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What Is Good A1c For Diabetics?

Why The A1c Test Is Important

Why The A1c Test Is Important

The A1c is a blood test, done in a lab, that shows what your average blood sugar has been for the past 3 months. Other names for this test are glycosylated hemoglobin, glycohemoglobin, hemoglobin A1c, and HbA1c. How the A1c Test Works The glucose that the body doesn't store or use for energy stays in the blood and attaches to red blood cells, which live in the bloodstream for about 4 months. The lab test measures the amount of glucose attached to the red blood cells. The amount is the A1c and is shown as a percentage. Your A1c number can give you and your health care team a good idea of how well you've controlled your blood sugar over the previous 2 to 3 months. When you get your A1c result from a Kaiser Permanente lab, you'll also see another number called the estimated Average Glucose, or eAG. Understanding the eAG Your estimated Average Glucose (eAG) number is calculated from the result of your A1c test. Like the A1c, the eAG shows what your average blood sugars have been over the previous 2 to 3 months. Instead of a percentage, the eAG is in the same units (mg/dl) as your blood glucose meter. The chart shows the relationship between the A1c percentage and the eAG. If A1c % is: Your eAG is: 6 126 6.5 140 7 154 7.5 169 8 183 8.5 197 9 212 9.5 226 10 240 10.5 255 11 269 11.5 283 12 298 What the Numbers Mean The A1c and eAG reflect your average blood sugar over a period of time. These numbers help you and your doctor see how well your treatment plan is working. The higher your A1c and eAG numbers are, the higher your chances for having long-term health problems caused by consistently high blood sugar levels. These problems include heart attacks, strokes, kidney failure, vision problems, and numbness in your legs or feet. The lower your A1c and eAG numbers, the lower you Continue reading >>

The Normal A1c Level

The Normal A1c Level

You want to control your diabetes as much as possible. You wouldn’t be reading this if you didn’t. So you regularly check your A1C level. This is the best measurement of our blood glucose control that we have now. It tells us what percentage of our hemoglobin – the protein in our red blood cells that carry oxygen – has glucose sticking to it. The less glucose that remains in our bloodstream rather than going to work in the cells that need it the better we feel now and the better our health will continue to be. Less glucose in the bloodstream over time leads to lower A1C values. As we are able to control our diabetes better and better, the reasonable goal is to bring our A1C levels down to normal – the A1C level that people who don’t have diabetes have. But before we can even set that goal, we have to know what the target is. The trouble with setting that target is that different experts tell us that quite different A1C levels are “normal.” They tell us that different levels are normal – but I have never heard of actual studies of normal A1C levels among people without diabetes – until now. The major laboratories that test our levels often say that the normal range is 4.0 to 6.0. They base that range on an old standard chemistry text, Tietz Fundamentals of Clinical Chemistry. The Diabetes Control and Complications Trial or DCCT, one of the two largest and most important studies of people with diabetes, said that 6.0 was a normal level. But the other key study, the United Kingdom Prospective Diabetes Study or UKPDS, which compared conventional and intensive therapy in more than 5,000 newly diagnosed people with type 2 diabetes, said that 6.2 is the normal level. Those levels, while unsubstantiated, are close. But then comes along one of my heroes, Dr. Continue reading >>

* What Is A Normal Blood Sugar?

* What Is A Normal Blood Sugar?

Normal blood sugars after a high carbohydrate breakfast eaten at 7:30 AM. The blue line is the average for the group. The brown lines show the range within which most readings fell (2 standard deviations). Bottom lines show Insulin and C-peptide levels at the same time. Click HERE if you don't see the graph. Graph is a screen shot from Dr. Christiansen's presentation cited below. The term "blood sugar" refers to the concentration of glucose, a simple, sugar, that is found in a set volume of blood. In the U.S. it is measured in milligrams per deciliter, abbreviated as mg/dl. In most of the rest of the world it is measured in millimoles per liter, abbreviated as mmol/L. The concentration of glucose in our blood changes continually throughout the day. It can even vary significantly from minute to minute. When you eat, it can rise dramatically. When you exercise it will often drop. The blood sugar measures that doctors are most interested in is the A1c, discussed below. When you are given a routine blood test doctors usually order a fasting glucose test. The most informative blood sugar reading is the post-meal blood sugar measured one and two hours after eating. Doctors rarely test this important blood sugar measurement as it is time consuming and hence expensive. Rarely doctors will order a Oral Glucose Tolerance Test, which tests your response to a huge dose of pure glucose, which hits your blood stream within minutes and produces results quite different from the blood sugars you will experience after each meal. Below you will find the normal readings for these various tests. Normal Fasting Blood Sugar Fasting blood sugar is usually measured first thing in the morning before you have eaten any food. A truly normal fasting blood sugar (which is also the blood sugar a norm 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 >>

Diabetes: Blood Sugar Levels

Diabetes: Blood Sugar Levels

Topic Overview Keeping your blood sugar in a target range reduces your risk of problems such as diabetic eye disease (retinopathy), kidney disease (nephropathy), and nerve disease (neuropathy). Some people can work toward lower numbers, and some people may need higher goals. For example, some children and adolescents with type 1 or type 2 diabetes, people who have severe complications from diabetes, people who may not live much longer, or people who have trouble recognizing the symptoms of low blood sugar may have a higher target range. And some people, such as those who are newly diagnosed with diabetes or who don't have any complications from diabetes, may do better with a lower target range. Work with your doctor to set your own target blood sugar range. This will help you achieve the best control possible without having a high risk of hypoglycemia. Diabetes Canada (formerly the Canadian Diabetes Association) suggests the following A1c and blood glucose ranges as a general guide. Continue reading >>

Glycolated Hemoglobin Test (a1c)

Glycolated Hemoglobin Test (a1c)

The glycosylated hemoglobin test (A1c, also called hemoglobin A1c or the glycosylated hemoglobin test) is an important blood test to diagnose diabetes or determine control of your diabetes. It provides an average blood glucose measurement over the past 3 months and is used in conjunction with home glucose monitoring to make treatment adjustments. The normal range for the A1c test is less than 5.7% for people without diabetes, 5.7%-6.4% for those with pre-diabetes. For people with diabetes, it is 6.5% or higher. For diagnostic purposes, two separate A1c tests at 6.5% are positive for diabetes. People with diabetes who are treated with insulin should have this test 4 times a year (every 3 months). The test may be needed more frequently when your diabetes is not well-controlled. However, the test should be performed no more often than every 6 weeks. Those who are not treated with insulin should have this test every 4 to 6 months. If your A1c is 12.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 298. If your A1c is 11.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 269. If your A1c is 10.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 240. If your A1c is 9.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 212. If your A1c is 8.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 183. If your A1c is 7.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 154. If your A1c is 6.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 126. If your A1c is 5.0%: Your average mean daily plasma blood sugar is around this (mg/dl): 97. Continue reading >>

Diabetes And The Hemoglobin A1c Test

Diabetes And The Hemoglobin A1c Test

Walter L. Aument Family Health Center The hemoglobin A1c ("A-one-C") test is a blood test used in the care of people who have diabetes. The hemoglobin A1c percentage is a way of looking at your average blood sugar control over a period of 3 months. Sugar absorbed from your digestive system circulates in the bloodstream. When the blood sugar is high, the sugar attaches to the hemoglobin protein in red blood cells, forming hemoglobin A1c. Red blood cells live 90 to 120 days. This means that once sugar has combined with the hemoglobin in red blood cells, the hemoglobin A1c stays in the blood for 90 to 120 days. This means the amount of hemoglobin A1c in your blood reflects how often and how high your blood sugar has been over the past 3 months. Hemoglobin A1c is an excellent way to check how well you are controlling your blood sugar over a 3-month period. Hemoglobin A1c measurements are important because: They confirm your daily home blood sugar monitoring results. They help predict your risk of diabetic complications. The higher the hemoglobin A1c percentage, the greater the risk of developing diabetic eye, kidney, cardiovascular, and nervous system disease. No preparation is necessary. One of the advantages of this test is that you do not have to fast before you take it. A small amount of blood is taken from your arm with a needle. The blood is collected in tubes and sent to a lab. There are also portable machines that can determine the value from a fingerstick – these can be performed in physician offices or even in a patient’s home. The hemoglobin A1c percentage rises as your average blood sugar level rises. For adult diabetics the results are usually judged as follows: less than 7%: excellent blood sugar control (some experts recommend less than 6.5%) less than 8% Continue reading >>

14 Amazing Herbs That Lower Blood Sugar

14 Amazing Herbs That Lower Blood Sugar

We live in a world where prescription medicine is getting more and more expensive as well as controversial. Alternative medicine is gaining momentum and with good reason! The same is true for treatments for diabetes type 2. You have therapies that can reverse diabetes through lifestyle and diet changes, natural supplements that can help stabilize blood sugar levels, and also herbs that lower blood sugar. Not only are these alternative therapies safer, but they are also easier on your pocket, on your body and mind. Maintaining normal blood sugar levels is necessary for the body’s overall health. Erratic blood sugar levels can affect the body’s ability to function normally and even lead to complications if left unchecked. Some herbs and spices found in nature do a tremendous job of naturally lowering blood sugar levels, making them a boon for diabetics and pre-diabetics. What’s more, being nature’s multi-taskers, herbs and spices also produce overall health benefits beyond just helping balance blood sugar. We want to clarify one thing right away – not everything on our list can be classified as ‘herbs’. However, they are all from natural sources. Herbs come from the leafy and green part of the plant. Spices are parts of the plant other than the leafy bit, such as the root, stem, bulb, bark or seeds. RELATED: Decoding The Dawn Phenomenon (High Morning Blood Sugar) With that in mind, let’s take a look at some of the best herbs that lower blood sugar, along with a few spices thrown in, to give you a more comprehensive list. Please note that while we normally do not use animal studies to support any dietary supplement, several herbs like garlic and ginger are considered ‘food’ and so, are used traditionally by cultures across the world in their daily diet Continue reading >>

The A1c Test & Diabetes

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 >>

New Guidelines For Diabetes In Seniors

New Guidelines For Diabetes In Seniors

Mom is 82, a diabetic, and her sugars often drop below 100 and she feels lightheaded. She’s been told that she should keep her sugars between 70 and 120 but we’ve noticed she often feels better if they are higher. What is a good range of finger-stick sugars for her? The guidelines for blood sugar control in seniors have changed recently. The Choosing Wisely Campaign from the AGS [American Geriatrics Society] I referenced in previous articles, now recommends that lower sugars are not good for seniors (as contrasted with younger adults, where tighter control is better). The new advice is: Avoid using medications to achieve hemoglobin A1c less than 7.5% in most adults age 65 and older; moderate control is generally better. What is the ‘A1c’? The ‘A1c’ is a protein—the hemoglobin A1c—produced in your blood in response to the level of sugar. As the sugar increases, the A1c rises, and reflects the average sugar over the preceding three months. Diabetics should have their A1c measured every 3-6 months. An A1c of 7% indicates an average blood sugar of 154; 7.5% means it’s been 168; 8.0%, it’s 182; for 9.0%, it’s 211. The AGS found no evidence that tight control in older adults with type 2 diabetes is beneficial. ‘Tight control’ means an A1c less than 7% which usually translates into finger-stick sugars under 100 before breakfast and under 200 the rest of the day. Compared with ‘looser control’, tight control in seniors results in more harm: higher death rates, and particularly higher rates of hypoglycemia—blood sugars that are too low, meaning less than 70-80, which increases the risk of dizziness, falling, injury, and generally just not feeling as well. Since it takes years for the benefits of ‘tight control’ to really be seen, the AGS recom Continue reading >>

When “normal” Blood Sugar Isn’t Normal (part 2)

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 >>

How Much Walking Is Best For Diabetes Control?

How Much Walking Is Best For Diabetes Control?

Exercise and walking are excellent tools for controlling Type II diabetes and improving health for people with diabetes. Walk 38 Minutes or 4400 Steps a Day for Diabetes A study measured how much walking is needed to produce the best effects for people with diabetes. Walking or doing other aerobic exercise for 38 minutes (about 2.2 miles or 4400 steps) showed a significant effect for those with diabetes, even if they didn't lose weight. They improved their hemoglobin A1C by 0.4 percent, reduced their risk of heart disease, and improved their cholesterol and triglyceride levels. They saved $288 a year in health care costs. 30-Minute Walking Workout for Diabetes Brisk walking workouts can help you maintain a steady blood sugar level and body weight if you have Type 2 diabetes. A 30-minute walk at least five days per week is recommended by the American College of Sports Medicine and the American Diabetes Association for people with diabetes. Consult your health care team to see if walking is the right exercise for you and any precautions necessary for your individual circumstances and adjustments to your medications or diet. Walking Goal: To walk for 30 minutes, with at least 20 continuous minutes at a brisk pace of 15 to 20 minutes per mile (3-4 mph.) What you will need: Walking shoes and socks: You need to protect your feet and prevent developing blisters or sores. Get fitted for flat and flexible athletic shoes at the best running shoe store in your area. Avoid cotton socks and tube socks and choose athletic socks or diabetic socks made of sweat-wicking polyester fiber. Walking clothing: You need good freedom of movement and you need to prevent chafing, which can lead to sores. Wear a fitness t-shirt and fitness shorts, warm-up pants or yoga pants. Sweat-wicking polyest Continue reading >>

Managing Diabetes: Six Healthy Steps With The Most Benefit

Managing Diabetes: Six Healthy Steps With The Most Benefit

Want to boost your overall health with diabetes? A Johns Hopkins expert offers healthy strategies to help you control your blood sugar, protect your heart, and more. Want more information, support, and advice about practical, everyday ways to stay healthy with diabetes? Ask your doctor about a diabetes self-management class near you. In a 2011 study from The Johns Hopkins University, people who took diabetes-education classes saw their A1C reduced by a significant 0.72 percent. About 17.7 million Americans with diabetes take medications—pills, injections, or both—to help keep their blood sugar within a healthy range, according to the Centers for Disease Control and Prevention. That’s important, and it’s important to take medication as prescribed, but don’t stop there. People with diabetes are two to four times more likely to have heart disease or a stroke than those without this chronic condition, according to the American Heart Association. “It’s very important to take care of your heart health too,” says Johns Hopkins diabetes expert Rita Rastogi Kalyani, M.D., M.H.S. “Making smart choices every day can help.” Kalyani recommends starting with these six critical steps today. Extra pounds? Lose a little. You don’t have to be a “biggest loser” or get an “extreme makeover” to enjoy big weight-loss benefits if you have diabetes. In a nationwide study of 5,145 people with type 2 diabetes, those who shed just 5 to 10 percent of their weight (for someone weighing 175 pounds, that’s a loss of 9 to 17.5 pounds) were three times more likely to lower their A1C (a test of long-term blood sugar control) by 0.5 percent, a significant drop. They were also 50 percent more likely to lower their blood pressure by 5 points and twice as likely to lower thei Continue reading >>

Have Diabetes? It Depends On What Country You're In

Have Diabetes? It Depends On What Country You're In

Open this photo in gallery: "So, Dr. Q, do I have it or not?" asked Michael, a 47-year-old man who had just returned from Michigan. His wife, my patient, had brought him in to see me to clarify his diagnosis. He had undergone blood tests in Detroit and was told by his doctor there that he had diabetes. Upset and disbelieving, he refused to take medications. Once in Canada, he went to see his own family doctor. After doing blood tests here, his Canadian physician told him he was fine - and that he did not have diabetes. "Well, yes and no," I had to reply. It was an unusual situation based on different diabetes-testing criteria in the United States and Canada. The same patient with the same results can be told that he either has or does not have the condition. "Michael, both your doctors are right. In Michigan, you have diabetes. In Toronto, you don't." That didn't seem to help his peace of mind. Doctors are supposed to be without borders, and the diagnosis of common conditions should not change between countries that share so much. But American physicians are diagnosing diabetes even more aggressively than their Canadian counterparts. In January, 2010, the American Diabetes Association essentially made it easier for patients to be diagnosed with diabetes by adding the important Hemoglobin A1C test to the diagnostic list. Now, in the United States, a HbA1C level greater than 6.5 per cent means you have diabetes. Previously, the U.S. gold standard test for diabetes was an overnight fasting sugar (glucose) level of 7.0 millimoles per litre of blood or higher. That still holds for Canada. In fact, Canadian doctors are not even supposed to do the HbA1C test until a person has been fully diagnosed with diabetes by the usual fasting glucose tests. The HbA1C test is used only to Continue reading >>

Hba1c Test Results Don't Tell The Full Story

Hba1c Test Results Don't Tell The Full Story

back to Overview When I was a teenager, the HbA1c test results cut straight through my lies and made-up paper logbook. It’s often viewed as the number to rule all numbers. But hemoglobin A1c (HbA1c) test results can be misleading and don’t tell the full story. As I learned in my teens, the HbA1c test shines a light on things I was trying to hide. Overall, It’s not good at getting to the details of blood sugars, but when used with other pieces of information it can draw attention to (sometimes unseen) problem areas in our diabetes management, and that’s a good thing. How do HbA1c test results work? Let’s take a quick look at the basics of the HbA1c test. A certain amount of sugar in your blood sticks to your red blood cells and can’t be unstuck. It’s there for the life of the cell, which is, on average, about 8-12 weeks. Those red blood cells in your body are constantly recycled, and by checking your HbA1c value every 8-12 weeks (or as often as recommended by your doctor – the ADA recommends at least twice a year), you get to see a fresh new grouping of them. So – A higher blood sugar for a longer time means more sugar on more cells – which means a higher HbA1c. Get it? Ideal HbA1c range HbA1c goals are very individual, which makes sense. We’re all different, right? Of course, there are reference values as a guide, and that’s a good place to start. The ADA suggests an HbA1c of 7%, but also say that “more or less stringent glycemic goals may be appropriate for each individual.” Why have different goals? Because, as you know, there’s a lot to consider with diabetes. Avoiding lows (hypoglycemia) while pushing for lower A1c’s is really important because low blood sugars are immediately dangerous. It’s simply not safe to push for a very low H Continue reading >>

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