Factors That Could Contribute To An A1c Level Of :
- Diet, particularly those low in fiber and high in refined carbohydrates and added sugars
- Overweight/ obesity
- Kidney failure, liver disease, or severe anemia
- Certain medicines, including opioids and some HIV medications
- Blood loss or blood transfusions
- Early or late pregnancy
- A less common type of hemoglobin found in people of African, Mediterranean, or Southeast Asian descent, as well as people with blood disorders like sickle cell anemia or thalassemia
How A1c Measures Blood Sugar
An A1c test is also known as glycated hemoglobin, glycohemoglobin, or HbA1c. It measures the amount of glucose in your blood. More specifically, it checks hemoglobin, an iron-rich protein that transports oxygen and nutrients throughout the body.
Glucose binds to hemoglobin, creating glycated hemoglobin compounds. The higher your blood glucose level, the more glucose attaches to the hemoglobin. Hemoglobin cells last about 90 days, so the A1C provides an overall picture of your blood sugar control for the previous three months.
For people without diabetes, A1C tests are recommended every three years in adults over the age of 45 and anyone with a high risk of diabetes. Risk factors include a family history of diabetes, a BMI above 25, high blood pressure, a history of heart disease, and a lack of physical activity.
For people with diabetes, regular A1C monitoring can catch a spike in blood sugar levels early. An increase should prompt your healthcare provider to re-evaluate your treatment plan. This may include a review of your medications, diet, and how often your test your blood sugar.
Is The A1c Test Accurate For Everyone
Since the A1C test has been made available , is has become a common way to measure glucose control. However, in the last several years some questions have been raised about potential limitations of A1C:
- Is the A1C accurate for everyone?
- It may not be accurate for some people, including people of African-American descent, people with liver and kidney disease, or with some anemias and sickle cell disease.
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Use This Chart To View A1c Values And Comparable Blood Glucose Values:
A note of caution: the A1c measurement is not always accurate. For example, if someone has certain type of hemoglobin mutations , is severely anemic , iron deficient or is being treated blood transfusions or medications to increase the production of new red blood cells, the A1c test may not be accurate.
If your finger-stick blood tests give an average blood sugar that is much higher or lower than your A1c test, ask your doctor if the A1c is the right test for you. An alternative test to the A1c is a fructosamine test. Unfortunately, the fructosamine test and the A1c are not interchangeable because they are measuring different things. The fructosamine test reflects the average blood sugars only over a 2-3 week period.
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: Reduce 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: These medications 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
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What Does The A1c Test Measure
When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. Everybody has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin.
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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How Often Do I Need An A1c Test
This calculator only estimates how the A1C of someone who self-monitors quite frequently might correlate with their average meter readings. But many factors can affect blood glucose, so it’s critical to have your A1C checked by your doctor regularly.
The ADA recommends an A1C test at least 2 times a year for those who are in good control. For those who have changed their therapy or who are not in good control and not meeting glycemic goals, an A1C test is recommended quarterly. Your doctor will help you decide what’s right for you.1
How Can I Treat High Blood Sugar
Talk to your doctor about how to keep your blood sugar levels within your target range. Your doctor may suggest the following:
- Be more active. Regular exercise can help keep your blood sugar levels on track. Important: dont exercise if ketones are present in your urine. This can make your blood sugar go even higher.
- Take medicine as instructed. If your blood sugar is often high, your doctor may change how much medicine you take or when you take it.
- Follow your diabetes meal plan. Ask your doctor or dietitian for help if youre having trouble sticking to it.
- Check your blood sugar as directed by your doctor. Check more often if youre sick or if youre concerned about high or low blood sugar.
- Talk to your doctor about adjusting how much insulin you take and what types of insulin to use.
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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 youre doing.
Glysolated Hemoglobin 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 doesnt 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 dont vary too much.
How To Monitor Blood Sugar
Your doctor will tell you how often to check your blood sugar at home. Checking blood sugar at home can be done in several ways. You can use a blood glucose monitor to check your blood sugar. This method uses a finger stick device to get a drop of blood. Then, you put a drop of blood on a test strip, which is inserted into the monitor. The monitor will then give you a reading of your blood sugar.
Another method of checking blood sugar is continuous glucose monitoring or CGM. This method places a sensor on the body, with a tiny attachment that goes under the skin. CGMs monitor interstitial blood sugar, the sugar found in fluid between cells. The data is transmitted to a receiver or an app on the patients mobile phone. Data is updated frequently. Depending on which CGM you use, your glucose data is updated every one to five minutes. This is especially useful in patients who use insulin and need frequent readings to make treatment decisions.
Your healthcare provider will give you a treatment plan. You will have a target blood sugar range. Depending on your diagnosis, your provider will give you more information on what to do if your blood sugar is too low , or if your blood sugar is too high .
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How To Lower Your A1c: The Complete Guide
We are always told that having a low A1c is an important goal in our diabetes management, but do you know why? Do you know what a good A1c target is, how to lower your A1c, and how quickly you can lower your A1c safely?
These are the questions I will answer in this comprehensive guide on what A1c is, how to lower your A1c, and why achieving a low A1c isnt the only goal when it comes to diabetes management.
How To Calculate A1c To Average Blood Sugar
There’s nothing more simple than using our A1c calculator. Just input the level of hemoglobin A1c from your laboratory test to get your result immediately. You can freely switch between units in both the hemoglobin and average blood sugar fields.
For those curious about the actual calculations, here is the A1c to average blood sugar formula:
Average Blood Sugar = HbA1c * 28.7 – 46.7
If you want to convert hemoglobin A1c level from a percent to millimoles per moles , use the following equation:
HbA1c = HbA1c * 10.93 – 23.5
To do the reverse calculation , use this formula:
HbA1c = HbA1c * 0.09148 + 2.152
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What Is A High A1c
A1C results show the percent of glucose and hemoglobin bound together in your bloodstream. For example, a 5% A1C indicates five out of every 100 hemoglobins are glycated. The higher your A1C, the greater the risk of developing complications.
The A1C ranges for normal, prediabetes, and diabetes are:
- Normal: Less than 5.7%
- Prediabetes: 5.7% to 6.4%
- Diabetes: 6.5% or higher
Talk to your healthcare provider if your A1C is in the prediabetic range. Prediabetes is a risk factor for type 2 diabetes. A diet change, increased activity, and moderate weight loss can help improve blood sugar control to prevent diabetes.
What Is An A1c Test
The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It’s also called HbA1c, glycated hemoglobin test, and glycohemoglobin. Itâs a lot like a baseball player’s season batting average. A single game doesn’t tell you how a player is performing in their career. And 1 day’s test results don’t give you the complete picture of how your treatment is working.
People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes.
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You Have An Abnormal Hemoglobin Variant
Did you know there are a number of variants of hemoglobin? The most common type is hemoglobin A. Itâs not common to know your type, but if youâre wondering whatâs leading to elevated A1C levels, you may want to check yours with your doctor.
Type HbAS, which is most commonly observed in people of African descent, is an inherited blood disorder that can lead to false A1C readings that may not accurately reflect your glycemic control.
To find out what types you have, you might talk to your doctor about considering a blood test called the hemoglobin electrophoresis test.
Why Does Blood Sugar Matter With Diabetes
Diabetes is a condition that makes it difficult or impossible for the body to regulate glucose levels on its own. When someone is living with diabetes, their body is either unable to produce enough insulinor make enough insulin available for use. Insulin is a hormone that helps the body use glucose for energy. When insulin levels are too low, glucose accumulates in the bloodstream and can damage organs and other tissues.
Diabetes occurs when a persons body cannot adequately manage sugar thats ingested normally in our everyday diet, says Jennifer Meller, M.D., chief medical officer at Sweetcha digital health care innovation company based in Tel Aviv, Israel. Chronically elevated sugar levels can lead to changes in both large and small blood vessels.
Over time, changes to large vessels can lead to an increased risk of heart attack and stroke, while damage to small vessels can cause nerve damage, vision loss and kidney failure, explains Dr. Meller.
For people living with diabetes, maintaining healthy blood sugar levels is essential to preventing serious health complications in the future. This requires understanding target glucose levels for different age groups and making lifestyle changes accordingly, as blood sugar can go up or or down based on what you eat and when, among other factors.
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What Is The Cost Benefit Of Lowering A1c
Recently the ADA published analysis diabetes costs. They showed total estimated costs of $327 billion with $237 billion on direct costs and $90 billion in indirect costs.5Economic costs of diabetes continues to rise.
Data from numerous studies show that better A1C results in lower total healthcare costs.6 A study using claims data from a large health maintenance organization showed that the group of mainly type 2 patients whose A1C was lowered by 1% experienced lower total health care costs in the range of $685 to $950 less per year compared to people who had no A1C improvement.
Another analysis from a large managed care organization showed that total diabetes-related costs for people whose A1C was greater than 7% was $1,540 per patient during the 1-year follow-up. This was 32% higher than the total diabetes-related costs for people whose A1C was at or below 7%.
Understand Nutrition And Adjust Your Diet
What you choose to eat and drink can have a major impact on not only your waistline, mood, and well-being, but also on your blood sugar levels.
All macronutrients can affect your blood sugar to some degree so developing a good understanding of how they affect your blood sugar will enable you to be proactive and prevent blood sugar swings.
Carbohydrates have the greatest impact on your blood sugar, which is why many people with diabetes can benefit from following a low- to medium-carb diet . The fewer carbs you eat, the less insulin you need to take, which makes diabetes management easier.
However, you dont have to follow a low-carb diet if it doesnt work for you physically or mentally. As I wrote in my post about which diet is best for people with diabetes, it is very possible to have great blood sugar control on a medium carb diet, as long as you experiment, take notes, and learn to take the right amounts of insulin for the carbs you are eating.
It is very important to realize that we all react differently to carbs so you have to find the diet and foods that are right for you.
As an example, people react very differently to carbs like oats or sweet potato. Some people can eat oats with only a small increase in blood sugar while others see a quick spike. By simply knowing this, people struggling with a certain type of carb can choose to reduce their consumption or cut it out of their diet altogether.
Protein & fats
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Why Your A1c Level Matters
Diabetes is the seventh leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. Most cases of type 2 diabetes can be managed with diet, exercise, and medication, but uncontrolled blood glucose levels increase the risk for heart disease, stroke, eye problems, foot and leg amputations, and kidney failure.
Approximately 30.3 million Americans have diabetes that’s about 9 percent of the U.S. population. Of those living with diabetes, 7.2 million are undiagnosed. Another 84.1 million American adults have prediabetes, meaning they’re at risk of developing diabetes without medical intervention and lifestyle changes. Regular A1C testing would help your doctor catch the disease early, often while it’s preventable. If you’ve already been diagnosed with diabetes, your A1C tells your doctor whether the current treatment plan is working.
How The Test Works
The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound.
Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months.
If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher.
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