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Which Is More Accurate Hba1c And Fbs

Comparison Of Hba1c And Fbs Among Diabetics And Non-diabetics To Evaluate Role Of Hba1c As A Screening Tool | Laxmikanth | International Journal Of Medical Research And Review

Comparison Of Hba1c And Fbs Among Diabetics And Non-diabetics To Evaluate Role Of Hba1c As A Screening Tool | Laxmikanth | International Journal Of Medical Research And Review

International Journal of Medical Research and Review Comparison of HbA1c AndFBS Among Diabetics And Non-diabetics to Evaluate Role ofHbA1c as a Screening Tool 1Dr. Bachu Laxmikanth,2Dr. Imran AhmedSiddiqui,3Neha Asst Professor, Department of Biochemistry ShriSathya SaiMedical College & Research Institute, Chennai. Specialist, Department of Biochemistry, ESIC Super SpecialtyHospital, Hyderabad. 3Ist MBBS Student, ShriSathya SaiMedical College & Research Institute, Chennai. Address forCorrespondence: Dr. B. Laxmikanth, Email:[email protected] Background:The increase in the incidence of Diabetes in both the urban and ruralsectors of population demands a proper screening strategy for earlydiagnosis, to delay the complications associated with this disorder. Aim: To evaluateHbA1c as a diagnostic tool for screening purposes at the communitylevel. Materials andMethods: 50 Type 2 Diabetics were included as cases and 50healthy individuals were taken as controls in this study. FBS and HbA1cwere estimated in them, and the data was statistically analyzed usingSPSS software version17. Results:A significantly (p<0.001) strong and positive correlationbetween FBS and HbA1c with a r value 0.908 wasobserved. HbA1c showed 100% sensitivity and specificity at a best cutoff value of 6.7%. Conclusion:Hba1c can be used as an effective screening tool at the communitylevel, provided that the test should be performed using a method thatis standardized. The high prevalence of diabetes mellitus in the recent yearshas emerged as a worldwide public health problem, with type 2accounting for 8590% of cases [1 ]. Diabetes is underdiagnosed as the average lag between onset and diagnosis is 7 years[2,3,1,4] Early diagnosis, lifestyle modification, and tight glycemiccontrol can reduce the risk of Continue reading >>

What Is The A1c Test? How Does A1c Relate To Blood Glucose?

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 >>

Hba1c Vs Blood Glucose: Knowing The Difference

Hba1c Vs Blood Glucose: Knowing The Difference

With the myriad of tests available to the general public serving to empower individuals in terms of wellbeing, it has become necessary to familiarise one’s self with the relevance and where possible, the difference, between tests previously thought of as the same or similar. For example, being assessed for a specific condition may require a more in-depth view than is commonly perceived. With this in mind, we look at the difference between the Blood Glucose and the HbA1c tests and why the one is more effective in managing an individual’s diabetic status than the other. Random Glucose test Activity levels, stress, types of food, infection and / or illness can affect glucose levels. The amount of food consumed and periods between meals also play a role in determining blood sugar levels. Generally, blood sugar levels are at their lowest after overnight fasting, or in instances where a meal has not been consumed for a period of at least eight hours. Blood sugar levels are raised to their highest levels within an hour of eating foods that are high in carbohydrates, such as potatoes, chocolate, bread, rice and pasta. Blood sugar levels are measured in two ways i.e. molar concentrations, measured in mmol/L (millimoles per litre) and mass concentration which is measured in mg/dL (milligrams per decilitre). The above graph depicts just how an individual’s Random Glucose level fluctuates throughout the day. Mealtimes such as breakfast, lunch and dinner produce spikes in the Glucose levels as expected. This person may still be diabetic or prediabetic, however, as we can see from the above, this method of diagnosis may be inaccurate. In terms of managing one’s day to day diet however, this test could prove useful, specifically for individuals using insulin. HBA1C test When s Continue reading >>

Accuracy Of Fasting Plasma Glucose And Hemoglobin A1c Testing For The Early Detection Of Diabetes: A Pilot Study

Accuracy Of Fasting Plasma Glucose And Hemoglobin A1c Testing For The Early Detection Of Diabetes: A Pilot Study

Abstract Diabetes, often referred as diabetes mellitus, describes a group of metabolic disorders characterized by chronic hyperglycaemia with disturbances of fat, carbohydrate and protein metabolism because of the defects in insulin releasing, insulin action, or both. The most common form of diabetes mellitus is type 2 diabetes which is a worldwide chronic disease. The aim of this study was to investigate the accuracy of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) testing for the early detection of diabetes and to evaluate the correlation between FPG and HbA1c as a biomarker for diabetes in the general population in Hong Kong. This study also observed and assessed the risk of diabetes by comparing different genders and ages in Hong Kong. A retrospective study was undertaken and the data was collected in the database of a HOKLAS (The Hong Kong Laboratory Accreditation Scheme) clinical laboratory from 200 diabetic and non-diabetic patients (83 females and 117 males, age ranged from 20 to 90) who attended the laboratory during January 2016 to February 2016 for both FPG and HbA1c measurements. A significant correlation between HbA1c and FPG (r2 = 0.713, p < 0.05) was observed in this study. Moreover, patients detected as diabetes in age groups 45–64, 65–74 and ≥75 years old were 2.5, 3 and 6 times respectively higher than that of the diabetic individuals under 45 years old. In conclusion, FPG was significantly correlated with HbA1c and a significant increase in FPG and HbA1c in male was observed by comparing with female. Furthermore, the incidence rate of diabetes mellitus in male was 3 times higher than that in female in Hong Kong and it progressed with increasing age. Further longer term and large scale research in each age group is warranted. Continue reading >>

Fasting Glucose And Hba1c May Both Be Useful To Predict Diabetes

Fasting Glucose And Hba1c May Both Be Useful To Predict Diabetes

Fasting Glucose and HbA1c May Both Be Useful to Predict Diabetes September 24, 2010 Fasting glucose and glycated hemoglobin (HbA1c) levels may both be useful to predict diabetes, according to the results of population-based analyses reported online September 20 in Diabetes Care. "Although ...HbA1c is now recommended to diagnose diabetes, its test performance for diagnosis and prognosis is uncertain," write Elizabeth Selvin, PhD, MPH, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, and colleagues. "Our objective was to assess the test performance of HbA1c against single and repeat glucose measurements for diagnosis of prevalent diabetes and for prediction of incident diabetes." The study sample consisted of 12,485 participants enrolled in the Atherosclerosis Risk in Communities (ARIC) Study and a subpopulation of 691 participants in the Third National Health and Nutrition Examination Survey (NHANES III) who had repeated glucose test results available. For detection of prevalent diabetes against a single fasting glucose level of 126 mg/dL or more, the sensitivity of an HbA1c level of at least 6.5% was 47%, and the specificity was 98% (area under the receiver operator characteristic curve [AUC], 0.892). Against fasting glucose measurements of 126 mg/dL or more repeated at an interval of 3 years, the sensitivity of an HbA1c level of at least 6.5% improved to 67%, whereas the specificity was still high at 97% (AUC, 0.936). In NHANES III, findings were similar with use of fasting glucose measurements repeated 2 weeks apart. For groups based on age, body mass index, and race, HbA1c had consistent accuracy. The 10-year risk for diagnosed diabetes was 88% for persons with a fasting glucose level of at least 126 mg/dL and an HbA1c level of at lea Continue reading >>

A Comparison Of Hba1c And Fasting Blood Sugar Tests In General Population

A Comparison Of Hba1c And Fasting Blood Sugar Tests In General Population

Go to: Abstract Objectives: Early diagnosis of diabetes is crucially important in reduction of the complications. Although HbA1c is an accurate marker for the prediction of complications, less information is available about its accuracy in diagnosis of diabetes. In this study, the association between HbA1c and FBS was assessed through a cross-sectional population-based study. Methods: A random sample of population in Kerman city was selected. The total number was 604 people. Their HbA1c and fasting blood sugar (FBS) were tested. The association between HbA1c and FBS and also their sensitivity, specificity and predictive values in detection of abnormal values of each other were determined. The association of HbA1c with FBS was relatively strong particularly in diabetic subjects. Generally, FBS was a more accurate predictor for HbA1c compared with HbA1c as a predictor of FBS. Although the optimum cutoff point of HbA1c was >6.15%, its precision was comparable with the conventional cutoff point of >6%. Conclusions: In conclusion, FBS sounds more reliable to separate diabetic from non-diabetic subjects than HbA1c. In case of being interested in using HbA1c in screening, the conventional cutoff points of 6% is an acceptable threshold for discrimination of diabetics from non-diabetics. Keywords: HbA1c, Blood glucose, Diabetics *The adjusted values were computed in a multivariable regression model with sex, BMI and age as independent variables. Continue reading >>

Askst: Which Is A Better Test To Screen For Diabetes - Hba1c Or Blood Sugar Test?

Askst: Which Is A Better Test To Screen For Diabetes - Hba1c Or Blood Sugar Test?

Reader Tan Thiam Guan said that his 19-year-old niece requested a HbA1c test at a polyclinic as "we have a history of diabetes in our family". However, she was told by the doctor that the HbA1c test was not an accurate indicator of diabetes, and that the fasting blood sugar test was preferred. Since she had not fasted that morning, the doctor refused to authorise any tests. Mr Tan said: "This is completely opposite to what I have been told. Is the doctor right or wrong?" Senior Health Correspondent Salma Khalik answered. In Singapore, HbA1c - which measures sugar in the blood over a three-month period - is used to monitor diabetics to ensure that their condition is under control, and not as a screening tool. The Ministry of Health (MOH) explains in its guidelines that this is so "until its performance in our multi-ethnic population has been evaluated". Fasting blood glucose is the preferred screening method as it is supported by strong evidence. Some countries, however, do accept the use of HbA1c test to screen for diabetes. The World Health Organisation says the HbA1c test can be used to screen for diabetes, but with conditions such as "stringent quality assurance tests" and "no conditions present that preclude its accurate measurement". It classifies the evidence on the use of HbA1c to screen for diabetes as "moderate" and the strength of this recommendation as "conditional". Continue reading >>

The Glucose Vs. Hba1c Controversy

The Glucose Vs. Hba1c Controversy

Which test should be used for the diagnosis of diabetes: glucose or HbA1c? Over the last few years, an increasing number of countries have moved from fasting plasma glucose to HbA1c as the method of choice. The measurement of glucose, which goes back more than 100 years, far pre-dates HbA1c, and it can be argued that it measures the analyte that is widely known as being central to diabetes. Hemoglobin does not have so strong a pedigree as a diabetes diagnostic. The red protein that transports oxygen from the lungs to the tissues and carbon dioxide back to the lungs is an artifact, or at most an indirect measure, of average glucose. HbA1c testing has historically been recommended only to determine glucose control in those who already have been diagnosed as diabetic. Why, then, are we seeing an increasing move toward measuring HbA1c rather than fasting plasma glucose as the diagnostic test for diabetes? Some relevant background The red blood cell has an average circulating life of some 120 days. The cell membrane allows some reagents to cross into the cell. These so-called penetrating solutes include glucose, urea, bicarbonate, phosphate, and water. Hemoglobin, which is highly concentrated within the cell, reacts with free glucose to form glycated hemoglobin. The main glycation site is at the N-terminal valine of the beta chain. The term HbA1c refers to glycation at this specific site. Hemoglobin is also glycated at a number of €-amino lysines such as ß-66, α-16, and ß-17, and also on the alpha N-terminal valine.1 In 1969 Samuel Rahbar, an Iranian scientist, was the first to report the linkage between diabetes and HbA1c.2 He showed a band migrating ahead of HbA (toward the cathode) using agar gel electrophoresis at pH 6.2. This band had the same chromatographic mobil Continue reading >>

Fasting Blood Sugar: Normal Levels And Testing

Fasting Blood Sugar: Normal Levels And Testing

Fasting blood sugar provides vital clues about how the body is managing blood sugar levels. Blood sugar tends to peak about an hour after eating, and declines after that. High fasting blood sugar levels point to insulin resistance or diabetes. Abnormally low fasting blood sugar could be due to diabetes medications. Knowing when to test and what to look for can help keep people with, or at risk of, diabetes healthy. What are fasting blood sugar levels? Following a meal, blood sugar levels rise, usually peaking about an hour after eating. How much blood sugar rises by and the precise timing of the peak depends on diet. Large meals tend to trigger larger blood sugar rises. High-sugar carbohydrates, such as bread and sweetened snacks, also cause more significant blood sugar swings. Normally, as blood sugar rises, the pancreas releases insulin. Insulin lowers blood sugar, breaking it down so that the body can use it for energy or store it for later. However, people who have diabetes have difficulties with insulin in the following ways: People with type 1 diabetes do not produce enough insulin because the body attacks insulin-producing cells. People with type 2 diabetes do not respond well to insulin and, later, may not make enough insulin. In both cases, the result is the same: elevated blood sugar levels and difficulties using sugar. This means that fasting blood sugar depends on three factors: the contents of the last meal the size of the last meal the body's ability to produce and respond to insulin Blood sugar levels in between meals offer a window into how the body manages sugar. High levels of fasting blood sugar suggest that the body has been unable to lower the levels of sugar in the blood. This points to either insulin resistance or inadequate insulin production, an Continue reading >>

Accuracy Of Fasting Plasma Glucose And Hemoglobin A1c Testing For The Early Detection Of Diabetes: A Pilot Study

Accuracy Of Fasting Plasma Glucose And Hemoglobin A1c Testing For The Early Detection Of Diabetes: A Pilot Study

Abstract Diabetes, often referred as diabetes mellitus, describes a group of metabolic disorders characterized by chronic hyperglycaemia with disturbances of fat, carbohydrate and protein metabolism because of the defects in insulin releasing, insulin action, or both. The most common form of diabetes mellitus is type 2 diabetes which is a worldwide chronic disease. The aim of this study was to investigate the accuracy of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) testing for the early detection of diabetes and to evaluate the correlation between FPG and HbA1c as a biomarker for diabetes in the general population in Hong Kong. This study also observed and assessed the risk of diabetes by comparing different genders and ages in Hong Kong. A retrospective study was undertaken and the data was collected in the database of a HOKLAS (The Hong Kong Laboratory Accreditation Scheme) clinical laboratory from 200 diabetic and non-diabetic patients (83 females and 117 males, age ranged from 20 to 90) who attended the laboratory during January 2016 to February 2016 for both FPG and HbA1c measurements. A significant correlation between HbA1c and FPG (r2 = 0.713, p < 0.05) was observed in this study. Moreover, patients detected as diabetes in age groups 45–64, 65–74 and ≥75 years old were 2.5, 3 and 6 times respectively higher than that of the diabetic individuals under 45 years old. In conclusion, FPG was significantly correlated with HbA1c and a significant increase in FPG and HbA1c in male was observed by comparing with female. Furthermore, the incidence rate of diabetes mellitus in male was 3 times higher than that in female in Hong Kong and it progressed with increasing age. Further longer term and large scale research in each age group is warranted. Fig. Continue reading >>

Fasting Blood Sugar Verses Hba1c

Fasting Blood Sugar Verses Hba1c

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community I have noticed that the most popular threads on here are the ones with morning fasting rates, that a lot of people post in every day (Some have really low figures) My fasting rates average 6.2 to 7.1 (More 6 than 7) with the occasional 5. The figures seem unrelated to what I eat, and I have stopped worrying too much about it as nothing I do seems to affect it. I was talking to my doctor, who has a modern view on diabetes and lower carbing, and his view is that he discounts almost completely the fasting figures, and concentrates solely on the HbAc1 reading, as that is the best overall measure. Is there a general view on this? My Hb figure is generall OK, at 41/42 for the past 2 years, and he is very happy with that. What do others think, or should I put some more effort into the fasting figures? I am current eating a pretty steady 140g of carbs a day. I have noticed that the most popular threads on here are the ones with morning fasting rates, that a lot of people post in every day (Some have really low figures) My fasting rates average 6.2 to 7.1 (More 6 than 7) with the occasional 5. The figures seem unrelated to what I eat, and I have stopped worrying too much about it as nothing I do seems to affect it. I was talking to my doctor, who has a modern view on diabetes and lower carbing, and his view is that he discounts almost completely the fasting figures, and concentrates solely on the HbAc1 reading, as that is the best overall measure. Is there a general view on this? My Hb figure is generall OK, at 41/42 for the past 2 years, and he is very happy with that. What do others think, or should I put some more effort into the fasting figures? I am curre Continue reading >>

Why Hemoglobin A1c Is Not A Reliable Marker

Why Hemoglobin A1c Is Not A Reliable Marker

Over the last few years doctors are increasingly relying on a test called hemoglobin A1c to screen for insulin resistance and diabetes. It’s more practical (and significantly cheaper) than post-meal glucose testing, and it’s less likely to be skewed by day-to-day changes than fasting blood glucose. While this sounds good in theory, the reality is not so black and white. The main problem is that there is actually a wide variation in how long red blood cells survive in different people. What is hemoglobin A1c? Sugar has a tendency to stick to stuff. Anyone that has cooked with sugar can tell you that. In our bodies, sugar also sticks – especially to proteins. The theory behind the A1c test is that our red blood cells live an average of three months, so if we measure the amount of sugar stuck to these cells (which is what the hemoglobin A1c test does), it will give us an idea of how much sugar has been in the blood over the previous three months. The number reported in the A1c test result (i.e. 5.2) indicates the percentage of hemoglobin that has become glycated (stuck to sugar). Why is hemoglobin A1c unreliable? While this sounds good in theory, the reality is not so black and white. The main problem is that there is actually a wide variation in how long red blood cells survive in different people. This study, for example, shows that red blood cells live longer than average at normal blood sugars. Researchers found that the lifetime of hemoglobin cells of diabetics turned over in as few as 81 days, while they lived as long as 146 days in non-diabetics. This proves that the assumption that everyone’s red blood cells live for three months is false, and that hemoglobin A1c can’t be relied upon as a blood sugar marker. In a person with normal blood sugar, hemoglobin Continue reading >>

Scientists Question Accuracy Of Hba1c Testing Due To Red Blood Cell Age Variability

Scientists Question Accuracy Of Hba1c Testing Due To Red Blood Cell Age Variability

A team of scientists from Harvard Medical School and Massachusetts General Hospital has suggested that, while reliable, the HbA1c test - commonly used to gauge blood sugar averages over the past three months - could be more accurate if it took into account the lifespan of red blood cells. In a study published recently in the journal Science Translational Medicine, the researchers show that not factoring the age of each patient's red blood cells into HbA1c estimations lead to identical readings for people with average blood sugar levels that can differ by as much as 0.8 mmol/l (15 mg/dl). The HbA1c test is currently considered by physicians the gold standard for estimating three-month blood sugar fluctuations. It is calculated by measuring hemoglobin to which glucose is bound in red blood cells over an extended period of time. The average lifespan of red blood cells is about 120 days, or four months, but various factors can affect this value, such as nutrition, stress and disease. The researchers estimated the influence of age-related variation in red blood cells by comparing the HbA1c test results of 200 patients. They found inaccuracies in the estimates of a third of these participants which could stem from individual variations in the lifespan of their red blood cells. In their experiment, the scientists incorporated the patients' red blood cell age into HbA1c testing to calculate new estimates of their average blood sugar. They then compared them to blood sugar values obtained from a continuous glucose monitor. The results revealed that the HbA1c test can lead to similar results for people having quite widely divergent blood sugar levels. The HbA1c test provided values that were significantly off target by 0.8 mmol/l or more in one out of three patients. Once correct Continue reading >>

New Diabetes Test Could Be More Accurate

New Diabetes Test Could Be More Accurate

For more than 400 million people with diabetes around the world, blood testing is a routine part of managing their disease. Those tests, however, aren’t always accurate for a variety of reasons. A team of researchers thinks there might be a better way. The researchers say they have devised a new method for estimating blood sugar levels that can reduce errors by more than 50 percent. The researchers published their findings today in the journal Science Translational Medicine. In their study, they combined a mathematical model of hemoglobin glycation in red blood cells with large data sets of patient glucose measurements. It indicated that the age of red blood cells is a major indicator of A1C variation because hemoglobin accumulates more sugar over time. When they controlled the age of cells and tested it on more than 200 people with diabetes, they say the error rate went from 1 in 3 to 1 in 10. One of the researchers, Dr. John Higgins, an associate professor at Harvard Medical School, told Healthline these calculations can be used to correct the test results that people with diabetes now get at their regular checkups. It can also provide an estimate of the A1C result for patients using continuous glucose monitors. Essentially, it has the potential to be the new gold standard in diabetic testing, Higgins said. Read more: Prediabetes: To screen or not to screen? » What’s wrong with current tests The current gold standard for diabetes screening is the glycohemoglobin test (HbA1c). It is a general gauge of diabetes control that specifies an average blood glucose level over a few months. It measures glucose that sticks to hemoglobin inside red blood cells. On a more daily basis, people with diabetes typically check their blood using meters, which measure blood glucose. 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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