Check Your Blood Sugar Levels As Your Doctor Has Directed
Work with your doctor to determine if, and how often, you should check your blood sugar. You may be tempted to pick up an A1C home testing kit, but Dowdell does not recommend doing that. As he mentions, day-to-day fluctuations in your blood sugar can be masked by an A1C result that is at your goal level. Instead, if you have a personal continuous glucose monitor, such as a Dexcom G6 or a Freestyle Libre , Dowdell recommends checking your time in range to see if you are at the optimal level. For many people that is 70 to 180 milligrams per decilter , according to ADA guidelines. Having your A1C checked by your healthcare provider every three to six months is sufficient, he adds.
Understanding your A1C levels is an important part of your overall diabetes management. If you have any questions about your A1C levels or what they mean, dont hesitate to ask your doctor.
Additional reporting by Mikel Theobald.
How Is The A1c Test Used To Diagnose Type 2 Diabetes And Prediabetes
Health care professionals can use the A1C test alone or in combination with other diabetes tests to diagnose type 2 diabetes and prediabetes. You dont have to fast before having your blood drawn for an A1C test, which means that blood can be drawn for the test at any time of the day.
If you dont have symptoms but the A1C test shows you have diabetes or prediabetes, you should have a repeat test on a different day using the A1C test or one of the other diabetes tests to confirm the diagnosis.2
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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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.
Medications With A1c Of 61
Many doctors wont prescribe diabetes medication for someone with an A1c of 6.1. 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 6.1 might be considered adequate, though getting below 5.6 is still recommended.
Talk to your doctor about whether an A1c of 6.1 is the optimal level for you and if medication, dosage or injection adjustments are necessary.
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Why Does A Person Need To Test Their Blood Sugars If They Can Get An A1c
The A1C is only an average blood sugar reading. This can be made up of highs and lows. If someone is on a treatment that doesnt cause lows , then they dont need to do blood tests as often and the A1C is fairly representative of their average blood sugar. However, blood testing will give specific information on the pattern of their blood sugars, showing when they are high and low, and what lifestyle factors such as food and exercise cause them to be higher or lower.
If a person is on insulin, self-monitoring their blood sugars is extremely important because it can give moment-to-moment information on how to adjust insulin. If a persons blood sugars are out of range, then testing gives information on what time of day to target therapy. For instance, if the morning numbers are higher, they may need nighttime insulin. Or if the morning numbers are at target but blood sugar is high after supper, they may need more medication at suppertime.
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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Advantages Of Hba1c Over Other Blood Glucose Tests
- The HbA1c test can be taken at any time and does not require fasting .
- It is unaffected by physical activity or stress prior to testing .
- As a marker of long-term blood sugar levels, it is unaffected by short-term hormonal surges .
- As a test, HbA1c has a low variability, both when measured in a single individual, and among people .
- HbA1c is more stable than glucose at 37°C .
- Symptomatic patients can be tested immediately at the same visit, saving costs .
However, some health conditions that affect red blood cells and hemoglobin can falsely increase or decrease HbA1c levels .
You Have A B12 Deficiency
One of the reasons your body needs B12 is because it helps create red blood cells. You already know iron-deficiency anemia is one cause of an elevated A1C test. Since a deficiency in B12 often leads to anemia, itâs no wonder that it leads to high A1C readings as well. Taking B12 vitamins can also affect these levels, producing a falsely low A1C reading.
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Whats The Difference Between A1c And Blood Glucose Levels
February 27, 2018 by Diabetes Care
Checking your A1C as well as your blood glucose levels are things youll do when you have diabetes. Thats because they are both key markers in determining whether your blood sugar levels are within the ideal target range to keep you healthy. So whats the difference between your A1C and blood glucose level? Heres a closer look at what each one means in relation to managing your diabetes.
Follow The Diabetes Treatment Plan Your Healthcare Team Recommends
Diabetes treatment is very individualized, noted an article published in May 2014 in Diabetes Spectrum. 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 the steps you need to take to successfully manage diabetes. Always talk to your doctor before making any changes, such as starting a very-low-carbohydrate diet or beginning a new exercise regimen, and especially before making any medication or insulin changes.
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How Often Is A1c Tested
To keep A1C levels in check, patients should have the test repeated regularly. If the A1C is less than 5.7, indicating you dont have diabetes, you should have it checked every three years, according to Robert Williams, MD, a family doctor and geriatrician in Lakewood, Colorado, and a medical advisor for eMediHealth. If it is between 5.7 and 6.4, indicating you are at risk of developing diabetes, you should have it rechecked every one to two years. If you have a confirmed diabetes diagnosis, and your blood sugar is well-controlled, you should have an A1C test every six months. If you already have diabetes and your medications change, or your blood sugar is not well-controlled, you should have an A1C test every three months.
Can You Have High A1c And Not Be Diabetic
According to one 2009 study, 3.8% of people without a history of diabetes have an elevated A1C level . This group is more likely to have other risk factors for Type 2 diabetes and cardiovascular disease. Researchers found that the following groups were more likely to have an elevated A1C without having a diagnosis of diabetes:
- Higher C-reactive protein levels
A high A1C result might signal that there is a problem. Even a modest increase in your blood sugar, above normal levels, can increase your risk of heart disease, even when you dont have full-blown diabetes, says Dr. Bellatoni. A physician can review test results and talk to patients about risk factors and lifestyle changes to improve blood sugar levels.
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Whats A Glycated Hemoglobin Test
A glycated hemoglobin test measures the amount of glucose in your blood. The test is often called A1c, or sometimes HbA1c. Its a simple blood test used to:
- Detect prediabetes high sugar levels that can lead to diabetes, heart disease and stroke.
- Diagnose diabetes.
- Tell how well a person with diabetes has been managing the disease.
What Is A1c And Why Is It Used
A1c estimates a persons average blood sugar levels over a 2 to 3-month span. It is the best measure we have of how well blood glucose is controlled and an indicator of diabetes management.
Though A1c doesnt provide day-to-day information, keeping A1c low has been proven to lower the risk of microvascular complications like kidney disease , vision loss , and nerve damage . The relationship between A1c and macrovascular complications like heart disease is harder to show in clinical trials, but having high blood sugar is a major risk factor for heart disease.
A1c is usually measured in a lab with routine blood work, or with a countertop machine in a doctors office using a fingerstick.
A1c measures the quantity of glycated hemoglobin, which refers to sugar attached to a red blood cell protein called hemoglobin. The number is reported as a percentage of the total hemoglobin in the blood. If a person consistently has higher blood glucose levels over time, A1c levels go up because more red blood cells are coated with sugar. The test is representative of a 2 to 3-month average because once a red blood cell becomes coated with sugar, the link is irreversible. It is only when the red blood cell is “recycled” that the sugar coating disappears.
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What Can Affect Your A1c Results
Anyone whos had diabetes for any length of time knows that A1C tests havent been reliable until recently. In the past, many different types of A1C tests gave different results depending on the lab that analyzed them. But the National Glycohemoglobin Standardization Program has helped improve the accuracy of these tests.
Manufacturers of A1C tests now have to prove that their tests are consistent with those used in a major diabetes study. Accurate home test kits are also now available for purchase.
But accuracy is relative when it comes to A1C or even blood glucose tests. The A1C test result can be up to half a percent higher or lower than the actual percentage. That means if your A1C is 6, it might indicate a range from 5.5 to 6.5.
Some people may have a blood glucose test that indicates diabetes but their A1C is normal, or vice versa. Before confirming a diagnosis of diabetes, your doctor should repeat the test that was abnormal on a different day. This isnt necessary in the presence of unequivocal symptoms of diabetes and a random sugar over 200 mg/dl.
Some people may get false results if they have kidney failure, liver disease, or severe anemia. Ethnicity can also influence the test. People of African, Mediterranean, or Southeast Asian descent may have a
changes in lifestyle can make a big difference and even put your diabetes in remission. Starting an exercise program can help. Type 1 diabetes needs insulin treatment as soon as its diagnosed.
Biological Variability Of A1c Is Lower Than That For Fpg
When the same subjects have two assessments of the available glucose-related parameters, the correlation is stronger among the individual A1C measurements than among the FPG or 2-h PG measurements. The coefficients of variation of A1C, FPG, and 2-h PG are 3.6, 5.7, and 16.6%, respectively . This reflects of course both biological and analytical variability. However, although the latter was similar for A1C and FPG , biological variability of A1C was severalfold lower than that of FPG . This finding confirms that the two required assessments of FPG to diagnose diabetes can provide quite unreliable information, whereas A1C, especially if measured twice as recommended, provides more robust clinical information.
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Reasons Your A1c Might Be High When Youre Not Diabetic
Are you worried youâre at risk of diabetes because of high blood sugar levels on your A1C test? Does your blood sugar spike even when youâre eating healthy foods like apples and pears?
While high blood sugar is a common sign of diabetes, itâs not exclusive to those with the health condition. In fact, people often encounter high levels even if they donât have a history of diabetes.
How Is The A1c Test Used After Diagnosis Of Diabetes
Your health care professional may use the A1C test to set your treatment goals, modify therapy, and monitor your diabetes management.
Experts recommend that people with diabetes have an A1C test at least twice a year.4 Health care professionals may check your A1C more often if you arent meeting your treatment goals.4
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The Difference Between Eag/a1c And The Average On Your Monitor
The catch is that eAG/A1C is not the same average glucose level as the average of the readings on your meter.
Monitoring measures your blood glucose at a moment in time, whereas eAG/A1C represent an average of your glucose levels 24 hours a day, including times when people are less likely to check their blood sugar .
People with diabetes are also more likely to check their blood glucose more often when they are low , so the average of readings on their meter is likely to be lower than their eAG.
You Have Kidney Disease Or Related Disorders
Those who suffer from kidney disease can find it more challenging to rely on the efficiency of A1C tests. They often see high A1C results, according to a report by DaVita Inc., that may not always be accurate. This is because kidney disease can cause complications like anemia and malnutrition. This, in turn, affects the results of an A1C test. With both diabetes and kidney disease, it can be more challenging to get accurate results.
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A1c Results And What The Numbers Mean
|Diabetes||6.5 percent or above|
When using the A1C test for diagnosis, your doctor will send your blood sample taken from a vein to a lab that uses an NGSP-certified method. The NGSP, formerly called the National Glycohemoglobin Standardization Program, certifies that makers of A1C tests provide results that are consistent and comparable with those used in the Diabetes Control and Complications Trial.
Blood samples analyzed in a doctors office or clinic, known as point-of-care tests, should not be used for diagnosis.
The A1C test should not be used to diagnose type 1 diabetes, gestational diabetes, or cystic fibrosis-related diabetes. The A1C test may give false results in people with certain conditions.
Having prediabetes is a risk factor for developing type 2 diabetes. Within the prediabetes A1C range of 5.7 to 6.4 percent, the higher the A1C, the greater the risk of diabetes.