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Average A1c For A Diabetic

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What Does The A1c Test Measure

What Is a Good Score on the A1c Diabetes Test?

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.

Hemoglobin A1c Not Reliable In Diagnosing Type 2 Diabetes

With Maria Mercedes Chang Villacreses, MD, and Elena Christofides, MD, FACE

The test that doctors most often rely on to detect a persons risk for prediabetes and type 2 diabetesthe hemoglobin A1c blood testtoo often delivers a poor reading, thereby missing the diagnosis in nearly three out of four at-risk individuals,1 according to research presented at the Endocrine Society meeting in New Orleans, Louisiana.

The investigators compared the accuracy of the A1c test with the other screening method used to assess patients risk of diabetesthe oral glucose tolerance test to arrive at this startling conclusion.1

The common use of the hemoglobin A1c test to screen for prediabetes and type 2 diabetes should be skipped in place of more reliable tests. Photo: 123rf

“The A1c missed almost 73% of the people with diabetes in comparison to the oral glucose tolerance test,” says Maria Mercedes Chang Villacreses, MD, a clinical endocrinology fellow at the City of Hope Diabetes and Metabolism Research Institute in Duarte, California, who introduced the findings at the annual meeting of the Endocrine Society but are considered preliminary until published in a peer-reviewed medical journal.

Since the fasting blood test requires a person to fast, the OGTT measures the body’s response to sugar it requires a person to fast overnight. First, blood is taken, then the person drinks a sugary drink. Blood is taken again two hours later.

How To Lower Your A1c Levels

Its important to get your hemoglobin A1C levels as close to normal as possible, says Dr. Bellatoni, Decreasing your hemoglobin A1C decreases your risk of having complications from diabetes. Even if you cannot get your A1C back to the normal range, any improvement lowers your risk of diabetes complications.

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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.

How Often Should You Check Your Hemoglobin A1c Levels

A1c #Diabetes Chart.

The American Diabetes Association suggests if people with diabetes want to reduce their hemoglobin A1c levels quickly, they should get their hemoglobin A1c levels checked every three months until they reach their treatment goals.

People with diabetes who are meeting treatment goals and have stable blood control are recommended to check their hemoglobin A1c every six months according to the ADA.

Tracking hemoglobin A1c levels allows an individual and their health-care professional to determine how well the person is controlling their blood sugar levels over time. However, they are not a substitute for daily glucose monitoring.

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Why Should A Person Get The A1c Test

Testing can help health care professionals

  • find prediabetes and counsel you about lifestyle changes to help you delay or prevent type 2 diabetes
  • find type 2 diabetes
  • work with you to monitor the disease and help make treatment decisions to prevent complications

If you have risk factors for prediabetes or diabetes, talk with your doctor about whether you should be tested.

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Large Trial Compared Usual Tools For Assessing For Diabetes In Adults

The researchers looked at data from 9,000 adults, ages 20 years and older, from the 2005-2014 National Health and Nutrition Examination Survey . The information collected by the research team included body weight and blood test results.

Based on the fasting blood glucose test and the OGTT, 765 patients were diagnosed as having type 2 diabetes . However, only about 27% of these individuals were classified as having diabetes based on their A1c levels, which is how Dr. Villacreses and her team determined that nearly three-quarters of those at risk for diabetes were not aware that they had this chronic disease, and therefore were not receiving treatment.1

“Most worrisome, 73 % of patients would have missed out on early intervention and treatment,” she tells EndocrineWeb. While the A1c test is convenient, ”we recommend that we do not rely solely on this number,” Dr. Villacreses says.

The guidelines for diagnosis and treatment of type 2 diabetes from the American Diabetes Association already advise against relying solely on A1c,3 she says. While the American Diabetes Association guidelines specify that diabetes can be diagnosed based on fasting plasma glucose , the OGTT, or the A1c, our findings confirm that reliance on A1c remains the least reliable method for assessing diabetes risk.

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Oral Glucose Tolerance Test

The OGTT is a two-hour test that checks your blood sugar levels before and two hours after you drink a special sweet drink. It tells the doctor how your body processes sugar.

  • Diabetes is diagnosed at 2 hour blood sugar of greater than or equal to 200 mg/dl

Oral Glucose Tolerance Test

Normal
140 mg/dl to 199 mg/dl
Diabetes 200 mg/dl or higher

What Is The A1c Test Measuring

Diabetes A1c Test

There can be several reasons for a spike in blood sugar levels, and itâs a good idea to know whatâs causing yours. But first, itâs essential to understand what A1C is and what the A1C test measures.

Any sugar that enters your bloodstream attaches itself to your hemoglobin on your red blood cells. The A1C test measures the amount of glucose âstuckâ to the hemoglobin, which provides a good proxy of how much average blood glucose was in your bloodstream over a two to three-month period.

A simple way to remember how to read the results is: the higher the percentage, the higher the risk of diabetes. According to the Centers for Disease Control and Prevention, under 5.7% is a regular A1C reading. A reading between 5.7% and 6.4% is considered a pre-diabetic range, while values above 6.4% indicate diabetes.

Before you start overanalyzing your results, remember that there are variables at play. For example, the U.S. National Library of Medicine found that adults without a history of diabetes often have A1C levels at 6% or greater. This means not every higher test result is cause for concern. Still, itâs worth checking with a doctor if you see consistently high values. High A1C levels lead to impaired fasting glucose, and an increased risk of type 2 diabetes and cardiovascular diseases.

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What Does This Mean For People Wondering About Their Diabetes Risk

For individuals who havent received a diagnosis of diabetes, Dr. Villacreses says, one important lesson from these fidings is that ”you should not feel 100% reassured if your A1c number is less than 6.5% that you are do not have diabetes. A test result that is greater than 6.4% defines the beginning of diabetes, so you may have prediabetes or have already progressed to type 2 diabetes.

The sooner you receive a diagnosis regarding your diabetes status, the earlier treatment can begin. This is important because by understanding your risks, and making the necessary lifestyle changes, you can prevent prediabetes from progressing or even reverse the type 2 diabetes.

In addition, she says, patients should feel comfortable asking their doctor about the choice of tests and indicate your desire to skip the A1c, and have one of the other more reliable screening methods, while more time consuming, to determine if you are at risk for pre-diabetes or diabetes.

Dr. Villacreses has received research funding and speaking fees from a variety of pharmaceutical companies but none that pose a conflict in this research. Dr. Christofides has no relevant financial disclosures.

Endos Comment On The Highest A1cs Seen

Dr. Silvio Inzucchi at the Yale School of Medicine is a diabetes guru who wrote a go-to e-book for clinical facts, Diabetes Facts and Guidelines. He told DiabetesMine, The highest we usually see is in the 12-14 percent range, though I think Ive seen an 18 percent a long time ago.

In the same ballpark is Donna Tomky, a New Mexico nurse practitioner and diabetes educator who has been past president of the American Association of Diabetes Educators .

Over the years, Ive seen an A1C as high as 19 percent in a type 1 individual who purposely omitted insulin and was admitted for DKA, she said.

In terms of youth and children, Dr. Shara Bialo, a pediatric endocrinologist and fellow T1D in New Jersey, told DiabetesMine that her clinic uses the same point-of-care A1C test that only goes as high as 14 percent. But when one of her patients lands in the hospital, a serum draw is done to determine that persons A1C.

The highest I have seen personally is a 17 percent, but my colleague had a patient with a 19 percent, she said, noting both were teenagers with established T1D and one of whom just found out she was pregnant.

Dr. David Hite, a diabetes education consultant based in California, reports: I had a patient in the clinic with a 17 percent. Thats rare. I usually see new diabetics in the clinic under 14 percent. They come in because they feel like crap and cant tolerate conditions needed to get it lower.

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What Do Your A1c Results Mean

The A1C test measures the glucose in your blood by assessing the amount of whats called glycated hemoglobin. Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin, or glycates. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin, Dr. Dodell says.

According to the ADA, A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 percent signals prediabetes, according to the ADA. Type 2 diabetes is diagnosed when the A1C is at or over 6.5 percent. For many people with type 2 diabetes, the goal is to lower A1C levels to a healthier percentage.

Your A1C goal is specific to you. Several factors come into play, such as your age, how advanced the diabetes is, and any other heath conditions you have. A common A1C goal for people with diabetes is less than 7 percent, Dodell says. If you can keep your A1C number below your goal, you help to reduce the risk of diabetes complications, such as nerve damage and eye problems.

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Small Changes In Temperature Equipment Or Sample Handling

A1c Levels Chart For Type 1 Diabetes

Even when the same blood sample is repeatedly measured in the same lab, the results may vary because of small changes in temperature, equipment, or sample handling. These factors tend to affect glucose measurementsfasting and OGTTmore than the A1C test.

Health care professionals understand these variations and repeat lab tests for confirmation. Diabetes develops over time, so even with variations in test results, health care professionals can tell when overall blood glucose levels are becoming too high.

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The 411 On A1c: Normal A1c Levels And 15 Ways To Lower High A1c

The hemoglobin A1C test is the closest thing to a diabetes scorecard you can find. Whether someone has had diabetes mellitus for years or if they have just been diagnosed, they have probably heard about this test. Unlike blood sugar meters people use at home, the A1C measures an average blood sugar level over the past several months by analyzing how many of a patients hemoglobin cells have glucose attached to them. The test results keep track of how well a person is managing his or her diabetes.

How To Lower Your A1c

Now that you have a thorough understanding of A1c and time-in-range, as well as why looking at your A1c in isolation isnt optimal, the obvious question is:

How do you lower your A1c while improving or sustaining your time-in-range?

I will cover the four most important things you can do below but its always recommended that you start by having a conversation with your medical team before making changes to your diabetes management.

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What A1c Goal Should I Have

People will have different A1C targets, depending on their diabetes history and their general health. You should discuss your A1C target with your health care professional. Studies have shown that some people with diabetes can reduce the risk of diabetes complications by keeping A1C levels below 7 percent.

Managing blood glucose early in the course of diabetes may provide benefits for many years to come. However, an A1C level that is safe for one person may not be safe for another. For example, keeping an A1C level below 7 percent may not be safe if it leads to problems with hypoglycemia, also called low blood glucose.

Less strict blood glucose control, or an A1C between 7 and 8 percentor even higher in some circumstancesmay be appropriate in people who have

  • limited life expectancy

How Often Do You Need To Take An A1c Test

U-M Type 1 Diabetes 101 | Module 3 | A1c

If your blood sugar levels have remained stable, the American Diabetes Association recommends getting the A1C test two times each year. If your therapy has changed or you are not meeting your glycemic targets, the ADA recommends getting the test four times per year. This simple blood draw can be done in your doctor’s office.

The A1C test results provide insight into how your treatment plan is working, and how it might be modified to better control the condition. Often your blood sample is sent out to a lab for your results though some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes. Such an in-office test can be used to monitor your condition.

Nonetheless, the National Institute of Diabetes and Digestive and Kidney Diseases notes that point-of-care tests should not be used for diagnosis, which can only be done by lab tests certified by the NGSP. Any results pointing to a change in your health should be confirmed by conventional lab tests.

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Natural Ways To Bring Hba1c Normal

Those who have higher levels of HbA1c can bring down the level of HbA1c to the normal range through medications. Apart from this, there are some natural ways as well which can bring your HbA1c normal. These include:

  • Quit smoking to get haemoglobin A1c levels down.
  • You should eat a balanced and healthy diet to maintain the immune system and hormonal balance.
  • Exercising is another natural way to control the increased glycosylated haemoglobin levels and it helps in losing weight and lowering blood sugar which ultimately results in enhancing insulin sensitivity.
  • Adopt a healthy lifestyle to keep your blood sugar levels in control.

You can easily achieve this without disturbing your daily schedule like Ms. Dheeraj Sabharwal who has been able to reduce her HbA1c level from 9.8 to 6.2 by switching on to a healthy lifestyle with the constant support and motivation of Diet Coach, Fitness Coach along with the Diabetologist. She has successfully reversed diabetes while pursuing her teaching profession and also taking care of the family.

How Often Should I Get Tested

If you are at risk for diabetes or prediabetes and have not been diagnosed, an A1c test can help you determine whether you have the condition or are likely to develop diabetes. Because prediabetes usually does not present any signs or symptoms, its important to identify your risk factors and notify your doctor.

How often you get tested depends on your diagnosis and your treatment plan. Here are some general recommendations:

  • If you are prediabetic, you should get tested annually to monitor your risk of progressing to diabetes.
  • Patients with type 2 diabetes who do not use insulin and whose A1c levels are consistently in the target range may only need the test twice a year.
  • If you have type 1 diabetes, you should be tested three to four times per year.
  • Patients with type 2 diabetes who use insulin for diabetes management or have difficulty keeping their blood sugar in their target range should be tested four times a year.

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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.

  • My perspective on A1c as a person living with diabetes
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