What To Do If Your A1c Is 66
An A1c of 6.6 falls into the diabetic range between 6.5 and 10.0.
Reducing an A1c of 6.6 will take a combination of medication and lifestyle modifications. Seek medical advice to gain control of your blood sugar and avoid further damage to critical organs.
Keep an eye on your blood sugar by testing at home. Its easier than ever and there are a variety of affordable blood glucose monitors available.
Diabetes is manageable but only if you stick to a plan and monitor your progress with the help of your doctor.
Top Diabetes Exercise Mistakes And How To Avoid Them
Physical activity can help prevent diabetes from beginning and progressing so long as you do it smartly. Avoid these common mistakes in the gym for a safer, more effective workout.
Right now more than ever, staying healthy is priority No. 1. According to the American Diabetes Association , scientists dont know if people with diabetes are at an increased risk of contracting the novel coronavirus that causes COVID-19, but its clear that they are at a higher risk for complications if they are infected. Dont let that add to your worries. Rather, take this fact as a push to make sure youre managing your blood sugar as well as you can.
Exercise can help, but people with diabetes need to keep a few factors in mind to stay safe. Some people may experience hypoglycemia when they exercise, while others report blood glucose spikes if they work out at certain times of the day or for longer than usual.
But dont let that deter you from exercising. Making sure youre being active and eating healthy will help prevent the progression of the disease, says Jessica Crandall Snyder, RDN, CDE, CEO of Vital RD in Englewood, Colorado.
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With your doctors approval, no type of exercise is off-limits biking, walking, stair climbing, and lifting weights are all good ideas.
A1c And Microvascular Complications
Hyperglycemia defines diabetes, and glycemic control is fundamental to diabetes management. The Diabetes Control and Complications Trial , a prospective randomized controlled trial of intensive versus standard glycemic control in patients with type 1 diabetes, showed definitively that better glycemic control is associated with 5076% reductions in rates of development and progression of microvascular complications. Follow-up of the DCCT cohorts in the Epidemiology of Diabetes Interventions and Complications study demonstrated persistence of these microvascular benefits over two decades despite the fact that the glycemic separation between the treatment groups diminished and disappeared during follow-up.
The Kumamoto Study and UK Prospective Diabetes Study confirmed that intensive glycemic control significantly decreased rates of microvascular complications in patients with short-duration type 2 diabetes. Long-term follow-up of the UKPDS cohorts showed enduring effects of early glycemic control on most microvascular complications .
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Diagnosing With And Interpreting The A1c
The A1C test is one way to diagnose diabetes. A fasting plasma glucose, oral glucose tolerance and a random blood glucose > than 200 with signs and symptoms of diabetes are all acceptable ways to diagnose diabetes. The important thing to remember is that each test must be repeated and there needs to be 2 abnormal lab results for a diagnosis. For instance, if someone had an A1c of 6.6% and a FPG of 135, that would be considered a diagnosis of diabetes. Or if a person had two subsequent A1Cs at 6.5% or above, that would also be a diagnosis.
Source: Adapted from American Diabetes Association. Standards of medical care in diabetes2012. Diabetes Care. 2012 35:S12, table 2.
Once you have been diagnosed, you and your doctor will want to know your A1C is on a regular basis. The test is an indicator of your risk for complications and gives your provider feedback on how well the treatment plan is working. Diabetes is a progressive disease and what works now for treatment, may not be the same thing that works 2 or 3 years from now. Knowing your numbers can help you stay on top of your treatment and possibly prevent complications.
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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What Is A Normal A1c
Now that you have your A1c number, lets look at what that number actually tells you. The American Diabetes Association has established the following guidelines:
This does NOT mean that you need an A1c of less than 5.7% if youre living with diabetes. It means that if you do NOT live with diabetes, your A1c is expected to be below 5.7%. There are different recommendations for what an appropriate A1c is for people living with diabetes.
I had a chance to asked Dr. Anne Peters, MD, Director, USC Clinical Diabetes Program and Professor of Clinical Medicine Keck School of Medicine of USC as well as Gary Scheiner, MS, CDE, owner and Clinical Director of Integrated Diabetes Services and author of Think Like a Pancreas, what their perspectives are on a good A1c target:
The A1c target should be whatever is best given the persons clinical situation. For athletes, too many lows can limit performance, for someone who is pregnant it should be < 6%, for an older person the target should be higher. I generally think an A1c target of 6.0 7.0% is ideal and data shows that going below 7% has fairly little impact on complications. Basically, Id rather see someone with an A1c of 6.9% and low blood sugar variability than an A1c of 6.2% with lots of variability
Gary Scheiner, MS, CDE:
To learn more about blood sugar levels, please read What are Normal Blood Sugar Levels.
How Meaningful Is Prediabetes For Older Adults
A new study indicates that the condition might be less of a worry than once believed.
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By Paula Span
A few years ago, routine lab tests showed that Susan Glickman Weinberg, then a 65-year-old clinical social worker in Los Angeles, had a hemoglobin A1C reading of 5.8 percent, barely above normal.
This is considered prediabetes, her internist told her. A1C measures how much sugar has been circulating in the bloodstream over time. If her results reached 6 percent still below the number that defines diabetes, which is 6.5 her doctor said he would recommend the widely prescribed drug metformin.
The thought that maybe Id get diabetes was very upsetting, recalled Ms. Weinberg, who as a child had heard relatives talking about it as this mysterious terrible thing.
She was already taking two blood pressure medications, a statin for cholesterol and an osteoporosis drug. Did she really need another prescription? She worried, too, about reports at the time of tainted imported drugs. She wasnt even sure what prediabetes meant, or how quickly it might become diabetes.
I felt like Patient Zero, she said. There were a lot of unknowns.
Or does labeling people prediabetic merely medicalize a normal part of aging, creating needless anxiety for those already coping with multiple health problems?
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What Are The Results Of The Mayo Clinic A1c Test
Book: Mayo Clinic Healthy Heart for Life! The A1C test measures your average blood sugar level for the past two to three months. The results of your A1C test can help your doctor: Identify prediabetes. If you have prediabetes, you have a higher risk of developing diabetes and cardiovascular disease. Diagnose type 1 and type 2 diabetes.
Ways To Lower Your A1c
A1C is a blood test that shows how well your diabetes management plan is working. Here’s how to reach a healthy A1C number and avoid diabetes complications.
For some, home blood sugar testing can be an important and useful tool for managing your blood sugar on a day-to-day basis. Still, it only provides a snapshot of whats happening in the moment, not a full picture of whats happened in the long term, says Gregory Dodell, MD, assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai Health System in New York City.
For this reason, your doctor may occasionally administer a blood test that measures your average blood sugar level over the past two to three months. Called the A1C test, or the hemoglobin A1C test, this provides another lens on how well your type 2 diabetes management plan is working.
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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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How To Set A Reasonable A1c Target
Remember these are the ranges obtained by the people who set the standards for A1C tests. Sadly, however, not every laboratory or home test kit meets those standards. Maybe the lab that Dr. Bernstein uses doesn’t. Does yours? Curt suggests that you ask your doctor if the lab running the test uses a method that is certified by the NGSP. The first conclusion of the research for me is that we need to shoot for a normal A1C level of no more than 6.0 instead of trying what may be impossible, a level of 4.2 to 4.6.
However, an A1C level of 6.0 can cause people who take insulin injections or one of the sulfonylureas to go hypo. That’s why the American Diabetes Associations sets the goal conservatively at 7.0 and the American Academy of Clilnical Endocrinologists uses 6.5. People with diabetes whose A1C values creep over these cuttoff values are at increasesd risk of developing long-term complications, such as nerve and eye damage.
Still, a lower A1C level among people who take those medications is possible without hypos. Dr. Bernstein has amply shown that both in his own life and that of thousands of his patients.
“I’m going to aim to be in the lower end of the normal A1C range,” my favorite CDE tells me, “because that is what I believe is optimal for human health.” And now that I know my A1C is in the normal range I am still going to do my best to bring it down as much as possible. Are you?
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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.
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.
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Can The A1c Test Result In A Different Diagnosis Than The Blood Glucose Tests
Yes. In some people, a blood glucose test may show diabetes when an A1C test does not. The reverse can also occuran A1C test may indicate diabetes even though a blood glucose test does not. Because of these differences in test results, health care professionals repeat tests before making a diagnosis.
People with differing test results may be in an early stage of the disease, when blood glucose levels have not risen high enough to show up on every test. In this case, health care professionals may choose to follow the person closely and repeat the test in several months.
Medications With A1c Of 62
Many doctors wont prescribe diabetes medication for someone with an A1c of 6.2. However, when other risk factors are present, such as high blood pressure or high cholesterol, your doctor might prescribe a first line drug to reduce your blood sugar.
The most common first line drug is Metformin, an oral drug that reduces glucose production in the liver, decreases the absorption of glucose in the stomach and improves your bodys insulin sensitivity.
Already on medication to manage your diabetes? If so, an A1c of 6.2 might be considered adequate, though getting below 5.6 is still recommended.
Talk to your doctor about whether an A1c of 6.2 is the optimal level for you and if medication, dosage or injection adjustments are necessary.
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Maintain A Healthy Weight
Eating a balanced diet and exercising can help you lose or maintain weight. Ask your doctor what a healthy weight is for you.
Work with them to determine how many calories you should be eating. If you need to lose weight, ask them how much weight you should be losing per week to stay healthy.
Crash diets and extreme workout plans may make for entertaining television, but they arent realistic for long-term maintenance. Theyre often unhealthy as well.
Assessment Of Glycemic Control
Glycemic control is assessed by the A1C measurement, continuous glucose monitoring , and self-monitoring of blood glucose . A1C is the metric used to date in clinical trials demonstrating the benefits of improved glycemic control. Patient SMBG can be used with self-management and medication adjustment, particularly in individuals taking insulin. CGM serves an important role in assessing the effectiveness and safety of treatment in many patients with type 1 diabetes, including prevention of hypoglycemia, and in selected patients with type 2 diabetes, such as in those on intensive insulin regimens and in those on regimens associated with hypoglycemia.
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How Often Do You Measure A1c
Your doctor will want to see what your A1C results is 2-4 times a year, and will typically order this lab with other important labs when its time for your blood draw. You can buy at home A1c test kits at your local pharmacy for approximately $20-$40. The kits in this price range usually include 2 tests and you can see the results in about 5 minutes. It is possible to see a significant change in your A1C in a one month time period, but the test typically isnt done too often because red blood cells only turnover about every 120 days. On the plus side, if you have made some changes in the month prior to going to visit your doctor, those positive changes in the last 30 days are going to make more of an impact on your result than what you did 2 months ago.