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 >>
What Are The Ideal Levels Of Blood Sugar?
A blood sugar or blood glucose chart identifies ideal blood sugar levels throughout the day, including before and after meals. Doctors use blood sugar charts to set target goals and monitor diabetes treatment plans. Blood sugar charts also help those with diabetes assess and self-monitor blood sugar test results. What is a blood sugar chart? Blood sugar charts act as a reference guide for blood sugar test results. As such, blood sugar charts are important tools for diabetes management. Most diabetes treatment plans involve keeping blood sugar levels as close to normal or target goals as possible. This requires frequent at-home and doctor-ordered testing, along with an understanding of how results compare to target levels. To help interpret and assess blood sugar results, the charts outline normal and abnormal blood sugar levels for those with and without diabetes. In the United States, blood sugar charts typically report sugar levels in milligrams per deciliter (mg/dL). In the United Kingdom and many other countries, blood sugar is reported in millimoles per liter (mmol/L). A1C blood sugar recommendations are frequently included in blood sugar charts. A1C results are often described as both a percentage and an average blood sugar level in mg/dL. An A1C test measures the average sugar levels over a 3-month period, which gives a wider insight into a person's overall management of their blood sugar levels. Blood sugar chart guidelines Appropriate blood sugar levels vary throughout the day and from person to person. Blood sugars are often lowest before breakfast and in the lead up to meals. Blood sugars are often highest in the hours following meals. People with diabetes will often have higher blood sugar targets or acceptable ranges than those without the condition. These Continue reading >>
What Is A Normal Blood Sugar Level?
The aim of diabetes treatment is to bring blood sugar (“glucose”) as close to normal as possible. What is a normal blood sugar level? And how can you achieve normal blood sugar? First, what is the difference between “sugar” and “glucose”? Sugar is the general name for sweet carbohydrates that dissolve in water. “Carbohydrate” means a food made only of carbon, oxygen, and hydrogen. There are various different kinds of sugars. The one our body uses most is called “glucose.” Other sugars we eat, like fructose from fruit or lactose from milk, are converted into glucose in our bodies. Then we can use them for energy. Our bodies also break down starches, which are sugars stuck together, into glucose. When people talk about “blood sugar,” they mean “blood glucose.” The two terms mean the same thing. In the U.S., blood sugar is normally measured in milligrams of glucose per deciliter of blood (mg/dl). A milligram is very little, about 0.00018 of a teaspoon. A deciliter is about 3 1/3 ounces. In Canada and the United Kingdom, blood sugar is reported in millimoles/liter (mmol/L). You can convert Canadian or British glucose levels to American numbers if you multiply them by 18. This is useful to know if you’re reading comments or studies from England or Canada. If someone reports that their fasting blood glucose was 7, you can multiply that by 18 and get their U.S. glucose level of 126 mg/dl. What are normal glucose numbers? They vary throughout the day. (Click here for a blood sugar chart.) For someone without diabetes, a fasting blood sugar on awakening should be under 100 mg/dl. Before-meal normal sugars are 70–99 mg/dl. “Postprandial” sugars taken two hours after meals should be less than 140 mg/dl. Those are the normal numbers for someone w Continue reading >>
Blood Glucose Meter Averages: Don’t Be Fooled
Most blood glucose meters store a certain number of readings in their memory, along with the date and time of each reading. Most also report either a 14-day or 30-day average of readings. An average is calculated by adding up all the numbers in a set and dividing the sum by the number of numbers in the set. For example, if you checked your blood glucose level 25 times in 14 days, your meter would tally all of your readings and divide the sum by 25 to get your 14-day average. Blood glucose averages can be useful, but they can also be misleading. Compare the before-dinner blood glucose readings of two different people over four days: Rhoda’s blood glucose before dinner: Monday 158 mg/dl Tuesday 178 mg/dl Wednesday 174 mg/dl Thursday 161 mg/dl Raul’s blood glucose before dinner: Monday 82 mg/dl Tuesday 302 mg/dl Wednesday 200 mg/dl Thursday 87 mg/dl Both Rhoda’s and Raul’s four-day average is 168 mg/dl, but there is a big difference in the patterns. Raul’s average gives no indication of the wide fluctuations in his blood glucose readings. By relying on the average, he’d miss the opportunity to correct the highs and lows. Luckily Raul keeps a logbook, which reveals that he exercises before dinner on Monday and Thursday, so he’ll probably require a change in his medicine dose on exercise days. On Tuesday he had a very stressful business meeting over lunch in a restaurant. That explains the reading of 302 mg/dl. Many people don’t check their blood glucose level if they suspect that the result will be high, so the average doesn’t tell them anything meaningful. Others only check before meals, then say, “How could my HbA1c be 8.8% when my average blood glucose is 148 mg/dl?” Your HbA1c (an indication of your average blood glucose over the previous 2–3 mon Continue reading >>
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What Are Blood Sugar Target Ranges? What Is Normal Blood Sugar Level?
Understanding blood sugar target ranges to better manage your diabetes As a person with diabetes, you may or may not know what your target ranges should be for your blood sugars first thing in the morning, before meals, after meals, or at bedtime. You may or may not understand what blood sugar ranges are for people without diabetes. You may or may not understand how your A1C correlates with your target ranges. How do you get a clear picture of what is going on with your blood sugar, and how it could be affecting your health? In this article, we will look at what recommended blood sugar target ranges are for people without diabetes. We will look at target ranges for different times of the day for people with diabetes. We will look at target ranges for Type 1 versus Type 2 diabetes. Is there a difference? We will also look at what blood sugars should be during pregnancy for those with gestational diabetes. We will look at other factors when determining blood sugar targets, such as: Age Other health conditions How long you’ve had diabetes for Stress Illness Lifestyle habits and activity levels We will see how these factors impact target ranges for your blood sugars when you have diabetes. We will learn that target ranges can be individualized based on the factors above. We will learn how target ranges help to predict the A1C levels. We will see how if you are in your target range, you can be pretty sure that your A1C will also be in target. We will see how you can document your blood sugar patterns in a notebook or in an “app,” and manage your blood sugars to get them in your target ranges. First, let’s look at the units by which blood sugars are measured… How is blood sugar measured? In the United States, blood sugar is measured in milligrams per deciliter (by w Continue reading >>
A New Number "average Glucose" Will Soon Be A Key Part Of Your Diabetes Tool Kit
From the Editor: The following article first appeared in the November 2008 issue of Diabetes Forecast. It will be of interest to anyone who keeps track of blood sugar. Here it is: So how’s your diabetes? One way to tell is by monitoring your blood glucose with a meter. By testing yourself when you wake up in the morning and before and after meals, you can get a quick look at whether your current regimen is keeping your glucose levels in the range you and your doctor have agreed is best for you. Depending on your particular situation, you may be doing this several times a day, a couple of times a week, or less frequently. The other main way your health care provider can see how you’re doing is by ordering a lab test called an A1C. Most people with diabetes get this test—which gives a rough average of your blood glucose levels for the past 2 to 3 months—two to four times a year. It’s reported as a percentage, with normal levels between 4 and 6 for people who don’t have diabetes. Pretty soon, however, another number may show up on your lab chart: the estimated average glucose, or eAG. Sound like the same thing as the A1C? It is, in a way, but the eAG will look a lot more familiar. Why another number? The new number comes in part from new research. A large international study, called the A1C-Derived Average Glucose (ADAG) study, published in Diabetes Care in August, established that the A1C does, in fact, do what scientists have long believed it does: provide an accurate test of average blood glucose. “The results of the ADAG study should give people with diabetes increased confidence that the A1C…is, indeed, a valid measurement of their average blood glucose,” says Susan McLaughlin, BS, RD, CDE, CPT. McLaughlin, who is president-elect of health care and e Continue reading >>
What Is The Average Blood Sugar Level?
Blood sugar, or glucose, serves as the fuel your body uses to generate energy. The level of glucose in your blood remains fairly stable, slightly rising after eating and declining a small amount between meals or after exercising. Blood glucose can be measured in many ways. Some tests measure glucose directly, while others measure the amount of glucose attached to a specific protein. Video of the Day Fasting and Premeal Blood Glucose Levels The amount of glucose in the blood varies, depending on when you last ate. A fasting blood glucose level after at least 8 hours without caloric intake in a healthy, nondiabetic adult typically ranges from 70 to 99 mg/dL, according to the American Diabetes Association (ADA). People with a fasting blood glucose of 100 to 125 mg/dL are considered prediabetic, meaning the body's handling of glucose is impaired but not yet to the point of warranting a diagnosis of diabetes. A fasting blood glucose of 126 mg/dL or greater typically indicates diabetes, according to ADA criteria. Among people diagnosed with diabetes who are not pregnant, the ADA recommends a target fasting or premeal blood sugar level of 80 to 130 mg/dL. Postprandial and Oral Glucose Tolerance Levels As the blood glucose level typically increases after eating, testing after a meal -- known as a postprandial glucose level -- provides information about the body's capacity to maintain a healthy blood sugar level when challenged with a caloric load. Blood glucose levels usually peak 1 to 2 hours after beginning a meal, depending largely on the amount of carbohydrates, proteins and fat in the meal. Among healthy, nondiabetic adults a normal postprandial glucose level 2 hours after a meal is less than 140 mg/dL. For people with diabetes, the ADA generally recommends a peak postpran Continue reading >>
Blood Sugar Level Ranges
Tweet Understanding blood glucose level ranges can be a key part of diabetes self-management. This page states 'normal' blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine people with diabetes. If a person with diabetes has a meter, test strips and is testing, it's important to know what the blood glucose level means. Recommended blood glucose levels have a degree of interpretation for every individual and you should discuss this with your healthcare team. In addition, women may be set target blood sugar levels during pregnancy. The following ranges are guidelines provided by the National Institute for Clinical Excellence (NICE) but each individual’s target range should be agreed by their doctor or diabetic consultant. Recommended target blood glucose level ranges The NICE recommended target blood glucose levels are stated below for adults with type 1 diabetes, type 2 diabetes and children with type 1 diabetes. In addition, the International Diabetes Federation's target ranges for people without diabetes is stated.    The table provides general guidance. An individual target set by your healthcare team is the one you should aim for. NICE recommended target blood glucose level ranges Target Levels by Type Upon waking Before meals (pre prandial) At least 90 minutes after meals (post prandial) Non-diabetic* 4.0 to 5.9 mmol/L under 7.8 mmol/L Type 2 diabetes 4 to 7 mmol/L under 8.5 mmol/L Type 1 diabetes 5 to 7 mmol/L 4 to 7 mmol/L 5 to 9 mmol/L Children w/ type 1 diabetes 4 to 7 mmol/L 4 to 7 mmol/L 5 to 9 mmol/L *The non-diabetic figures are provided for information but are not part of NICE guidelines. Normal and diabetic blood sugar ranges For the majority of healthy ind Continue reading >>
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 >>
An Overview Of Estimated Average Glucose (eag)
Estimated average glucose (eAG) or "average glucose" is a newer term you may see reported by your doctor. The American Diabetes Association (ADA) introduced this term to help us translate our A1c tests into numbers that would more closely represent our daily glucose meter readings. Making Sense of eAG: Estimated Average Glucose To understand eAG, we have to begin with the A1c test (also known as glycated hemoglobin or HbA1c). The A1c test measures the amount of hemoglobin in your blood that has glucose attached to it in the red blood cells (glycated hemoglobin). It tells you what your average blood glucose control has been for the past two to three months. The problem is that the A1c test reports a percentage of total hemoglobin that is glycated hemoglobin. In other words, an A1c of 7 percent means that 7 percent of the total hemoglobin has glucose attached to it. But your glucose meter measure glucose directly in the blood in milligrams per deciliter (for example, 150 mg/dl). The two types of numbers are confusing and few of us would be able to easily translate one into the other. Researchers discovered an accurate way to calculate estimated glucose levels from the A1c results. This way we can use the same numbers we are accustomed to seeing on our daily glucose meters. Quick Reference Chart for Hemoglobin A1c to eAG Below is a quick reference guide that will help you calculate your estimated average blood glucose level from your A1c result. A1c (%) to eAG (mg/dl) 6.0% = 126 mg/dl 6.5% = 140 mg/dl 7.0% = 154 mg/dl 7.5% = 169 mg/dl 8.0% = 183 mg/dl 8.5% = 197 mg/dl 9.0% = 212 mg/dl 9.5% = 226 mg/dl 10.0% = 240 mg/dl A1c Versus Daily Monitoring While the A1c test is important for measuring your long-term blood glucose management, it can’t replace daily blood glucose te Continue reading >>
Understanding Your Average Blood Sugar
A1c is an average of all your blood sugars. It does not tell you your blood sugar patterns. Use it only as yet another indicator of how well you’re doing. Glysolated Hemoglobin (or A1c) is a measure of your average blood glucose control over the previous three months. Glucose attaches to hemoglobin the oxygen carrying molecule in red blood cells. The glucose-hemoglobin unit is called glycosolated hemoglobin. As red blood cells live an average of three months, the glycosolated hemoglobin reflects the sugar exposure to the cells over that time. The higher the amount of glucose in the blood, the higher the percentage of hemoglobin molecules that will have glucose attached. Think of the A1c as a long-term blood glucose measure that changes very gradually as red blood cells die and are replaced by new cells. The A1c doesn’t replace self blood-glucose monitoring. Because the A1c is an average of all your blood sugars, it does not tell you your blood sugar patterns. For example, one person with frequent highs and lows can have the same A1c as another person with very stable blood sugars that don’t vary too much. So what’s the point? A1c is yet another indicator of how well you’re doing. An A1c measurement between 4-6% is considered the range that someone without diabetes will have. The American Diabetes Association goal is an A1c less than 7%. Research has shown that an A1c less than 7% lowers risk for complications. The American College of Endocrinology goal is an A1c less than 6.5%. For some people with diabetes an A1c goal of less than 6% is appropriate. Talk with your doctor about your A1c goal. Use this chart to view A1c values and comparable blood glucose values: A1c Estimated Average Glucose mg/dL 5% 97 6% 126 7% 154 8% 183 9% 212 10% 240 11% 269 12% 298 A not Continue reading >>
Estimated Average Glucose (eag)
An average blood glucose level, expressed in milligrams per deciliter (mg/dl), based on a person’s glycosylated hemoglobin (HbA1c) level. Estimated average glucose (eAG) is considered easier for people with diabetes and their doctors to work with than HbA1c, since it is given in the same units as everyday blood glucose readings. The HbA1c test is currently considered the best measure of overall blood glucose control and of the risk of developing diabetic complications in the future. The test measures the percentage of hemoglobin molecules in the blood that have glucose attached to them. People without diabetes typically have an HbA1c level under 6%, and the American Diabetes Association recommends that people with diabetes strive for an HbA1c level below 7% (below 6% in certain individuals). In a study recently published in the journal Diabetes Care, researchers sought to define the relationship between HbA1c and average blood glucose level. Over a period of three months, they recorded continuous glucose monitor readings and seven-times-daily blood glucose meter readings in 268 people with Type 1 diabetes, 159 with Type 2 diabetes, and 80 without diabetes. The researchers compared these data with the HbA1c levels of the participants at the end of the three-month period. Based on the relationship between the two, they designed a mathematical formula for translating HbA1c into eAG. Someday, eAG may be printed alongside HbA1c in laboratory reports. Until then, there are a few ways to calculate eAG yourself: You can log on to the American Diabetes Association’s Web site at www.diabetes.org/ag, where you’ll find a conversion calculator as well as a chart showing equivalent values of HbA1c and eAG. You can also use the formula directly, using a calculator: 28.7 x HbA1c Continue reading >>
Eag (estimated Average Glucose) = Glucose Standards War
For at least three consecutive years now at the annual ADA Conference, we keep hearing about a rumored switchover from the A1c as the gold standard average glucose measurement. Instead, we'll get something new and supposedly easier to understand: a new measure that more closely reflects the mg/dL (and international mmol/l)numbers we all get on our home glucose meters. This new test is now dubbed the eAG (estimated average glucose). One of the big news announcements Scientific Sessions this week was the results of a large international study that supposedly underscores the accuracy of the eAG. In this 10-center study, 507 volunteers with diabetes had their A1c translated into eAG readings and compared with their running daily BG results, if I understood the press materials correctly. "Study investigators found a simple linear relationship," the ADA press release states. Also stated: "Patients find it difficult to relate the A1c's percentage of hemoglobin that is glycated (and a goal of under 7%) to the self-monitoring of blood glucose they do at home... To reduce confusion, researchers have conducted a major international study to demonstrate how A1c correlates with self-monitoring." The ADA is clearly pushing hard for a massive migration to the eAG, which I find incredibly odd. They've even created little red handheld calculators (shown here) that they plan to sell to physicians off their website for easier conversion of A1c values into the "simpler" eAG. You can try their online calculator HERE. One reason I find this so odd is that just last September, the Diabetes Care Coalition, a consortium backed by the ADA, JDRF and AADE, along with a half-dozen major pharma companies, launched a sweeping "Know Your A1C" public service campaign to get people aware of their A1c an Continue reading >>
Average blood glucose and the A1C test Your A1C test result (also known as HbA1c or glycated hemoglobin) can be a good general gauge of your diabetes control, because it provides an average blood glucose level over the past few months. Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you check blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target of 7% or lower recommended by the American Diabetes Association (ADA) for many adults who are not pregnant. For some people, a tighter goal of 6.5% may be appropriate, and for others, a less stringent goal such as 8% may be better.1 Talk to your doctor about the right goal for you. GET YOURS FREE The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management. See how average daily blood sugar may correlate to A1C levels.2 Enter your average blood sugar reading and click Calculate. *Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes. What is A1C? Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a Continue reading >>
Blood Sugar Levels For Adults With Diabetes
Each time you test your blood sugar, log it in a notebook or online tool or with an app. Note the date, time, results, and any recent activities: What medication and dosage you took What you ate How much and what kind of exercise you were doing That will help you and your doctor see how your treatment is working. Well-managed diabetes can delay or prevent complications that affect your eyes, kidneys, and nerves. Diabetes doubles your risk for heart disease and stroke, too. Fortunately, controlling your blood sugar will also make these problems less likely. Tight blood sugar control, however, means a greater chance of low blood sugar levels, so your doctor may suggest higher targets. Continue reading >>