal law, the Clinical Laboratory Improvement Act, regulates all aspects of clinical laboratory testing. It states exactly what information must be included in your lab test report. Some of the standard features include the following: • Your name and a unique identification number, which may be either your birth date or a medical record number assigned to you by the lab. • The name and address of the lab that tested your bloo Continue reading >>
Low-carb Lab Testing – Part 2 – Fasting Insulin Test
This is the second installment in a series of articles exploring pertinent lab tests for people following low-carb diets, and how a slightly different perspective is needed when interpreting the results compared to results from people following high-carb diets. In the previous post in this series, we looked at three measurements related to blood glucose: fasting glucose, hemoglobin A1c, and fructosamine. We left off saying that while these are important to monitor regularly, they offer a limited view of a much larger metabolic control system. Blood glucose, hemoglobin A1c (HbA1c), and fructosamine indicate only what’s happening with blood glucose. They reveal nothing about insulin, which we will explore in this post. Knowing your numbers is an important step for anyone who wants to transform their health. Heads Up Health was designed to empower you to manage all of your health data, including your lab test results, in one secure location. You can learn more on our homepage or by clicking below to create your account and start building your own centralized health portfolio. The Fasting Insulin Test We said it last time, and it’s worth repeating: A fasting insulin test is the most important test your doctor probably isn’t ordering. The reason it’s so important to track insulin is that in many cases, fasting glucose and A1c remain normal due to chronically elevated insulin—that is, sky-high insulin is keeping the glucose “in check.” Fasting glucose and HbA1c are often the last things to rise, and they become elevated only after one of two things has happened: The pancreas can no longer pump out the inordinate amounts of insulin required to keep blood glucose within a safe range (sometimes called “beta cell burnout”). This is relatively rare, except in typ Continue reading >>
Lab Test Dictionary
The listings below discuss a few of the more common things measured in chemistry and hematology tests and their clinical significance. Profiles Test Clinical Significance Lytes Centrifuge specimen and refrigerate if pickup time is more than 2 hrs. Why get tested? To detect a problem with the body's electrolyte balance. When to get tested? As part of routine health screening, or when your doctor suspects that you have an excess or deficit of one of the electrolytes (usually sodium or potassium), or if your doctor suspects an acid-base imbalance. Basic Metabolic Panel (BMP) Centrifuge specimen and refrigerate if pickup time is more than 2 hrs. The Basic Metabolic Panel (BMP) is a group of 8 tests (or sometimes 7 tests) that is ordered as a screening tool to check for conditions, such as diabetes and kidney disease. The BMP uses a tube of blood collected by inserting a needle into a vein in your arm. Fasting for 10 to 12 hours prior to the blood draw may be preferred. The BMP is often ordered in the hospital emergency room setting because its components give your doctor important information about the current status of your kidneys, electrolyte and acid/base balance, and blood sugar level. Significant changes in these test results can indicate acute problems, such as kidney failure, insulin shock or diabetic coma, respiratory distress, or heart rhythm changes. The BMP is also used to monitor some known conditions, such as hypertension and hypokalemia (low potassium level). If your doctor is interested in following two or more individual BMP components, he may order the entire BMP because it offers more information. Alternatively, he may order an electrolyte panel to monitor your sodium, potassium, chloride, and CO2. If your doctor wants even more information, he may order Continue reading >>
Glycated Hemoglobin
Glycated hemoglobin (hemoglobin A1c, HbA1c, A1C, or Hb1c; sometimes also referred to as being Hb1c or HGBA1C) is a form of hemoglobin that is measured primarily to identify the three-month average plasma glucose concentration. The test is limited to a three-month average because the lifespan of a red blood cell is four months (120 days). However, since RBCs do not all undergo lysis at the same time, HbA1C is taken as a limited measure of 3 months. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. HbA1c is a measure of the beta-N-1-deoxy fructosyl component of hemoglobin.[1] The origin of the naming derives from Hemoglobin type A being separated on cation exchange chromatography. The first fraction to separate, probably considered to be pure Hemoglobin A, was designated HbA0, the following fractions were designated HbA1a, HbA1b, and HbA1c, respective of their order of elution. There have subsequently been many more sub fractions as separation techniques have improved.[2] Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous three months before the measurement as this is the lifespan of red blood cells. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, neuropathy, and retinopathy. A trial on a group of patients with Type 1 diabetes found that monitoring by caregivers of HbA1c led to changes in diabetes treatment and improvement of metabolic control compared to monitoring only of blood or urine glu Continue reading >>
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 >>
