A1c Differences In Ethnic Populations And Children
In the ADAG study, there were no significant differences among racial and ethnic groups in the regression lines between A1C and mean glucose, although the study was underpowered to detect a difference and there was a trend toward a difference between the African/African American and non-Hispanic white cohorts, with higher values observed in Africans/African Americans compared with non-Hispanic whites. Other studies have also demonstrated higher A1C levels in African Amercans than in whites . A small study comparing A1C to CGM data in children with type 1 diabetes found a highly statistically significant correlation between A1C and mean blood glucose, although the correlation was significantly lower than in the ADAG trial . Whether there are clinically meaningful differences in how A1C relates to average glucose in children or in different ethnicities is an area for further study . For the time being, the question has not led to different recommendations about testing A1C or to different interpretations of the clinical meaning of given levels of A1C in those populations. Until further evidence is available, it seems prudent to establish A1C goals in these populations with consideration of both individualized SMBG and A1C results.
What Are The Risks Of Chronic High Blood Glucose Level
Increase your physical activity. You donât have to train to be an Olympic athlete, but you should strive to include a few short walks in your daily routine. Every step is crucial!
- Attempt to reach and maintain a healthy BMI .
- The BMI is the most fundamental indicator, but you should also consider your waist-hip ratio. A large amount of visceral fat has been related to an increased risk of diabetes and heart disease.
- Maintain a healthy, well-balanced diet. If youâre overweight, donât go over your daily calorie restriction, and attempt to eat even less. Say goodbye to processed meals and sweets.
- If you follow those recommendations, your hemoglobin A1C levels will almost certainly improve.
- A higher risk of cardiovascular disease, such as myocardial infarction or stroke.
- Thereâs a chance youâll get chronic renal disease or perhaps kidney failure.
- Nerve injury and paresthesia are more likely.
- There is a high risk of retinopathy and vision loss.
- Infections, including as skin infections and mycoses, are common.
- Difficulties with conceiving,
- Diabetic foot, which could cause amputation!
They may diagnose you with diabetes if your A1C result is equal to or higher than 6.5 percent. If this is the case, make an appointment with your doctor away!
A1c Levels In People With Diabetes
For people with diabetes, an A1C under 7% is typically considered good control. Research shows an A1C above 9% significantly increases the risk of diabetic complications. For adults with diabetes, the target A1C range is typically between 7% and 8%. This depends on your age and other health factors.
A1C levels correspond to the following average blood sugar levels:
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Create A Plan For Your Diabetes Management
Now that you have a better idea of what your pain points are, you can start making changes to your diabetes management.
Your doctor may suggest a different medication regime. For example, some people are prescribed Metformin to help with Dawn Phenomenon . Others may need adjustments to insulin dosing, etc.
If youre insulin-dependent and consistently have high blood sugars in the morning, getting your blood sugar fluctuations and A1c down might be as simple as adjusting your nighttime basal insulin. Or, if you run high every day after meals, your carb-to-insulin ratio might be off, and adjusting that could be what sets you on a path of a lower A1c. Until you collect the data and do the analysis, you have no way of knowing this.
I want to make an important point here: increasing your diabetes medication is not a sign of failure! Its often the best way to control your blood sugar and bring down your A1c.
I adjust my insulin up and down all the time when I change my diet or exercise routine. Adjusting your medication is an important tool in your diabetes toolbox and something you should always discuss with your medical team.
Using The Gmi To Estimate Your A1c: How Accurate Is It
GMI provides an estimated A1C level based on continuous glucose monitoring data and can avoid some of the limitations of A1C tests. A recent study compared actual A1C levels with GMI to see how the two compared in the real world.
The A1C test is commonly used to assess a persons glucose management. A higher A1C is associated with higher glucose levels and more health complications. Although long considered a gold standard in diabetes care, the A1C has a huge limitation: its just an average. A person could spend a lot of time with low blood sugar levels and a lot of time with high blood sugar levels, yet have an A1C under 7%, which is the target for most people with diabetes. You can learn more about the limitations of A1C here.
For those who wear a continuous glucose monitoring system , the glucose management indicator essentially estimates A1C in fact, it used to be called an estimated A1C. Without the need for a blood draw, it takes the average of your glucose readings and uses a formula to estimate what your A1C is expected to be. To calculate GMI you should have at least 14 days of data.
Your glucose management can also be measured by Time in Range , Time Below Range and Time Above Range . Generally, a Time in Range of 70% or greater is equivalent to an A1C of 7% or less. This data is quite useful to see if you are meeting your glucose targets or if you need to adjust your diabetes treatment plan. Learn about TIR and how it can help your diabetes management here.
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Medications Used To Improve A1c Results
- Insulin: Typically given by injection or through a pump to increase glucose uptake by cells and thus decrease blood sugar
- Sulfonylureas: Increase insulin production by stimulating insulin-producing beta cells in the pancreas
- Alpha-glucosidase inhibitors: Help your body break down starches and sugars found in food, lowering your blood sugar levels
- Biguanides: Decreases the amount of sugar your liver produces, as well as how much sugar your intestines absorb and makes your body more sensitive to insulin. The most common biguanide is metformin.
- Dopamine agonist: Work by affecting the way the brain processes dopamine, an important neurotransmitter . By increasing the activity of dopamine receptors, dopamine agonists increase insulin sensitivity, allowing cells to use blood glucose more effectively and lower blood sugar.
- DPP-4 inhibitors: Help the body continue to make insulin, which lowers blood sugar
- GLP-1 receptor agonists: Increase growth of insulin-producing beta-cells in the pancreas, slow stomach emptying, and decrease appetite and how much glucagon your body uses
- Meglitinides: Similar to sulfonylureas meglitinides stimulate the pancreas to release insulin in response to a meal. This increase in insulin production helps lower blood sugar.
- SGLT 2 inhibitors: Prevent the kidneys from holding on to glucose and increasing its excretion in urine
- Thiazolidinediones: Decrease glucose in your liver and also help your fat cells better utilize insulin
What To Do If Your A1c Level Is 69
- Move your body every day. Aim for 30-60 minutes of moderate exercise 5 days per week.
- Fill half of your plate with non-starchy veggies at every meal, as well as some lean protein and plant-based fat to assist with blood sugar control.
- Limit refined carbohydrates and added sugar, and choose whole-grain carbohydrates such as whole wheat bread/ pasta, quinoa, farro, and steel-cut oats, instead.
- Lose excess weight if you are overweight or obese.
- Manage stress and get adequate sleep to help balance hormone levels that can impact blood sugar.
- Follow your diabetes treatment plan if you have been diagnosed with diabetes.
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How To Lower Sugar Levels
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Diabetes Tracking And Treatment
- Follow your diabetes treatment plan: Understand the treatment plan before leaving the healthcare providers office and discuss barriers that could prevent you from following the program. Attend all follow-up visits.
- Consistently take prescribed medications: If a healthcare provider has prescribed medications to reduce blood sugar levels, take them regularly. Some people only take medication when they arent feeling well, but these medications dont work unless taken consistently.
- Monitor and track blood sugar: Regular blood sugar monitoring is the most important step in diabetes management, according to the CDC. Healthcare providers can inform patients of different types of meters and help patients find the best one for them. Providers can also tell patients how often to check their blood sugar and what their target blood sugar range is.Keep a log of your blood sugar levels to look for patterns and triggers for blood sugar spikes and lows. If you wear a continuous glucose monitor, you can use the data. Learning what causes blood sugar to rise or decrease can help you create a plan to keep it consistent.
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How Do You Measure A1c
A1C is typically measured by a blood test, also called a blood glucose test, ordered by your doctor. Compared to traditional blood glucose tests, fasting is not required for A1C tests.
You can also measure A1C levels at home with digital A1C meters. To use one, you typically prick a finger with a lancet or fingerstick, add a drop of blood to a test strip, and insert the strip into the meter. While convenient, the reliability of readings from at-home A1C tests is debated.
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Can Your A1c Be Too Low
As described above, the answer to this question depends almost entirely on how often you experience hypoglycemia . If you never experience hypoglycemia, your A1c technically cannot be too low. Some people achieve A1c levels below 5% by following a very strict diabetes management and diet regimen and have almost no blood sugar fluctuations.
HOWEVER, if you often experience hypoglycemia, that will result in an artificial low A1c reading because your hypoglycemia events are lowering your blood sugar average. In that case, focusing on increasing time-in-range is much more important than further lowering your A1c. In fact, you may even benefit from a slightly higher A1c with fewer blood sugar fluctuations.
Its also important to note that lowering your A1c below the recommended range of 6-7% hasnt been proven to provide any health benefits. Therefore, a very low A1c shouldnt be a goal in itself.
Average From A Glucose Meter
Although an A1C level gives you a sense of average glucose levels over the past few months, a person with type 1 or type 2 diabetes needs a blood glucose meter to check blood sugar and make treatment decisions on a day-to-day basis.
If you test often during the day like before and after meals and other times that your blood sugar can vary and use an accurate glucose meter, this can give you valuable information on daily variations in blood sugar levels. Many blood glucose meters are also equipped to provide 7, 14, 30, or 90-day averages. A 90-day average on your meter can be used in the calculator above to estimate how it may correlate to an A1C.
Glucose meter averages are based on the frequency that you have tested per day, so if you do not have many data points or are unable to test at certain times , it probably wont give you a full picture of your blood sugar levels and may skew lower than an A1C test result.
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Medications With A1c Of 69
There are a variety of medications available to treat diabetes. Type 1 and type 2 diabetes are generally treated with different medications.
Type 1 diabetics need insulin to replace what their body no longer produces. There are four main forms of insulin.
- Rapid-Acting Injections The insulin takes effect within 5 to 15 minutes and lasts for 2 to 4 hours. Popular brands include Humalog and NovoLog
- Short-Acting Injections The insulin takes effect between 30 minutes and 1 hour and lasts for 3 to 6 hours. Often referred to as regular insulin, popular brands include Humulin R and Novolin R.
- Intermediate-Acting Injections The insulin takes effect between 1 to 4 hours and lasts for 12 to 18 hours. Often referred to as NPH insulin, popular brands include Humulin N and Novolin N.
- Long-Acting Injections The insulin takes effect after 1 or 2 hours and lasts up to 24 hours. Popular brands include Lantus, Toujeo, Levemir and Tresiba.
Type 1 diabetics may also take a premixed injection of the above to better manage their specific blood sugar levels throughout the day. In addition, your doctor might prescribe one of the following type 2 diabetes medications in conjunction with insulin.
Insulin can also be used to treat type 2 diabetes but doctors often resort to insulin only after other medications have failed to control a patients blood sugar.
The good news is there are a lot of type 2 diabetes medications out there.
Follow The Diabetes Treatment Plan Your Healthcare Team Recommends
Diabetes treatment is very individualized, noted a February 2022 article in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. After all, factors including how long youve lived with the disease, your socioeconomic status, and any other conditions youre living with can play a role in the best treatment approach for you.
Your healthcare team will help you determine which steps to take to successfully manage diabetes. Always talk to your doctor before making any changes, such as starting a diet very low in carbohydrates or beginning a new exercise regimen. This is especially important before making any medication or insulin changes.
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A glucose levels chart can help identify a persons normal and abnormal blood sugar levels. This is particularly important for men over 60 since diabetes, a disease in which the body loses its normal ability to control blood sugar, is relatively more common with age. The chart is often used to help set target goals.
A normalbloodsugar is lower than 140 mg/dl. A bloodsugar between 140 and 199 mg/dl is considered to be prediabetes, and a bloodsugar of 200 mg/dl or higher can indicate diabetes. Someone who does not have diabetes is unlikely to be checking their bloodsugars. Dec 28, 2019 · I always check my bloodsugar between 2am and 4am every day. If my bloodsugar level is over 200 then I take between 13 and 16 units of Regular insulin. If my bloodsugar lever is between 150-199, then I take 7-12 units of Regular insulin..If my bloodsugar is between 100 and 149 then I take between 6 and 8 units of Regular insulin.. Blood Sugar Levels Chart Charts: mmol/l *This chart shows the blood sugar levels from normal to type 2 diabetes diagnoses. Category Fasting value Post prandial / aka post meal Minimum Maximum 2 hours after meal Normal 4 mmol/l 6 mmol/l Less than 7.8 mmol/l.
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