What is the A1C test and how does it measure blood sugar levels. How often should you get an A1C test. What are the normal A1C ranges for diagnosing prediabetes and diabetes. How can you interpret your A1C results and set appropriate goals.

What Is the A1C Test and Why Is It Important?

The A1C test, also known as the hemoglobin A1C or HbA1c test, is a crucial tool in diabetes management and diagnosis. This simple blood test provides valuable insights into a person’s average blood sugar levels over the past three months. Understanding your A1C results is essential for assessing your risk of prediabetes or type 2 diabetes, as well as monitoring the effectiveness of diabetes management strategies.

The test measures the percentage of red blood cells that have sugar-coated hemoglobin. As sugar enters the bloodstream, it attaches to hemoglobin, a protein in red blood cells. People with higher blood sugar levels tend to have a higher percentage of sugar-coated hemoglobin.

Why is the A1C test important for diabetes management?

• Provides a long-term view of blood sugar control
• Helps diagnose prediabetes and diabetes
• Guides treatment decisions and medication adjustments
• Indicates the risk of diabetes-related complications

Who Should Get an A1C Test and How Often?

The frequency of A1C testing depends on various factors, including age, risk factors, and existing health conditions. Here are some general guidelines for A1C testing:

For adults without diabetes:

• Baseline test for adults over 45 years old
• For those under 45, overweight, and with risk factors for prediabetes or type 2 diabetes
• Repeat every 3 years if results are normal but risk factors are present

For individuals with prediabetes:

• Repeat test every 1 to 2 years, or as recommended by a healthcare provider
• More frequent testing may be necessary if lifestyle changes or medications are implemented

For people with diabetes:

• At least twice a year for those with stable blood sugar control
• Four times a year (or more) if treatment changes or blood sugar control is not optimal
• More frequent testing may be necessary for those with other health conditions or medication changes

Is special preparation required for an A1C test? Unlike some other blood tests, the A1C test doesn’t require fasting or any special preparation. The test can be performed using a blood sample from a finger stick or drawn from a vein in your arm. However, it’s always best to consult with your healthcare provider about any specific instructions or if additional tests will be conducted simultaneously.

Understanding A1C Results and Diagnostic Criteria

Interpreting A1C results is crucial for diagnosing prediabetes and diabetes, as well as for setting treatment goals. The American Diabetes Association (ADA) provides the following guidelines for A1C interpretation:

It’s important to note that within the prediabetes range (5.7% to 6.4%), higher A1C levels indicate a greater risk of developing type 2 diabetes. This information can be valuable for implementing preventive measures and lifestyle changes.

How does A1C relate to average blood glucose levels?

A1C results can also be reported as estimated average glucose (eAG), which provides a more familiar reference point for those accustomed to daily blood glucose monitoring. Here’s a quick conversion chart:

Factors That Can Affect A1C Results

While the A1C test is generally reliable, several factors can influence the results, potentially leading to falsely high or low readings. It’s crucial to be aware of these factors and discuss them with your healthcare provider to ensure accurate interpretation of your results.

What conditions can impact A1C accuracy?

• Kidney failure
• Liver disease
• Severe anemia
• Certain hemoglobin variants (more common in people of African, Mediterranean, or Southeast Asian descent)
• Blood disorders such as sickle cell anemia or thalassemia
• Recent blood loss or blood transfusions
• Pregnancy (early or late stages)

Can medications affect A1C results?

Yes, certain medications can interfere with A1C measurements. These may include:

• Opioids
• Some HIV medications
• Certain antibiotics and anti-inflammatory drugs

If you’re taking any of these medications or have any of the aforementioned conditions, inform your healthcare provider. They may recommend additional tests to ensure accurate blood glucose assessment.

Setting A1C Goals for Diabetes Management

Establishing an appropriate A1C goal is a crucial aspect of diabetes management. While the American Diabetes Association suggests a general target of 7% or less for most adults with diabetes, it’s essential to recognize that A1C goals should be individualized based on various factors.

What factors influence individual A1C goals?

• Age
• Duration of diabetes
• Presence of other medical conditions
• Risk of hypoglycemia
• Life expectancy
• Personal preferences and lifestyle

For younger individuals with diabetes, a lower A1C goal (e.g., below 7%) may be appropriate to reduce the long-term risk of complications. However, this should be balanced against the risk of hypoglycemia. Older adults or those with multiple health conditions may have a higher A1C goal to prioritize safety and quality of life.

How do you determine the right A1C goal for you? Collaborate with your healthcare team to establish a personalized A1C target that balances effective diabetes management with your overall health and lifestyle considerations. Regular reassessment of this goal is important as your health status or life circumstances change.

The Role of A1C in Comprehensive Diabetes Management

While the A1C test is a valuable tool in diabetes management, it’s important to recognize its limitations and use it as part of a comprehensive approach to blood glucose monitoring and overall health management.

Why is A1C testing not a replacement for daily blood glucose monitoring?

• A1C provides an average but doesn’t capture daily fluctuations
• It doesn’t show the timing of high or low blood sugar episodes
• Two people can have the same A1C but very different daily glucose patterns

For individuals managing diabetes, combining A1C testing with regular blood glucose monitoring provides a more complete picture of glycemic control. This comprehensive approach allows for better-informed treatment decisions and lifestyle adjustments.

How can you use A1C results in conjunction with daily monitoring?

1. Compare A1C results with your daily blood glucose readings
2. Look for patterns or discrepancies between A1C and daily readings
3. Discuss any concerns or questions with your healthcare provider
4. Use insights to adjust your diabetes management plan as needed

Remember, even if you’re reaching your A1C goal, experiencing symptoms of high or low blood sugar warrants increased monitoring and discussion with your healthcare team. This proactive approach ensures that your diabetes management strategy remains effective and tailored to your individual needs.

Lifestyle Changes and Interventions to Improve A1C Levels

Improving A1C levels often requires a multifaceted approach that combines lifestyle modifications, medication management, and regular monitoring. Whether you’re aiming to prevent diabetes, manage prediabetes, or optimize your diabetes control, there are several strategies you can employ to positively impact your A1C results.

What dietary changes can help lower A1C levels?

• Focus on a balanced diet rich in whole grains, lean proteins, and vegetables
• Limit intake of refined carbohydrates and added sugars
• Incorporate more fiber-rich foods to help stabilize blood sugar levels
• Practice portion control to manage overall calorie intake
• Consider working with a registered dietitian for personalized meal planning

How does physical activity impact A1C levels?

Regular physical activity plays a crucial role in improving insulin sensitivity and lowering A1C levels. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, spread over at least three days. Additionally, incorporate strength training exercises twice a week. Always consult with your healthcare provider before starting a new exercise regimen, especially if you have any diabetes-related complications.

Can stress management techniques influence A1C results?

Yes, chronic stress can negatively impact blood sugar control and, consequently, A1C levels. Implementing stress-reduction techniques can be beneficial:

• Practice mindfulness meditation or deep breathing exercises
• Engage in regular physical activity
• Ensure adequate sleep and maintain a consistent sleep schedule
• Consider counseling or therapy if stress becomes overwhelming

How quickly can lifestyle changes affect A1C levels? While individual responses may vary, significant improvements in A1C can often be seen within 2-3 months of consistent lifestyle changes. However, it’s important to maintain these habits long-term for sustained benefits.

The Future of A1C Testing and Diabetes Management

As medical technology advances, new developments in A1C testing and diabetes management continue to emerge. These innovations aim to provide more accurate, convenient, and comprehensive tools for monitoring and managing blood glucose levels.

What are some emerging technologies in A1C testing?

• Point-of-care A1C testing devices for rapid results in clinical settings
• At-home A1C testing kits for more frequent monitoring
• Continuous glucose monitoring (CGM) systems that provide real-time glucose data
• Artificial intelligence algorithms to predict A1C trends based on daily glucose readings

How might these advancements impact diabetes care? These technologies have the potential to revolutionize diabetes management by providing more frequent and detailed glucose data, enabling earlier interventions, and facilitating personalized treatment strategies.

What role will A1C testing play in future diabetes prevention efforts?

As our understanding of diabetes risk factors and progression improves, A1C testing is likely to play an increasingly important role in early detection and prevention strategies. This may include:

• More widespread screening for prediabetes in at-risk populations
• Integration of A1C testing with other biomarkers for more comprehensive risk assessment
• Development of targeted interventions based on A1C trends and individual risk profiles

While these advancements hold promise, it’s important to remember that they should complement, not replace, the fundamental aspects of diabetes management: a healthy diet, regular physical activity, stress management, and consistent medication adherence when prescribed.

As we look to the future of diabetes care, the A1C test remains a cornerstone of management and diagnosis. By understanding its significance, interpreting results accurately, and using it as part of a comprehensive approach to health, individuals can take proactive steps towards better blood sugar control and overall well-being. Always work closely with your healthcare team to develop and adjust your diabetes management plan based on your A1C results and individual needs.

All About Your A1C

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What has your blood sugar been up to lately? Get an A1C test to find out your average levels—important to know if you’re at risk for prediabetes or type 2 diabetes, or if you’re managing diabetes.

The A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months. It’s one of the commonly used tests to diagnose prediabetes and diabetes, and is also the main test to help you and your health care team manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is really important if you have diabetes.

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.

Who Should Get an A1C Test, and When?

Testing for diabetes or prediabetes:
Get a baseline A1C test if you’re an adult over age 45—or if you’re under 45, are overweight, and have one or more risk factors for prediabetes or type 2 diabetes:

• If your result is normal but you’re over 45, have risk factors, or have ever had gestational diabetes, repeat the A1C test every 3 years.
• If your result shows you have prediabetes, talk to your doctor about taking steps now to improve your health and lower your risk for type 2 diabetes. Repeat the A1C test as often as your doctor recommends, usually every 1 to 2 years.
• If you don’t have symptoms but your result shows you have prediabetes or diabetes, get a second test on a different day to confirm the result.
• If your test shows you have diabetes, ask your doctor to refer you to diabetes self-management education and support services so you can have the best start in managing your diabetes.

Managing diabetes:
If you have diabetes, get an A1C test at least twice a year, more often if your medicine changes or if you have other health conditions. Talk to your doctor about how often is right for you.

How to Prepare for Your A1C Test

The test is done in a doctor’s office or a lab using a sample of blood from a finger stick or from your arm. You don’t need to do anything special to prepare for your A1C test. However, ask your doctor if other tests will be done at the same time and if you need to prepare for them.

Your A1C Result

Diagnosing Prediabetes or Diabetes

A normal A1C level is below 5.7%, a level of 5. 7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.

Managing Diabetes
Your A1C result can also be reported as estimated average glucose (eAG), the same numbers (mg/dL) you’re used to seeing on your blood sugar meter:

What Can Affect Your A1C Result?

Get your A1C tested in addition to—not instead of—regular blood sugar self-testing if you have diabetes.

Several factors can falsely increase or decrease your A1C result, including:

• Kidney failure, liver disease, or severe anemia.
• A less common type of hemoglobin that people of African, Mediterranean, or Southeast Asian descent and people with certain blood disorders (such as sickle cell anemia or thalassemia) may have.
• Certain medicines, including opioids and some HIV medications.
• Blood loss or blood transfusions.
• Early or late pregnancy.

Let your doctor know if any of these factors apply to you, and ask if you need additional tests to find out.

Your A1C Goal

The goal for most people with diabetes is 7% or less. However, your personal goal will depend on many things such as your age and any other medical conditions. Work with your doctor to set your own individual A1C goal.

Younger people have more years with diabetes ahead, so their goal may be lower to reduce the risk of complications, unless they often have hypoglycemia (low blood sugar, or a “low”). People who are older, have severe lows, or have other serious health problems may have a higher goal.

A1C: Just Part of the Toolkit

A1C is an important tool for managing diabetes, but it doesn’t replace regular blood sugar testing at home. Blood sugar goes up and down throughout the day and night, which isn’t captured by your A1C. Two people can have the same A1C, one with steady blood sugar levels and the other with high and low swings.

If you’re reaching your A1C goal but having symptoms of highs or lows, check your blood sugar more often and at different times of day. Keep track and share the results with your doctor so you can make changes to your treatment plan if needed.

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A1C and eAG | ADA

What is the difference between eAG and the average on my monitor?  

The A1C test gives you a picture of your average blood glucose (blood sugar) control for the past two to three months. The results give you and your diabetes care team a good idea of how well your diabetes treatment plan is working.

In some ways, the A1C test is like a baseball player’s season batting average: it tells you about a person’s overall success. Neither a single day’s blood test results nor a single game’s batting record gives the same big picture.

The A1C test can help you manage your diabetes by:

• Confirming self-testing results or blood test results by the doctor.
• Judging whether a treatment plan is working.
• Showing you how healthy choices can make a difference in diabetes control.

Your health care provider may report your A1C test result as eAG, or “average glucose,” which directly correlates to your A1C. eAG may help you understand your A1C value because eAG is reported as the same unit (mg/dL) that you see through self-monitoring on your meter or continuous glucose monitor (CGM).

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 (for example, post-meal periods of higher blood sugar).

People with diabetes are also more likely to check their blood glucose more often when they are low (for example, first thing in the morning and before meals), so the average of readings on their meter is likely to be lower than their eAG.

So, how does A1C work?

Hemoglobin, a protein that links up with glucose, is found inside red blood cells. Its job is to carry oxygen from the lungs to all the cells of the body. Glucose enters your red blood cells and links up (or glycates) with molecules of hemoglobin. The more glucose in your blood, the more hemoglobin gets glycated. By measuring the percentage of A1C in the blood, you get an overview of your average blood glucose control for the past few months. Your doctor should measure your A1C level at least twice a year.

What’s your number?

The American Diabetes Association suggests an A1C of 7 percent for nonpregnant adults, which is an eAG of 154 mg/dl, but more or less stringent glycemic goals may be appropriate for each individual.

A1C to eAG

eAG to A1C

Enter your A1C percentage:

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. Don’t compare yourself or your child to others. Know your goals and be clear, persistent and honest in your approach to managing diabetes. 

Your diabetes care team is here to help

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.

Human Hearing Characteristics – Hearing Thresholds and Ranges

Hearing threshold

The human hearing threshold is the minimum level of sound that a person can perceive. This characteristic is one of the main ones.

Hearing sensitivity depends on the hearing threshold: the lower the hearing threshold, the higher the hearing sensitivity, and vice versa. The range of the highest sound sensitivity is from 1000 to 4000 Hz. It is in this interval that information about speech signals is located. Hearing thresholds at 200 Hz are 35 dB higher and at 100 Hz are 60 dB higher than hearing thresholds at 1000 Hz.

The normal hearing threshold is between -10dB and +10dB. In cases of hearing impairment, the thresholds can be different – from 20 to 120 dB.

Source: introduction to audiology and hearing aid I.V. Queen

Discomfort threshold

The threshold of discomfort is the level of sound that causes discomfort in a person. The norm is 100-110 dB, and it depends not only on the state of the hearing organ, but also on the excitability of the nervous system as a whole. In patients with hearing impairments, the discomfort threshold is usually greater than 110 dB. However, many people with sensorineural hearing loss have thresholds of discomfort that are the same as those of people with normal hearing or lower – a phenomenon called recruitment, or the “amplifying loudness phenomenon.”

Pain threshold

Pain in the organ of hearing, as a rule, causes a sound of 130-140 dB. In addition, one should distinguish between the threshold of touch and the pain threshold – in the first case, a person feels only pressure on the eardrum (130 dB), in the second – already pain sensations (140 dB). The threshold of discomfort for people with hearing impairment may differ from the norm, but the pain threshold is always the same for everyone.

Hearing frequency range

The ability to perceive sounds in the frequency range from 20 to 20,000 Hz is considered the norm for a person. Sounds with a frequency above 20,000 Hz are called ultrasonics, and those below 20 Hz are called infrasounds. A person can perceive ultrasound only if its source is applied to the bones of the skull – this property is sometimes used in the diagnosis of hearing impairment.

Source: introduction to audiology and hearing aid I.V. Queen

Approaching the study of hearing, the sound frequency range is conventionally divided:

to low frequencies – up to 500 Hz;

at medium frequencies – 500-3000 Hz;

to high frequencies – 3000–8000 Hz;

for ultra-high frequencies – above 8000 Hz

Hearing dynamic range

The dynamic range of hearing is the total amount of sound levels that a person is able to perceive, normally it is 130 dB. The difference between the quietest and loudest sound perceived by the human ear (up to palpable or pain thresholds) is large – the latter is higher by about 10 ¹³ times.

In audiology, the dynamic range of hearing is the range from a person’s hearing threshold to their discomfort threshold.

Both dynamic and frequency range can be different for people with hearing loss.

Differential hearing threshold

The minimum differences in frequency, intensity, or duration of a sound perceived by human hearing are called the differential hearing threshold.

It is the ability to detect minimal differences between sounds that allows us to perceive speech. The intensity and frequency of the differential hearing threshold depends on the duration, level and frequency of the sound. The norm for a person is 1–1.5 dB in intensity at frequencies of 500–4000 Hz at a sound level of 40 dB.

The reason for the poor perception of speech by people with hearing impairment lies in the increase in their differential hearing threshold – they simply cease to perceive small differences between speech sounds.

Binaural hearing

The ability of a person to perceive sound with two ears and process the received signals in the corresponding symmetrical auditory centers of the brain is called binaural hearing. This property provides the so-called process of binaural fusion – this is when sounds of different characteristics entering the right and left ears of a person are perceived by the human auditory system as a single and integral auditory image. In addition, by comparing the sounds entering the right and left ears, the auditory system determines where the sound source is.

It is binaural hearing that allows us to perceive speech in noisy environments – the so-called “binaural release from disguise” effect occurs.

Article about binaural prosthetics.

Source: introduction to audiology and hearing aid I.V. Queen

Hearing adaptation

Like other sensory systems of the human body, the auditory system is able to adapt to external conditions. This is manifested in a temporary decrease in sensitivity due to an increase in hearing thresholds in cases of excessive sound exposure. With this ability, the auditory system protects itself from damage.

The hearing threshold is raised by any exposure to sound that exceeds this threshold by 10-20 dB. In cases of short-term exposure to sound no higher than 80-90 dB, and the increase in the threshold will be short-term. With more intense exposure, the increase in hearing thresholds will last longer – up to several minutes. After the cessation of sound exposure, the hearing thresholds gradually return to their original state.

What is the norm of the pulse and what to do if yours does not meet it

Likbez

Health

May 9, 2021

When the heart beats faster than a certain value, the risk of premature death doubles.

From Latin the word pulsus is translated as “blow”, “push”. The pulse is a measure of how many beats the heart makes in one minute. Sometimes another term is used – heart rate (HR).

Lifehacker found out everything about why you need to know your pulse and when its values ​​can warn of danger.

Why measure the pulse

Pulse is an important parameter that allows you to assess the state of the cardiovascular system and the body as a whole. It shows whether your heart is able to fully provide the internal organs and tissues with oxygen and nutrients.

If your heart beats calmly, unhurriedly, pumping blood evenly, then your body feels great. If the heart rate rises, this indicates that the organs do not have enough nutrition and respiration, and the heart has to strain to provide them with blood. This condition is called tachycardia. Too rare a pulse, in turn, may be a sign that the heart is “tired” and cannot give the body the necessary amount of blood. In this case, we speak of bradycardia.

To assess which pulse is too fast and which is too slow, the concept of the norm is established. But, before moving on to it, you need to learn how to measure the heart rate. Lifehacker has already written about this.

Find out 🔥

• How to measure the pulse

What is the norm of the pulse

The norm has a fairly wide range. This is due to the individual characteristics of each person, his age, weight, height, physical fitness.

Normal resting heart rate is within the following limits:

90 109

9 0109

If your heart rate is in the indicated range, everything is in order (with some nuances, but about them below). But if the heart rate goes beyond the upper or lower limit, this is a warning symptom.

Why the pulse can be lower or higher than normal

In itself, a temporary decrease or increase in heart rate is a normal phenomenon. A healthy heart does not beat like clockwork. It speeds up and slows down to meet the body’s changing need for oxygen.

Both tachycardia (a heart rate faster than 100 beats per minute for an adult) and bradycardia (less than 60 beats per minute) can be completely natural physiological phenomena. For example, the heart rate increases during sports. On the other hand, in active people accustomed to physical activity, the heart rate at rest is often reduced – sometimes up to 40 beats per minute. This is due to the fact that the heart muscle of athletes is also developed, it does not have to strain to maintain a steady rhythm.

There are other factors that can speed up or slow down the pulse:

• Air temperature. As temperature and humidity increase, the heart rate increases. But, as a rule, no more than 5-10 beats per minute.
• Change of body position. When you lie down, sit or stand, the pulse will be the same. But if you stand up, your heart rate may increase slightly in the first 15 to 20 seconds. Most often, it returns to normal within a couple of minutes.
• Anxiety or stress. Experiences make the heart pump blood more actively, so the heart rate “on the nerves” increases.
• Fever. As body temperature rises, the heart also increases activity.
• Bad habits. Excessive use of coffee and alcohol, love of cigarettes – all this speeds up the heart rate.
• Side effect of some drugs. Medicines can change the pulse in one direction or the other.

If your heart rate is faster or slower due to one of the above reasons, this is normal. As soon as you calm down, get rid of the fever or, for example, reduce your coffee intake, your heart rate will return to normal.

It’s much more dangerous if none of these factors are present, and your resting heart rate is regularly above or below normal.

What to do if the pulse is below or above normal

If you observe such situations constantly, consult a therapist.

This recommendation becomes mandatory if such fluctuations in heart rate are accompanied by weakness and dizziness.

Such symptoms may be a sign of cardiovascular disorders or other diseases, such as anemia, hyper- or hypothyroidism, rheumatism, lupus.

When to call an ambulance

Dial 103 or 112 immediately if the pulse drops or rises above normal and this situation is accompanied by the following symptoms:

• difficulty breathing;
• dizziness, weakness, pre-syncope;
• chest pain that lasts longer than a few minutes.

Which pulse is considered ideal within the normal range and which is dangerous

Despite the fact that the upper limit of the normal pulse reaches 100 beats per minute, there are some nuances.

For example, one study of middle-aged men (50 years and older) found the following.