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Difference Between A1c And Glucose

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Your Diabetes Care Team Is Here To Help

What is the difference between A1c and Fasting Blood Glucose Testing?

Never avoid going to see your health care team because you feel like a failure or are afraid of disappointing them. The members of your diabetes care team are your coaches. They understand there are multiple life challenges that influence diabetes each day and night. Life is always changing, and you/your child will need support along the way. This is all part of the process of living with diabetes.

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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Unit of Measurement for glucose is mg/dL. The unit of measurement for A1c is a percentage.
Affects Factors that can affect the Glucose test or glucose concentration in a persons blood are medications, posture, acute stress, etc. Factors that can affect the A1c test are kidney disease, liver disease, any recent blood loss.

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What Are The Similarities Between A1c And Glucose

  • A1c and blood glucose are two tests a doctor uses to diagnose and confirm diabetes.
  • The regular A1c and glucose testing reveal whether the persons treatment is working well or need some adjustments.
  • Moreover, managing A1c and glucose is of utmost importance in order to prevent complications of diabetes, such as cardiovascular diseases.

What Happens To A Diabetic With Low Blood Sugar

Difference Between A1C and Glucose

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If you think you studied you might have high blood glucose already, Zanini says that any adjustments in your well being count as trigger to see your doctor Make Normal Blood Sugar Level an appointment to endure the diagnostic tests listed above and to debate treatment choices with your provider If you have excessive blood glucose and experience trouble respiration, vomiting, confusion, extraordinarily excessive thirst, or other signs of diabetic ketoacidosis, seek medical consideration right away This situation occurs when your physique burns fat too quickly and converts it into ketones, which make your blood acidic A doctor could prescribe anti diabetes medicine like metformin to Blood Sugar Levels Normal help decrease your blood glucose ranges.

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What Happens During An A1c Test

Some healthcare provider offices have an A1c machine that requires only a small drop of blood from the fingertip and provides a result in just a few minutes.

Other healthcare providers may order the A1c as a lab test to be drawn in the medical office, a hospital or a lab. The test usually takes less than five minutes, and it often takes a day or two to get the result.

The person drawing your blood will:

  • Ask you to expose your upper arm .
  • Put a tight band called a tourniquet around your upper arm.
  • Clean the area on the inner arm, where it bends.
  • Insert a thin needle into a vein.
  • Collect blood into a tube attached to the needle.
  • Remove the needle, then put a bandage on the tiny hole.

Application To The Real World

The GMI provides a clue as to what your next A1C result might be, but dont be surprised if they arent a perfect match. The good news is that most people had results within 0.5 percentage points, meaning the two values should still be somewhat close. The GMI may actually be more reflective of true average glucose since there is not any lab interference. Many healthcare offices have been relying on GMI more during COVID-19 when its been challenging to get the lab test.

While A1C and GMI provide a measure of how your glucose management is working, keep in mind that both are just averages. Try focusing on your Time in Range, a metric you can compare day-to-day and week-to-week. If you can increase your TIR, especially focusing on a TIR of 70% or greater, your GMI and A1C are much more likely to also reach their targets. However, if you dont reach your A1C and GMI goals, please dont be disappointed. Its possible to lower A1C and GMI by having tons of hypoglycemia, but this is not good for short-term or long-term health outcomes. If you focus on that Time in Range, you are more likely to feel good and have great diabetes outcomes.

This article is part of a series on Time in Range. The diaTribe Foundation, in concert with the Time in Range Coalition, is committed to helping people with diabetes and their caregivers understand Time in Range to maximize patients’ health. Learn more about the Time in Range Coalition here.

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Difference Between A1c And Serum Glucose

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Getting An A1c Test And Understanding Its Results

The difference between blood sugar and A1c

An A1c test requires either a blood draw or a finger prick and is often done at a doctors office or clinic.² An A1c test can sometimes be done at home, but the blood sample must still be mailed to a testing center to get the results.

A healthy range for A1c results can vary from person to persona doctor or healthcare professional should help you understand what A1c range is right for you.

The following guidelines from the National Institute of Diabetes and Digestive and Kidney Diseases can help you understand what A1c results may mean:

  • Below 5.7%usually normal for a nondiabetic person
  • Between 5.7% and 6.4%possible sign of prediabetes
  • Above 6.5%may indicate diabetes
  • Above 8%could mean the diabetes is not well-controlled

Sometimes you can get a false result. Things like iron deficiency anemia can give a false high A1c result, or a recent blood transfusion can create a false low result.

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Why Is My A1c High When My Blood Sugar Levels Are In My Target Range

Results of an A1C test and a blood glucose check don’t always match up. The A1C test measures your average blood sugar levels over a 120-day period . But a blood glucose check measures your blood sugar at a single moment. If your blood sugar levels were high last week, and you adjusted your diabetes treatment plan so that your blood sugar returned to normal, the A1C result may still be high, because it includes the high blood sugar levels from the previous week.

The A1C test measures the percentage of glycated hemoglobin in your blood. Glycated hemoglobin is created when molecules of hemoglobin attach to molecules of glucose . The more sugar you have in your blood, the higher your percentage of glycated hemoglobin.

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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A1c Tests Can Be Affected By Changes In Red Blood Cells Or Hemoglobin

Conditions that change the life span of red blood cells, such as recent blood loss, sickle cell disease, erythropoietin treatment, hemodialysis, or transfusion, can change A1C levels.

A falsely high A1C result can occur in people who are very low in iron for example, those with iron-deficiency anemia. Other causes of false A1C results include kidney failure or liver disease.

If youre of African, Mediterranean, or Southeast Asian descent or have family members with sickle cell anemia or a thalassemia, an A1C test can be unreliable for diagnosing or monitoring diabetes and prediabetes. People in these groups may have a different type of hemoglobin, known as a hemoglobin variant, which can interfere with some A1C tests. Most people with a hemoglobin variant have no symptoms and may not know that they carry this type of hemoglobin. Health care professionals may suspect interferencea falsely high or low resultwhen your A1C and blood glucose test results dont match.

Not all A1C tests are unreliable for people with a hemoglobin variant. People with false results from one type of A1C test may need a different type of A1C test to measure their average blood glucose level. The NGSP provides information for health care professionals about which A1C tests are appropriate to use for specific hemoglobin variants.

When Is An A1c Test Needed

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If you have diabetes, you should have an A1c test two to four times a year to see how youre managing it. Your healthcare team will recommend exactly how often you should get tested.

If you havent gotten diagnosed with diabetes, a healthcare provider may order an A1c test if you have symptoms of the condition. These symptoms include:

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How Do We Measure Blood Glucose Levels

You can check your blood sugar levels at home using a portable device called a blood glucose meter. Ideally, your blood glucose level before a meal should be between 4.0 to 7.0 mmol/L. Two hours after a meal the level should be between 5.0 to 10.0 mmol/L. Find more on blood sugar level targets when you have diabetes in this article.

Whole Blood Versus Plasma

Despite whole blood glucose being the most common measurement in medicine worldwide, we can begin this discussion with the observation that there is no internationally recognized reference method for the measurement of blood glucose.7 This difficulty stems from the composition of blood, being predominantly a mixture of plasma and the red blood cell hematocrit. Plasma is largely water , the rest being accounted for by protein and lipids. Red blood cells are also largely water , and water-soluble glucose can diffuse freely into that compartment. The concentration of glucose in the red cell is 0.763 of the concentration of glucose in plasma . The higher the hematocrit, the more the overall blood glucose concentration will reflect the red cells and vice versa. The difficulty in standardizing whole blood glucose measurements relies on this fact, and not surprisingly, the use of whole blood glucose standards improves the agreement of whole blood meters8 as does the simultaneous measurement of hematocrit.9

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Hemoglobin A1c Versus Fasting Venous Plasma Glucose

Table 1 also lists the correlation of HbA1c with fasting venous plasma glucose. As glucose levels are lower when fasting, the average glucose in these 33,563 samples was expectedly lower compared to the nonfasting samples . Furthermore, the slope of the HbA1c versus venous plasma fasting glucose was also decreased compared to the nonfasting slope .

The large number of points allowed further subanalysis, which reveals that the correlation was no different for the fasting venous plasma samples from women versus men, young versus old , nor in the summer versus winter quarters.

How Does The A1c Test Work

HbA1c vs Glucose: Whats The Difference?

A1c testing relies on hemoglobin. Hemoglobin is the part of the red blood cell that carries oxygen throughout the body. When you have glucose in your blood, it glycates to hemoglobin. The more glucose in your blood, the more it sticks. And it can stay there for around three months, or about how long the average red blood cell lives.

The A1c test measures the average amount of glucose thats been attached to hemoglobin over time. So the A1c test provides more information about blood sugar over a longer period of time than home monitoring does.

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You Have High Triglyceride Levels

Your triglycerides are a type of fat in your blood, serving as an energy source for your body. Your body can convert energy it doesnât need to burn right away into triglycerides. It then uses them as an energy source between meals.

The NIH has found that A1C levels can be an indicator of your triglyceride count. If one is high, the other most likely is as well. This is especially true if your diet is high in added sugars.

What Do The Results Mean

A1C results tell you what percentage of your hemoglobin is coated with glucose. The percent ranges are just a guide to what is normal. What’s normal for you depends on your health, age, and other factors. Ask your provider what A1C percentage is healthy for you.

To diagnose diabetes or prediabetes, the percentages commonly used are:

  • Normal: A1C below 5.7%
  • Prediabetes: A1C between 5.7% and 6.4%
  • Diabetes: A1C of 6.5% or higher

Providers often use more than one test to diagnose diabetes. So, if your test result was higher than normal, you may have another A1C test or a different type of diabetes test, usually either a fasting blood glucose test or an oral glucose tolerance test .

If your A1C test was done to monitor your diabetes, talk with your provider about what your test results mean.

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Your A1c Target Is Your Own

You are unique and you need advice based on your own set of circumstances. If someone who hears your A1C says, Your A1C level should be x, y, or z. Your response can be: I am working with my doctor on reaching my own safe diabetes target, and it has been customized for my condition.

A1C targets often change over time, sometimes decreasing and sometimes increasing. It all depends on the person and circumstances. Dont compare yourself or your child to others. Know your goals and be clear, persistent and honest in your approach to managing diabetes.

What If Your Test Says You Have A Higher Level Of A1c But You Do Not Have Diabetes

One Drop

High A1c levels do not always necessarily mean that you have diabetes. The NIH reports that high A1c causes include blood disorders like anemia, as well as liver disease, kidney failure, and sickle cell disease.

If your A1c levels are high, your doctor may perform a blood glucose test to diagnose or rule out diabetes. If you do not have diabetes, your doctor may order another type of lab test to identify the root cause of high A1c.

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How Often Do You Need The Test

Your doctor probably will have you take the A1c test as soon as youâre diagnosed with diabetes. Youâll also have the test if your doctor thinks you may get diabetes. The test will set a baseline level so you can see how well youâre controlling your blood sugar.

How often youâll need the test after that depends on several things, like:

  • The type of diabetes you have
  • Your blood sugar control
  • Your treatment plan

Youâll probably get tested once a year if you have prediabetes, which means you have a strong chance of developing diabetes.

You may get tested twice each year if you have type 2 diabetes, you don’t use insulin, and your blood sugar level is usually in your target range.

You could get it three or four times each year if you have type 1 diabetes.

You may also need the test more often if your diabetes plan changes or if you start a new medicine.

Itâs not a fasting test. You can take it any time of day, before or after eating.

People with diseases affecting hemoglobin, such as anemia, may get misleading results with this test. Other things that can affect the results of the hemoglobin A1c include supplements, such as vitamins C and E, and high cholesterol levels. Kidney disease and liver disease may also affect the test.

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