About all

Normal numbers for a1c: A1c Chart, Test, Levels, & Normal Range

Содержание

A1c Chart, Test, Levels, & Normal Range

What Is an A1c Test?

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It’s also called HbA1c, glycated hemoglobin test, and glycohemoglobin. It’s a lot like a baseball player’s season batting average. A single game doesn’t tell you how a player is performing in their career. And 1 day’s test results don’t give you the complete picture of how your treatment is working.

People who have diabetes need this test regularly to see if their levels are staying within range. It can tell if you need to adjust your diabetes medicines. The A1c test is also used to diagnose diabetes.

What Is Hemoglobin?

Hemoglobin is a protein found in red blood cells. It gives blood its red color, and its job is to carry oxygen throughout your body.

How the Test Works

The sugar in your blood is called glucose. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The A1c test measures how much glucose is bound.

Continued

Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months.

If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher.

What’s a Normal Hemoglobin A1c Test?

For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have prediabetes and a higher chance of getting diabetes. Levels of 6.5% or higher mean you have diabetes.

 

Setting Goals for A1c Levels

The target A1c level for people with diabetes is usually less than 7%. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes. Someone who has had untreated diabetes for a long time might have a level above 8%.

If you have diabetes and your level is above your target, your doctor may change your treatment plan to get your level down.

Continued

A combination of diet, exercise, and medication can bring your levels down.

People with diabetes should have an A1c test every 3 months to make sure their blood sugar is in their target range. If your diabetes is under good control, you may be able to wait longer between the blood tests. But experts recommend checking at least two times a year.

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.

How Often Do You Need the Test?

Your doctor probably will have you take the A1c test as soon as you’re diagnosed with diabetes. You’ll 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 you’re controlling your blood sugar.

Continued

How often you’ll need the test after that depends on several things, like:

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

You’ll 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.

It’s 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.

Diabetes Urine Tests To Determine Sugar & Glucose Levels

When you have diabetes, you’re no stranger to tests that keep track of your disease. Most look at your blood, but there are others. Two simple ones that check your urine can help you and your doctor watch for kidney disease and severe high blood sugar.

Tests for Kidney Disease

About one-third of people with diabetes have problems with their kidneys. But early and tight control of your blood sugar and blood pressure, plus help from certain medications, can keep these organs working like they should

To check for problems, your doctor can do a test that measures the amount of protein in your urine, called microalbuminuria. It shows up when small amounts of albumin (the main protein in your blood) seep into your pee. Without treatment to slow the leak, your kidneys could be damaged and eventually fail.

You should get this test every year starting as soon as you’re diagnosed with type 2 diabetes. That’s because high blood sugar is usually present many years before you find out you have the disease.

If you have type 1 diabetes, you probably won’t get the test until you’ve been diagnosed for 5 years.

What Does a Positive Result Mean?

If the test is positive, your kidneys are leaking protein into your urine. This is a sign that your kidneys are not working as well as they should — even if you feel fine and have no symptoms. Your doctor will suggest medications or lifestyle changes to help control these conditions:

  • Kidney damage. You may start specific medicines to prevent further harm. If your microalbumin level is high, your doctor may suggest another type of test that requires you to collect samples for 24 hours. This can better tell the extent of damage to the kidneys and see how well they’re working.
  • High blood sugar. Studies show tight control of your blood sugar can lower kidney damage, so your doctor may put you on more aggressive treatments.
  • Blood pressure. Lowering blood pressure reduces your risk of diabetes-related kidney damage. Get it checked each time you have an office visit. The recommended reading for most people with diabetes is less than 130/80.
  • Cholesterol. Since increases in microalbuminuria over time has been linked to heart disease risk, your doctor will work with you to keep your cholesterol and other fats in a healthy range.
  • Other factors that can increase the risk of kidney disease are being overweight or obese and smoking.

Tests for High Blood Sugar

If you have type 1 diabetes, your doctor could ask you to check the urine for ketones. Your body makes them when it doesn’t have enough insulin and turns to fat stores to create energy for your cells. Ketones are toxic in large amounts. Too many of them can cause a life-threatening emergency condition called ketoacidosis.

How Do I Test?

Your doctor can check for ketone levels, or you can do it at home with an over-the-counter kit. You simply dip a test strip into your urine. It will change color, and you’ll compare it to a chart to see what your reading means.

When Should I Test?

If you have type 1 diabetes, you may need to check your urine for ketones if:

  • You feel sick (have a cold, the flu, or other illness) and have nausea or vomiting.
  • You’re pregnant.
  • Your blood sugar level is over 300 mg/dL.
  • You have symptoms of high blood sugar including extreme thirst or tiredness, a flushed or foggy feeling, or your breath smells fruity.
  • The doctor tells you to.

If you have type 2 diabetes, there isn’t much chance you’ll have too many ketones, even if you’re taking insulin. But it could happen during a severe illness. Your doctor may tell you to check your urine when:

  • You have a cold, the flu, or other illness or have unexplained nausea or vomiting.
  • Your blood sugar level is over 300 mg/dL and continues to rise throughout the day.

When Should I Call the Doctor?

A urine test for ketones should always be negative. Report a positive result to your doctor immediately. You should also let them know right away if your blood sugar remains high or if you have stomach pain, nausea, vomiting, rapid breathing, sweet-smelling breath, or if you’re peeing a lot.

The doctor may tell you to:

  • Drink plenty of water and fluids to lower the amounts of ketones and stay hydrated.
  • Continue to check your blood sugar. If it’s high, you may need to give yourself a small amount of rapid-acting insulin.
  • Go to the local emergency room so you can get intravenous fluids and insulin.

How Do I Record My Results?

Keep detailed records of any urine or ketone tests you perform. These can help alert you and your doctor to any problems. Bring them with you on every office visit.

A1C test – Mayo Clinic

Overview

The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes. If you’re living with diabetes, the test is also used to monitor how well you’re managing blood sugar levels. The A1C test is also called the glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C or HbA1c test.

An A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of hemoglobin proteins in your blood are coated with sugar (glycated). Hemoglobin proteins in red blood cells transport oxygen.

The higher your A1C level is, the poorer your blood sugar control and the higher your risk of diabetes complications.

Products & Services

Show more products from Mayo Clinic

Why it’s done

The results of an A1C test can help your doctor or other health care provider:

  • Diagnose prediabetes. If you have prediabetes, you have a higher risk of developing diabetes and cardiovascular disease.
  • Diagnose type 1 and type 2 diabetes. To confirm a diabetes diagnosis, your doctor will likely look at the results of two blood tests given on different days — either two A1C tests or the A1C test plus another test, such as a fasting or random blood sugar test.
  • Monitor your diabetes treatment plan. The result of an initial A1C test also helps establish your baseline A1C level. The test is then repeated regularly to monitor your diabetes treatment plan.

How often you need the A1C test depends on the type of diabetes, your treatment plan, how well you’re meeting treatment goals and your primary care doctor’s clinical judgment. For example, the A1C test may be recommended:

  • Once every year if you have prediabetes
  • Twice a year if you don’t use insulin and your blood sugar level is consistently within your target range
  • Four times a year if you take insulin or have trouble keeping your blood sugar level within your target range

You may need more-frequent A1C tests if your doctor changes your diabetes treatment plan or you begin taking a new diabetes medication.

More Information

Show more related information

How you prepare

The A1C test is a simple blood test. You don’t need to fast for the A1C test, so you can eat and drink normally before the test.

What you can expect

During the A1C test, a member of your health care team takes a blood sample by inserting a needle into a vein in your arm or pricking your finger tip with a small, pointed lancet. If the blood is taken from a vein, the blood sample is sent to a lab for analysis.

Blood from a finger prick may be analyzed in your doctor’s office for same-day results. This in-office test is only used for monitoring your treatment plan, not for diagnosis or screening.

Results

A1C test results are reported as a percentage. A higher A1C percentage corresponds to higher average blood sugar levels. Results for a diagnosis are interpreted as follows:

  • Below 5.7% is normal.
  • 5.7% to 6.4% is diagnosed as prediabetes.
  • 6.5% or higher on two separate tests indicates diabetes.

For most adults living with diabetes, an A1C level of less than 7% is a common treatment target. Lower or higher targets may be appropriate for some people.

The target of less than 7% is associated with a lower risk of diabetes-related complications. If your A1C level is above your target, your doctor may recommend an adjustment in your diabetes treatment plan.

A1C and self-monitoring

A part of your treatment plan will include self-monitoring at home with a blood glucose meter or other device. Your health care team will direct you on how often and when you should test your blood sugar.

Your self-monitoring device reports your blood sugar levels in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per liter (mmol/L). The measurement shows your blood sugar level at the time you do the test. Therefore, there is some variability throughout the day based on eating, exercise, stress and other factors.

Self-monitoring helps you make choices about diet and exercise and daily treatment goals, but it also helps you track whether you are meeting your A1C target. For example, if your A1C target is below 7%, your self-monitoring blood sugar levels should be, on average, below 154 mg/dL (8.6 mmol/L).

A1C test results generally correspond with the following results of blood sugar levels:

A1C level Estimated average blood sugar (glucose) level
6% 126 mg/dL (7 mmol/L)
7% 154 mg/dL (8.6 mmol/L)
8% 183 mg/dL (10.2 mmol/L)
9% 212 mg/dL (11.8 mmol/L)
10% 240 mg/dL (13.4 mmol/L)
11% 269 mg/dL (14.9 mmol/L)
12% 298 mg/dL (16.5 mmol/L)

Limitations of the A1C test

Some factors may interfere with the accuracy of A1C test results. These include:

  • Pregnancy
  • Recent or heavy blood loss
  • Recent blood transfusion
  • Conditions that result in insufficient red blood cells (anemias)
  • Hemoglobin variants

The most common form of the oxygen-transporting hemoglobin protein is called hemoglobin A. The presence of other variants of the protein may result in inaccurate A1C test results. Hemoglobin variants are more common among people of African, Mediterranean or Southeast Asian descent.

If you have a hemoglobin variant, your test may need to be sent to a specialized lab or you may need a different test for diagnosis and monitoring of diabetes.

Clinical trials


Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.


Jan. 30, 2021

Test, levels, and more for diabetes

The A1C test is a blood test that measures a person’s average blood glucose levels over the past 3 months. Blood glucose is another name for blood sugar.

Doctors use the A1C test to check for:

  • prediabetes
  • type 1 diabetes
  • type 2 diabetes

This test also helps doctors monitor blood glucose levels in people with diagnosed diabetes.

Keeping A1C levels within the normal or target range lowers the risk of developing diabetes or its complications. Read on to learn what A1C test results mean.

The A1C chart below can help a person convert and understand their A1C test results. The doctor can provide more context and describe ways to keep blood glucose levels in a safe range.

The A1C test is also known as the:

  • hemoglobin A1C, or HbA1c, test
  • glycated hemoglobin test
  • glycohemoglobin test

The A1C test measures the percentage of red blood cells that have glucose-coated hemoglobin. This measurement gives doctors an idea of the person’s average blood glucose levels over the past 2–3 months.

Hemoglobin is an iron-rich protein in red blood cells. It helps carry oxygen from the lungs to other tissues.

When glucose enters the blood, it binds to hemoglobin. The more glucose in a person’s bloodstream, the more hemoglobin is bound to glucose.

Undergoing the A1C test is straightforward: A healthcare professional takes a blood sample and sends it to a laboratory for testing.

A doctor may order this test to:

  • diagnose prediabetes
  • diagnose type 1 or type 2 diabetes
  • monitor the blood glucose levels of a person with diabetes to check how well their treatment is working

If a person takes insulin to manage diabetes, their doctor may also ask them to monitor their blood glucose levels at home with a blood glucose meter or continuous glucose monitor.

In this case, the person still needs to undergo regular A1C testing.

Traditionally, A1C levels are reported as a percentage. Alternately, they may be reported as estimated average glucose (eAG), in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).

Blood glucose meters and continuous glucose monitors also give eAG readings, some from at least 12 days of data.

The A1C test gives a more accurate long-term average. It takes into account fluctuations throughout the day, such as overnight and after meals.

A normal A1C level is below 5.7%. Normal eAG is below 117 mg/dL or 6.5 mmol/L.

If someone’s A1C levels are higher than normal, they may have diabetes or prediabetes. Their doctor might order a repeat test to confirm this.

Target levels in people with diabetes

A doctor will set a person’s target A1C level based on many factors. The right target varies from person to person.

For someone with diabetes, the target A1C level may depend on:

  • the person’s age
  • their overall health
  • whether they are pregnant
  • how long they have had diabetes
  • their prescribed treatment plan
  • any history of adverse effects from the treatment, including episodes of low blood glucose, or hypoglycemia
  • any complications from diabetes
  • the person’s preferences and treatment priorities

In general, a doctor might recommend aiming for A1C levels under 6.5% if a person:

  • is young and has a long life expectancy
  • has had diabetes for a short period
  • is effectively managing their diabetes with lifestyle changes or metformin alone
  • is otherwise in good health

A doctor might recommend A1C targets of 7.0–8.5% if a person:

  • is older and has a shorter life expectancy
  • has had diabetes for a longer period
  • has diabetes that is hard to manage, even with multiple medications
  • has a history of severe hypoglycemia or other adverse effects of treatment
  • has experienced complications of diabetes
  • has other chronic health conditions

A person should work with their doctor to reassess and adjust their A1C targets over time. The condition and treatment goals may change.

To screen for diabetes, a doctor may order an A1C test for someone older than 45. They may also do this for younger people who have other risk factors.

After diagnosing diabetes, a doctor determines how often to test A1C levels.

If a person is meeting their treatment goals, they may need an A1C test twice a year. When managing blood glucose levels is challenging, a person tends to need this test more frequently.

A person should make an appointment with their doctor if they:

  • have questions or concerns about their treatment plan
  • are finding it hard to keep their blood glucose levels within the target range
  • have had symptoms of high or low blood glucose levels
  • think they might have complications of diabetes

Symptoms of high blood glucose levels include:

  • fatigue
  • unusual thirst
  • frequent urination
  • blurred vision

Symptoms of low blood glucose levels include:

  • nervousness, irritability, or anxiety
  • confusion
  • dizziness
  • hunger
  • shaking
  • sweating

Anyone who develops any of the symptoms above or notices other changes in their health should let their doctor know.

A doctor orders an A1C test to check whether someone has prediabetes or type 1 or 2 diabetes. Doctors also use this test to monitor blood glucose levels in people with diabetes to see how well their treatment plan is working.

A1C test results are usually a percentage, but they may come as an eAG measurement. Target A1C levels vary from person to person, depending on age, overall health, and other factors.

Having high A1C levels may indicate that the person has diabetes or a high risk of related complications. In this case, the doctor will work with the person to adjust the approach to treatment.

A1C Test and A1C Calculator

 

Your A1C test result (also known as HbA1c or glycated hemoglobin) can be a good general gauge of your diabetes control, because it provides an average blood glucose level over the past few months.

Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you check blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target of 7% or lower recommended by the American Diabetes Association (ADA) for many adults who are not pregnant. For some people, a tighter goal of 6.5% may be appropriate, and for others, a less stringent goal such as 8% may be better.1 Talk to your doctor about the right goal for you.

A1C calculator*

The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management.

See how average daily blood sugar may correlate to A1C levels.2 Enter your average blood sugar reading and click Calculate.

A1C Calculator

Average Blood Sugar
(100-300 mg/dL)

Please use a number
between 100 and 300.

Please use a number
between 100 and 300.

*Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes.

What is A1C?

Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a sample of hemoglobin A1C cells—a component of your red blood cells.

Here’s how it works:

  • Some blood sugar (or glucose) naturally attaches itself to A1C cells as they move through your bloodstream. When this happens, the cell is considered “glycated.”
  • Once a cell has been glycated, it stays that way. And since each A1C cell has a lifespan of about 4 months, your A1C sample will include cells that are a few days, a few weeks and a few months old. As a result, the test covers a span of about 2 to 3 months.
  • The more sugar in your blood, the higher the percentage of glycated A1C cells you’ll have—that percentage is your A1C test result.3

Self-monitoring blood glucose and A1C

A1C is important, but it’s not a substitute for frequent self-monitoring. Only regular blood sugar checks show you how meals, activity, medications and stress affect your blood sugar at a single moment in time, as well as over the course of a day or week.

Without regular self-testing to provide day-to-day insights, an A1C result can be confusing. Because it gives a long-term view, a person with frequent highs and lows could have an in-range A1C result that looks quite healthy.4

The only way to get a complete picture of your blood sugar control is by reviewing your day-to-day self-checks along with your regular A1C tests, and working closely with your healthcare team to interpret the results.

How often do I need an A1C test?

This calculator only estimates how the A1C of someone who self-monitors quite frequently might correlate with their average meter readings. But many factors can affect blood glucose, so it’s critical to have your A1C checked by your doctor regularly.

The ADA recommends an A1C test at least 2 times a year for those who are in good control. For those who have changed their therapy or who are not in good control and not meeting glycemic goals, an A1C test is recommended quarterly. Your doctor will help you decide what’s right for you.1

Benefits of lowering your A1C test result

Keeping your A1C test results low can significantly reduce the risk of long-term diabetes complications such as nerve problems, damage to your eyes, kidney disease and heart problems.3


1American Diabetes Association. Standards of medical care in diabetes—2017 [position statement]. Diabetes Care. 2017;40(1): S1-S135. Available at: http://care.diabetesjournals.org/content/diacare/suppl/2016/12/15/40.Sup…. Accessed July 28, 2017.

2Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ. Translating the A1C assay into estimated average glucose values. Diabetes Care. 2008;31(8): 1473-1478. Available at http://care.diabetesjournals.org/content/31/8/1473.full.pdf. Accessed July 28, 2017.

3American Diabetes Association. A1C and eAG. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-gl…. Accessed July 28, 2017.

4Tylee TS, Trence DL. Glycemic variability: looking beyond the A1C. Diabetes Spectrum. 2012;24(3): 149-153. Available at http://spectrum.diabetesjournals.org/content/25/3/149.full. Accessed July 28, 2017.

The A1C Test & Diabetes

On this page:

What is the A1C test?

The A1C test is a blood test that provides information about your average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test can be used to diagnose type 2 diabetes and prediabetes.1 The A1C test is also the primary test used for diabetes management.

An A1C test is a blood test that reflects your average blood glucose levels over the past 3 months.

The A1C test is sometimes called the hemoglobin A1C, HbA1c, glycated hemoglobin, or glycohemoglobin test. Hemoglobin is the part of a red blood cell that carries oxygen to the cells. Glucose attaches to or binds with hemoglobin in your blood cells, and the A1C test is based on this attachment of glucose to hemoglobin.

The higher the glucose level in your bloodstream, the more glucose will attach to the hemoglobin. The A1C test measures the amount of hemoglobin with attached glucose and reflects your average blood glucose levels over the past 3 months.

The A1C test result is reported as a percentage. The higher the percentage, the higher your blood glucose levels have been. A normal A1C level is below 5.7 percent.

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.

You may be able to prevent or delay type 2 diabetes with lifestyle changes such as weight loss or being physically active most days of the week.

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 don’t 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 don’t 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

A1C results and what the numbers mean

*Any test used to diagnose diabetes requires confirmation with a second measurement, unless there are clear symptoms of diabetes.
Diagnosis* A1C Level
Normal below 5.7 percent
Prediabetes 5.7 to 6.4 percent
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 doctor’s 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.

Is the A1C test used during pregnancy?

Health care professionals may use the A1C test early in pregnancy to see if a woman with risk factors had undiagnosed diabetes before becoming pregnant. Since the A1C test reflects your average blood glucose levels over the past 3 months, testing early in pregnancy may include values reflecting time before you were pregnant. The glucose challenge test or the oral glucose tolerance test (OGTT) are used to check for gestational diabetes, usually between 24 and 28 weeks of pregnancy. If you had gestational diabetes, you should be tested for diabetes no later than 12 weeks after your baby is born. If your blood glucose is still high, you may have type 2 diabetes. Even if your blood glucose is normal, you still have a greater chance of developing type 2 diabetes in the future and should get tested every 3 years.

Can other blood glucose tests be used to diagnose type 2 diabetes and prediabetes?

Yes. Health care professionals also use the fasting plasma glucose (FPG) test and the OGTT to diagnose type 2 diabetes and prediabetes. For these blood glucose tests used to diagnose diabetes, you must fast at least 8 hours before you have your blood drawn. If you have symptoms of diabetes, your doctor may use the random plasma glucose test, which doesn’t require fasting. In some cases, health care professionals use the A1C test to help confirm the results of another blood glucose test.

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 occur—an 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.

Why do diabetes blood test results vary?

Lab test results can vary from day to day and from test to test. This can be a result of the following factors:

Blood glucose levels move up and down

Your results can vary because of natural changes in your blood glucose level. For example, your blood glucose level moves up and down when you eat or exercise. Sickness and stress also can affect your blood glucose test results. A1C tests are less likely to be affected by short-term changes than FPG or OGTT tests.

The following chart shows how multiple blood glucose measurements over 4 days compare with an A1C measurement.

Blood Glucose Measurements Compared with A1C Measurements over 4 Days

Blood glucose (mg/dL) measurements were taken four times per day (fasting or pre-breakfast, pre-lunch, pre-dinner, and bedtime).

The straight black line shows an A1C measurement of 7.0 percent. The blue line shows an example of how blood glucose test results might look from self-monitoring four times a day over a 4-day period.

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 you’re 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 interference—a falsely high or low result—when your A1C and blood glucose test results don’t match.

If you’re of African, Mediterranean, or Southeast Asian descent, you could have a different type of hemoglobin that affects your diabetes care.

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.

Read about diabetes blood tests for people of African, Mediterranean, or Southeast Asian descent. The NIDDK has information for health care providers on Sickle Cell Trait & Other Hemoglobinopathies & Diabetes.

Small changes in temperature, equipment, or sample handling

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 measurements—fasting and OGTT—more than the A1C test.

Your health care professional can help you understand your test results.

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.

How precise is the A1C test?

When repeated, the A1C test result can be slightly higher or lower than the first measurement. This means, for example, an A1C reported as 6.8 percent on one test could be reported in a range from 6.4 to 7.2 percent on a repeat test from the same blood sample.3 In the past, this range was larger but new, stricter quality-control standards mean more precise A1C test results.

Health care professionals can visit www.ngsp.org to find information about the precision of the A1C test used by their lab.

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 aren’t meeting your treatment goals.4

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 percent—or even higher in some circumstances—may be appropriate in people who have

  • limited life expectancy
  • long-standing diabetes and trouble reaching a lower goal
  • severe hypoglycemia or inability to sense hypoglycemia (also called hypoglycemia unawareness)
  • advanced diabetes complications such as chronic kidney disease, nerve problems, or cardiovascular disease

How does A1C relate to estimated average glucose?

Estimated average glucose (eAG) is calculated from your A1C. Some laboratories report eAG with A1C test results. The eAG number helps you relate your A1C to daily glucose monitoring levels. The eAG calculation converts the A1C percentage to the same units used by home glucose meters—milligrams per deciliter (mg/dL).

The eAG number will not match daily glucose readings because it’s a long-term average—rather than your blood glucose level at a single time, as is measured with a home glucose meter.

Will the A1C test show short-term changes in blood glucose levels?

Large changes in your blood glucose levels over the past month will show up in your A1C test result, but the A1C test doesn’t show sudden, temporary increases or decreases in blood glucose levels. Even though A1C results represent a long-term average, blood glucose levels within the past 30 days have a greater effect on the A1C reading than those in previous months.

Clinical Trials for the A1C Test and Diabetes

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.

What are clinical trials and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Scientists are conducting research to learn more about diabetes, including studies about A1C. For example

  • how the relationship between A1C and blood glucose may vary in different racial and ethnic groups
  • to find other tests that may be better than A1C for some people
  • to look for ways to further improve A1C test results. Because the A1C value depends on the average life span of your red blood cells, knowing whether the life span of your red blood cells is longer or shorter may give your doctor helpful information.

Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

What clinical trials are open?

Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.

References

[1] Gillett MJ. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32(7):1327–1334.

[2] American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes—2018. Diabetes Care. 2018;41(suppl 1):S13–S27.

[3] Penttilä I, Penttilä K, Holm P, et al. Methods, units and quality requirements for the analysis of haemoglobin A1c in diabetes mellitus. World Journal of Methodology. 2016;6(2):133–142.

[4] American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes—2018. Diabetes Care. 2018;41(suppl 1):S55–S64.

What Are Normal Hemoglobin A1c Levels?

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Normal hemoglobin A1c levels are <5.7%

Hemoglobin A1c is a type of hemoglobin in the blood that is bound to glucose. There is normally a low percentage of hemoglobin A1c in the blood. However, if blood sugar levels are elevated, the percentage of hemoglobin A1c increases as well. This makes hemoglobin A1c an important marker for chronically high blood sugar levels.

The hemoglobin A1c level can give a good estimation of how well blood sugar has been controlled over a three-month period. A hemoglobin A1c level of 5.7–6.4% is considered prediabetes. A hemoglobin A1c level of 6.5% or higher is considered diabetes. According to some organizations, the target hemoglobin A1c level for people who are diagnosed with diabetes is 7.0–8.0%. This can be achieved by controlling blood sugar levels, which is, in turn, done through diet, exercise, and oral and injectable medications. You can read more about hemoglobin A1c here.

Advertisement

Over 500 generic drugs, each $5 per month

Switch to Ro Pharmacy to get your prescriptions filled for just $5 per month each (without insurance).

Learn more

In medicine, using the term “normal” can sometimes be off-putting. Saying something is “normal” implies that everything else is “abnormal.” Additionally, saying something is “normal” may not be accurate, since something that is “normal” for you may not be “normal” for somebody else. Therefore, instead of saying certain values are “normal,” alternative terminology may be to say that these values are “healthy” or “within the reference range.”
 
Additionally, some values have well-defined cutoffs, while others do not. For example, when looking at hemoglobin A1c levels, a value of 6.5 or greater is always diagnostic of diabetes. On the other hand, when looking at testosterone levels, some use cutoffs of 270–1,070 ng/dL while others use cutoffs of 300–1,000 ng/dL.
 
The information below represents values that are commonly used as cutoffs. However, depending on the specific source you’re looking at or the laboratory you go to, their values may be a little different.

90,000 What you need to know about HbA1C

Among the many numbers of test results that doctors prepare, the simple meaning of an HbA1C test can help you figure out how well you are at keeping track of your blood sugar.

First of all, let’s find out what is HbA1C?

You can find various names for this indicator:

  • A1c
  • Glycated hemoglobin
  • Glycosylated hemoglobin
  • Hemoglobin A1C

The level of HbA1C (glycated hemoglobin) shows what percentage of hemoglobin in erythrocytes binds to glucose 1 .Since the lifetime of an erythrocyte that contains hemoglobin is several months, the HbA1C test allows you to establish how effective blood sugar control was in the previous 2-3 months.

How often should the HbA1C level be checked?

The American Diabetes Association (ADA) recommends that diabetic patients with stable blood sugar have an HbA1C test every six months, and if the target blood sugar level is not achieved or the treatment needs to be changed, such a test is done every 3 months 2 .

What level of HbA1C should you strive for?

The American Diabetes Association recommends that HbA1C levels be 7% or lower, and the closer to 6% with no health risk, the better. However, for each person, this level should be set depending on the state of health at the current moment and taking into account many factors (in particular, whether a person feels the onset of hypoglycemia). Most likely, if your HbA1C level exceeds 7%, your doctor will advise you on what to do to reduce it, because, among other things, lowering this indicator helps to reduce the risk of long-term complications of diabetes, which we are trying to prevent 2 .

Is it possible to do without measuring blood sugar if an HbA1C test is done?

Since HbA1C is an average value, it cannot guarantee that blood sugar levels are within a safe range throughout the day. Let’s see what the average value means. The average for the numbers 5-5-5-5 and the numbers 1-9-1-9 will be 5, but on the chart, the numbers 1-9-1-9 will look like sharp ups and downs. This also applies to blood sugar levels. If there are many sharp rises and falls after averaging, the HbA1C level may be similar to the HbA1C level of a healthy person 3 .

Therefore, it is most correct to evaluate the results of the analysis for HbA1C in the presence of the results of self-monitoring of blood sugar levels. It is impossible to understand how the disease develops without self-monitoring of blood sugar levels.

If HbA1C is low, do fluctuations in blood sugar matter?

Blood sugar levels tend to change throughout the day, and this is due to what we eat, how much we move and how much we rest. Currently, along with the results of the HbA1C analysis, a high variability of glycemia is also assessed – this is the name of these fluctuations in blood sugar levels.

Data obtained in a study on the treatment and complications of diabetes (Diabetes Control and Complications Trial, DCCT 4 ) showed that at the same level of HbA1C, those patients who have more pronounced fluctuations in blood sugar levels are more susceptible to certain types of complications …

If you want to know if you are at risk and how your actions affect your blood sugar, then using the Accu-Chek 360 ° Form (Blood Glucose Test: Before and After Meals) you can understand how food , exercise, medication, stress, or illness can affect blood sugar levels throughout the day.It has been proven that this analysis system even helps to reduce the level of HbA1C when worked with a doctor 5 . Start making a difference now.

Glycosylated hemoglobin – norm, analysis, table, determination of the level of glycosylated hemoglobin (HbA1c)

Published: 16.04.2012 Updated: 20.05.2021 Hits: 89290 90 003

It is very important to achieve optimal blood glucose levels in the management of patients with diabetes mellitus.The patient can control the level of glucose in the blood independently (with portable glucometers) or in the laboratory.

The result of a single determination of glucose in the blood shows the glucose concentration at the time of sampling, therefore, it is not possible to make any assumptions about the state of the patient’s carbohydrate metabolism between measurements. It is possible to assess carbohydrate metabolism in a patient over a long period of time only by measuring the concentration of glycosylated hemoglobin in the blood, according to the recommendations of the Committee on the Control of Diabetes and Its Clinical Complications (DCCT).

According to studies conducted by DCCT, it was shown that the risk of development and progression of long-term complications of type 1 diabetes is closely related to the degree of efficiency of glycemic control, expressed in the content of glycosylated hemoglobin in the blood [10]. Specialists from the UK have shown that a decrease in the patient’s blood glucose, assessed by the HbA1c concentration, reduces the incidence of microangiopathies in type 2 diabetes mellitus [4].

Characteristics of the indicator

Glycosylated hemoglobin (the term “glycated hemoglobin” is also used) is formed as a result of non-enzymatic attachment of glucose to the N-terminal regions of β-chains of hemoglobin A1 globin and is designated as HbA1c.The HbA1c concentration is directly proportional to the average blood glucose concentration. In healthy people, the concentration of HbA1c in the blood is from 4 to 6%, in patients with diabetes mellitus, its level is 2-3 times higher (depending on the degree of hyperglycemia).

The formed HbA1 accumulates inside the erythrocytes and remains during the entire life of the erythrocyte. The half-life of erythrocyte circulation in the bloodstream is 60 days, thus the HbA1c concentration reflects the patient’s glycemic level 60-90 days before the study [2, 3].

A huge number of studies using traditional methods of glucose measurement have confirmed the relationship between HbA1c and the patient’s glycemic level [12-14]. The results of studies carried out by the DCCT in the 90s served as the basis for confirming the hypothesis that the level of HbA1c reflects the level of glucose in the blood and is an effective criterion for monitoring patients with diabetes mellitus.

Standardization of methods for the study of glycosylated hemoglobin

In the early 90s, there was no interlaboratory standardization of methods for measuring glycosylated hemoglobin, which reduced the clinical effectiveness of this test [15-17].In this regard, the American Association of Clinical Chemistry in 1993 formed a subcommittee on the standardization of methods for measuring glycosylated hemoglobin. As a result of his work, the National Glycosylated Hemoglobin Research Standardization Program (NGSP) was developed. Manufacturers of test kits for measuring glycosylated hemoglobin were required to undergo rigorous testing to ensure that the results match the data obtained by the DCCT reference methods. In the event of a positive test result, the manufacturer is issued a “DCCT Certificate of Conformity”.The American Diabetes Association recommends that all laboratories use only NGSP-certified tests [7].

There are currently many methods for studying glycosylated hemoglobin:

  • liquid chromatography;
  • affinity chromatography;
  • electrophoresis;
  • column methods;
  • immunological methods.

When a laboratory chooses an analyzer for the study of glycosylated hemoglobin, preference should be given to analyzers based on the DCCT reference method, which is liquid chromatography.The use of standardized test methods enables the laboratory to obtain results that can be compared with data obtained using reference methods and published by the DCCT. This comparison maximizes the reliability of the research results.

It is extremely important that the attending physician uses in his work the research results obtained only in those laboratories that conduct research on glycosylated hemoglobin using methods certified by NGSP.

Study of the concentration of HbA1c in the laboratories of the Association “Citylab”

The concentration of glycosylated hemoglobin (HbA1c) in the laboratories of the Association “Citylab” is determined by the reference method (DCCT) high performance liquid chromatography (HPLC), (the method is certified by NGSP), on D 10 analyzers from Bio-Rad, which is the world leader in the production of glycosylated hemoglobin. This study is 23-10-002 – Glycosylated Hemoglobin.

Estimated mean blood glucose

The DCCT research team demonstrated the clinical significance of HbA1c as an estimate of the mean blood glucose concentration (over 60-90 days). In these studies, a daily glucose profile (seven measurements daily) was recorded in patients every 3 months. The resulting profile was compared with the HbA1c level. Over 9 years, more than 36,000 studies have been carried out. Empirically, a linear relationship between the average glucose and HbA1c levels was obtained:

Average glucose concentration (mg / 100 ml) = 30.9 x (HbA1c) -60.6, where:

HbA1c – concentration of glycosylated hemoglobin.

Simply put, a 1% change in HbA1c corresponds to a 30 mg / 100 ml (1.7 mmol / L) change in mean glucose.

Note: The indicated relationship was obtained by examining the concentration of glucose in capillary blood. Serum glucose concentration is approximately 15% higher.

The diagram (Fig. 1) [11] can be used to interpret the results of HbA1c studies.

Fig.1. Diagram of the control of carbohydrate metabolism in patients with diabetes mellitus

Note: The concentration of glucose is indicated in mmol / l, in parentheses in mg / 100 ml, 1 – High risk of developing long-term complications such as retinopathy, nephropathy and neuropathy. 2 – Increased risk of hypoglycemic reactions in patients with type 1 or 2 diabetes when taking insulin or oral hypoglycemic drugs.

To convert the concentration of glucose in mg / 100 ml to SI units (mmol / L), use the following formula:

Glucose (mg / 100 ml) x 0.0555 = Glucose (mmol / L)

Recommended study frequency

The American Diabetes Association recommends that for patients whose therapy has been successful (stable level of carbohydrate metabolism), the HbA1c test should be carried out at least 2 times a year, while in case of dietary or treatment changes, the frequency of examination should be increased to 4 times a year [ 7].In the Russian Federation, according to the Federal Target Program “Diabetes Mellitus”, the HbA1c study should be carried out 4 times a year for any type of diabetes [1].

According to the recommendations of the American Diabetes Association, women with diabetes mellitus in the period prior to pregnancy need a special monitoring regimen. It is recommended to reduce the level of HbA1c to create optimal conditions for conception and development of the fetus in the body of the expectant mother. At the beginning, HbA1c should be tested monthly.When, with appropriate therapy, carbohydrate metabolism is stabilized, the HbA1c study should be carried out at intervals of 6-8 weeks until the moment of conception [5, 6].

Modern research has shown that many patients do not adhere to the recommended interval between studies [8], but experts have come to the general opinion that regular studies of the HbA1c content significantly reduce the risk of complications in patients with diabetes mellitus.

Interpretation of research results

The task of glucose-lowering therapy in diabetes mellitus is to normalize blood glucose levels.Studies within the DCCT have shown that intensive treatment prevents the patient from developing long-term complications such as retinopathy, nephropathy and neuropathy, or significantly delays their clinical manifestation. If patients strictly adhere to a regimen aimed at normalizing carbohydrate metabolism, the incidence of retinopathy decreases by 75%, nephropathy – by 35-36%, and the risk of polyneuropathy decreases by 60% [10].

Below are the therapeutic goals in the treatment of diabetes mellitus according to the Federal Target Program “Diabetes mellitus”.

Table 1.

Therapeutic goals in the treatment of type 1 diabetes mellitus [1, 18]

Study name

Reference values

Adequate level

Inadequate

level

Self-monitoring of blood glucose, mmol / l (mg%)

fasting

4.0 – 5.0 (70 – 90)

5.1 – 6.5 (91 – 117)

> 6.5 (> 117)

2 hours after eating

4.0 – 7.5 (70 – 135)

7.6 – 9.0 (136 – 162)

> 9.0 (> 162)

before bedtime

4.0 – 5.0 (70 – 90)

6.0 – 7.5 (110 – 135)

> 7.5 (> 135)

HbA1c

<6

6.1 – 7.5

> 7.5

Table 2.

Therapeutic goals in the treatment of type 2 diabetes mellitus [1, 19]

Study name

Low risk

angiopathies

Risk

macroangiopathies

Risk

microangiopathies

Self-monitoring of blood glucose, mmol / l (mg%)

fasting

<5.5 (<100)

> 5.5 (> 100)

> 6.0 (> 110)

2 hours after eating

<7.5 (<135)

> 7.5 (> 135)

> 9.0 (> 160)

HbA1c

<6.5

> 6.5

> 7.5

Note: Glucose values ​​in mg / 100 ml are shown in parentheses.

The Federal Target Program “Diabetes Mellitus” [1] adopted the values ​​recommended by the European Diabetes Commission [18, 19].

When assessing the results of treatment in patients with concomitant diseases, young people, the elderly, pregnant women and patients with an unusual pattern of diabetes mellitus, it is necessary to apply other criteria for stabilizing carbohydrate metabolism.

With an inadequate level of carbohydrate metabolism in a patient, additional measures are required, which depend on the clinical picture of the patient’s disease, such measures may include:

  • extended patient education on self-monitoring of glucose levels;
  • organization of patient support groups;
  • regular examination by an endocrinologist;
  • changes in drug therapy;
  • More frequent testing of glucose and HbA1c concentration.

Conclusions

  1. The HbA1c study allows you to assess the level of glycemia in a patient with diabetes mellitus for 60-90 days prior to the study.
  2. This study makes it possible to monitor the course of the disease and control the adequacy of the treatment.
  3. The HbA1c study is necessary to assess the risk of complications in a patient with diabetes mellitus.

Literature Used

  1. Dedov I.I., Shestakova M.V., Maksimova M.A. Federal target program “Diabetes mellitus”. // Moscow, 2002, 84 p.
  2. Peters – Harmel E., Mathur R. Diabetes mellitus. Diagnostics and treatment. // Practice, 2008.
  3. Popova Yu.S. Diabetes. // Krylov, 2008.
  4. ADA. Implications of the United Kingdom Prospective Diabetes Study (Position Statement). // Diabetes Care 1999, (SI), 27-31.
  5. ADA. Standards of Medical Care for Patients With Diabetes Mellitus (Position Statement).// Diabetes Care 1999, (SI), 32-41.
  6. ADA. Preconception Care of Women With Diabetes (Position Statement). // Diabetes Care 1999, (SI), 62-63.
  7. ADA. Tests of Glycemia in Diabetes (Position Statement). // Diabetes Care 1999, (SI) 77-79.
  8. Auxter S. Another Study Shows Laboratory Tests are Underutilized. // Clin Lab News 1998, 24 (9): 24-5.
  9. Bodor G., Little R., Garrett N. et al. Standardization of Glycohemoglobin Determinations in the Clinical Laboratory: Three Years Experience.// Clin Chem 1992; 38: 2414-18.
  10. DCCT Research Group. The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long – Term Complications in Insulin – Dependent Diabetes Mellitus. // Engl J Med 1993; 329: 977-86.
  11. Goldstein D.E., Little R.R. Bringing Order to Chaos: Standardizing the Hemoglobin A1c Assay. // Contemp Int Med 1997; 9 (5): 27-32 /
  12. Gonen B. A., Rubinstein A. H., Rochman H. et al. Hemoglobin A1: An Indicator of the Metabolic Control of Diabetic Patients.// The Lancet 1977, Oct 8; 2 (804): 734-7.
  13. Koenig R. J., Peterson C. M., Kilo C. et al. Hemoglobin A1c as an Indicator of the Degree of Glucose Intolerance in Diabetes. // Diabetes 1976, 25 (3): 230-2.
  14. Koenig R.J., Peterson C.M., Jones R.L. et al. Correlation of Glucose Regulation and Hemoglobin A1c in Diabetes Mellitus. // Engl J Med 1976, 295 (8): 417-20.
  15. Little R.R., England J.D., Wiedmeyer H.M. et al. Interlaboratory Standardization of Glycated Hemoglobin Determinations.// Clin Chem 1986; 32: 358-60.
  16. Little R.R., England J.D., Wiedmeyer H.M. et al. Interlaboratory Comparison of Glycated Hemoglobin Results: College of American Pathologists (CAP) Survey Data. // Clin Chem 1991; 37: 1725-29.
  17. Little R.R., England J.D., Wiedmeyer H.M. et al. Interlaboratory Standardization of Measurements of Glycohemoglobin. // Clin Chem 1992; 38: 2472-78.
  18. European Diabetes Policy Group. Guidelines for a desktop guide to Type 1 (insulindependent) Diabetes Mellitus.- International Diabetes Federation European Region. – 1998.
  19. European Diabetes Policy Group. Guidelines for a desktop guide to Type 2 Diabetes Mellitus. – International Diabetes Federation European Region. – 1998 – 1999.

90,000 A1C DIABETES TEST: NORMAL RANGE, ACCURACY AND MUCH MORE – HEALTH

People with diabetes used to rely only on urine tests or daily finger pricks to measure their blood sugar.These tests are accurate, but only for the time being. In fact, they are very limited to

Content:

What is the A1C test?

People with diabetes used to rely only on urine tests or daily finger pricks to measure their blood sugar. These tests are accurate, but only for the time being.

They are actually very limited as a general measurement of blood sugar control.This is because blood sugar levels can vary greatly depending on the time of day, your level of activity, and even hormonal changes. Some people may have high blood sugar at 3 AM without even knowing it.

A1C tests became available in the 1980s and quickly became an important monitoring tool for diabetes control. A1C tests measure your average blood glucose level over the past two to three months, so even if you have high fasting blood sugar, your total blood sugar may be normal, or vice versa.

Normal fasting blood sugar cannot rule out the possibility of type 2 diabetes. This is why A1C tests are now used to diagnose and screen for prediabetes and diabetes. Since this does not require fasting, the test can be done at any time as part of a general blood screening.

A1C test is also known as hemoglobin A1c test or HbA1c test. Other test names include glycosylated hemoglobin test, glycohemoglobin test, glycated hemoglobin test, or A1C.

What exactly does the A1C measure?

A1C measures the amount of hemoglobin in the blood to which glucose is attached. Hemoglobin is a protein found in red blood cells that carries oxygen to the body. Hemoglobin cells are constantly dying and regenerating. Their lifespan is approximately three months.

Glucose attaches (glycates) to hemoglobin, so the recording of how much glucose is attached to hemoglobin also takes about three months.If too much glucose is attached to the hemoglobin cells, you will have a high A1C. If your glucose is normal, your A1C will be normal.

How does the test work?

The test is effective due to the lifespan of the hemoglobin cells.

Let’s say you had high blood glucose last week or last month, but it is now normal. Your hemoglobin will carry the “record” of high blood glucose last week as more A1C in your blood.Glucose that has been attached to hemoglobin in the past three months will still be registered with the test, since the cells live for about three months.

The A1C test provides an average blood sugar reading over the past three months. It is not accurate for every day, but it gives your doctor a good idea of ​​how effective your blood sugar control is over time.

What do the numbers mean?

A person without diabetes has about 5 percent glycosylated hemoglobin.Normal A1C levels are 5.6 percent or lower, according to the National Institute for Diabetes, Digestive and Kidney Diseases.

A level between 5.7 and 6.4 percent indicates prediabetes. People with diabetes have an A1C level of 6.5 percent or higher.

The American Diabetes Association provides a calculator that shows how A1C levels compare to glucose levels.

People with diabetes must have an A1C test at least twice a year to monitor their total glucose levels.More frequent measurements (for example, every 3 months) should be done if you have type 1 diabetes, if your treatment is adjusted, if you and your doctor are setting specific blood sugar targets, or if you are pregnant.

What factors can affect my test results?

Anyone who has had diabetes for a while knows that A1C tests were unreliable until recently. In the past, many different types of A1C tests gave different results depending on the laboratory that analyzed them.

However, the National Glycohemoglobin Standardization Program has helped improve the accuracy of these tests. A1C test makers now have to prove that their tests match those used in a large diabetes study. Precise home test kits are now available for purchase as well.

However, accuracy is relative when it comes to A1C or even blood glucose tests. The A1C test result can be half a percentage point higher or lower than the actual percentage.This means that if your A1C is 6, it could indicate a range of 5.5 to 6.5.

Some people may have a blood glucose test that indicates diabetes, but their A1C levels are normal, or vice versa. Before confirming the diagnosis of diabetes, your doctor must repeat the test that was abnormal on another day. This is not necessary if you have clear symptoms of diabetes (increased thirst, urination and weight loss) and an occasional amount of sugar over 200.

Some people may get false results if they have kidney failure, liver disease, or severe anemia.Ethnicity can also affect test results. People of African, Mediterranean, or Southeast Asian descent may have a less common type of hemoglobin that can interfere with some A1C tests. A1C can also be affected if the survival rate of red blood cells decreases.

What if you have a high A1C number?

A high A1C level indicates uncontrolled diabetes, which is associated with an increased risk of the following conditions:

  • cardiovascular diseases such as stroke and heart attack
  • kidney disease
  • nerve damage
  • eye damage that can lead to blindness
  • Numbness, tingling and numbness in the legs due to nerve damage
  • Slower wound healing and infection

If you are in the early stages of type 2 diabetes, small lifestyle changes can make a big difference and even lead to remission diabetes.Losing a few pounds or starting an exercise program can help. In type 1 diabetes, insulin is required immediately after diagnosis.

For those who have had prediabetes or diabetes for a long time, higher A1C scores may be a sign that you need to start taking medication or change what you are already taking. Prediabetes can progress to diabetes at a rate of 5-10 percent per year. You may also need to make other lifestyle changes and monitor your daily blood glucose more closely.Talk to your doctor about the most appropriate treatment plan for you.

Output

The A1C test measures the amount of hemoglobin in the blood to which glucose is attached. The test allows you to get the average blood sugar level over the past three months.

It is used to control blood sugar levels and to diagnose and screen for prediabetes and diabetes. People with diabetes should get tested for A1C at least twice a year, and in some cases more often.

Read this article in Spanish.

Hemoglobin A1c versus Glucose Tolerance Test in Oral Postpartum Screening

Hemoglobin A1c Versus Oral Glucose Tolerance Test in Postpartum Diabetes Screening
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402242/

M.J.P. and M.M. equally contributed to this research.

To determine the usefulness of hemoglobin A1c (A1C) measurements, alone or in combination with a fasting glucose test, versus an oral glucose tolerance test (OGTT) for reassessing carbohydrate metabolic status in postpartum women with a history of gestational diabetes mellitus (GDM) …

We assessed carbohydrate metabolic status by performing OGTT and fasting glucose and A1C tests in 231 postpartum women with prior GDM at 1 year postpartum.

The prevalence of abnormal carbohydrate metabolism was 45.89% by the OGTT test, 19.05% by the A1C test, 38.10% by the fasting glucose test, and 46.75% by the A1C blood glucose test. Using OGTT as the gold standard, abnormal carbohydrate metabolism as measured by the A1C criterion had 22.64% sensitivity and 54.55% positive predictive value; abnormal carbohydrate metabolism by the criterion of fasting glucose had 83.02% sensitivity and 100% positive predictive value.The A1C-onslaught-based glucose test criteria classified 18 women with normal carbohydrate metabolism as abnormal carbohydrate metabolism. Abnormal carbohydrate metabolism by glucose test criteria at A1C level was 83.02% and 81.48% positive predictive value.

Our results appear to indicate that the A1C test alone or in combination with the fasting glucose test criterion does not provide a sensitive and specific diagnosis of abnormal carbohydrate metabolism in women who have had GDM.

Gestational diabetes mellitus (GDM) is described as any degree of glucose intolerance with onset or first recognition during pregnancy (1). The prevalence of GDM varies globally and among racial and ethnic groups within the country (2,3). Variations in prevalence also depend on the method used and the diagnostic criteria. According to the diagnostic criteria of the International Diabetes and Pregnancy Association, ~ 18% of women worldwide will be diagnosed with diabetes during pregnancy (4).In Spain, the prevalence of GDM is estimated at 8.8% according to the National Diabetes Data Group (5).

Almost all women with GDM (~ 90%) are normoglycemic immediately after delivery, but they are at high risk for abnormal carbohydrate metabolism and recurrent GDM (6). The recurrence rate of GDM in consecutive pregnancies is ~ 35%, increasing with age and weight of the mother (7). As previous history of GDM predicts an increased risk of type 2 diabetes and cardiovascular disease (8), it is important to reevaluate these women and identify as many cases as possible.

The American College of Obstetricians and Gynecologists (9), the American Diabetes Association (ADA) (10), and the Fifth International Gestational Diabetes Seminar and Conference (11) recommend long-term follow-up of women with GDM using a 2-h, 75 g oral test for glucose tolerance (OGTT). This long-term follow-up is essential, and reassessment of glycemic status should be performed for at least 3 years, because a negative postpartum screening test only rules out the presence of type 1 or type 2 diabetes at the time of the test.

During the last decade, the ADA has updated its screening guidelines for abnormal carbohydrate metabolism. Previously, to identify patients at high risk of developing diabetes, ADA chose to use the fasting glucose test instead of OGTT because of its logical advantage (12). However, people still need to fast for at least 8 hours before testing. Since the hemoglobin A1c (A1C) test is a non-sterile test, it has significant practical advantages over OGTT and is now becoming the test of choice for diagnosing abnormal carbohydrate metabolism (13).

Against this background, the aim of this study was to evaluate the usefulness of A1C (alone or in combination with a fasting glucose test) for reassessing carbohydrate metabolic status in postpartum women with a history of GDM.

A total of 231 Spanish women with a previous GDM underwent OGTT at the Department of Endocrinology at Virgen de la Victoria Hospital 1 year after delivery, as the cumulative incidence of abnormal carbohydrate metabolism in women of postpartum GDM increases during this time (14). Participants completed a structured interview to obtain the following data: age, personal history of GDM and macrosomia in previous pregnancies, family history of diabetes, type of delivery, insulin requirement during pregnancy, and pre-pregnancy BMI.The following data were also collected: weight, height, waist circumference, BMI and blood pressure.

The seizure rate of women with previous GDM was less than half (31.5%), which is similar to that of Russell et al. (fifteen). There were no significant differences in the following variables between those present and those who did not attend the reevaluation: age, BMI before pregnancy, gestational age at which GDM monitoring began, history of GDM in previous pregnancies, history of macrosomia, family history of diabetes, and need for insulin treatment.Women were excluded if they increased breastfeeding by more than 6 months after delivery, were diagnosed with diabetes immediately after delivery, or had anemia.

Blood pressure was measured twice, at 8:00, with the patient and with an interval of 5 min between measurements. Blood pressure measurements were taken on the right arm, which was weakened and supported by a table at an angle of 45 ° from the trunk (ELKA manometric sphygmomanometer), Von Schlieben, Mannheim, Germany).

Blood samples were collected after 12 hours quickly at 8:15 am.The women underwent a 75-gram oral glucose overload with a commercial drug. During this process, only water was allowed and no exercise was performed. Blood samples were collected before and 2 hours after the tolerance test.

Plasma biochemical parameters were measured in duplicate by standard enzymatic methods. Glucose, cholesterol, HDL cholesterol, triglycerides and uric acid were measured using a Dimension Vista analyzer (Siemens AG).LDL cholesterol was calculated using the Friedewald formula. A1C was measured using the VARIANTTM II TURBO A1C-2.0 kit.

Patients were classified according to their fasting glucose as normal (fasting plasma glucose [FPG]

The study was approved by the Ethics Committee of Virgen de la Victoria Hospital, and all participants gave their consent after being fully informed about the purpose and characteristics of the study.

Results are shown as mean ± SD.All clinical parameters are summarized by descriptive statistics. Typical data distributions were tested using the Kolmogorov-Smirnov test. The relationship between the clinical parameters of the patients was analyzed using the Student’s t test. Differences in the frequency distribution of qualitative variables between groups were assessed using Fisher’s exact test. Agreement between diagnoses derived from A1C, fasting glucose, or a combination of both test criteria and OGTT criteria was assessed by calculating Cohen’s coefficient (κ).Using OGTT as a gold standard, diagnostic values ​​for A1C, FPG, or a combination thereof were assessed for sensitivity, specificity, and positive and negative predictive values. The sample size was estimated under the assumption that the sensitivity was ~ 50% (16,17), which corresponds to the worst-case scenario of maximum uncertainty. In 97 patients, the 95% CI accuracy for this sensitivity would be 10%. Since we have calculated that the prevalence of abnormal carbohydrate metabolism may be ~ 50% (14), and assuming a loss rate of 16%, 231 patients will be sufficient to have the strength to achieve the above accuracy.

In all cases, the level of rejection for the null hypothesis was α = 0.05 for the two tails. Statistical analysis was performed using SPSS (version 15.0 for Windows, SPSS, Chicago, IL).

The age of the study subjects was 34.63 ± 4.65 years, and their BMI was 27.74 ± 5.95 kg / m2. The assessment was carried out 13.2 ± 3.0 months after delivery. Table 1 shows the distribution of clinical and medical history variables in women with normal and abnormal carbohydrate metabolism according to oral glucose tolerance, fasting glucose, and A1C test criteria.All diagnostic studies showed that a group of women with abnormal carbohydrate metabolism had higher BMI, waist circumference, blood pressure (except A1C), glucose levels and lipid abnormalities, all variables associated with increased vascular risk.

Distribution of clinical indicators in women with normal or abnormal glucose tolerance according to various diagnostic tests

Based on OGTT results, 125 women (54.11%) had normal glucose tolerance, 92 (39.83%) had prediabetes (58 with IFG, 16 with IGT, and 18 with IFG + IGT) and 14 (6.06%) ) had diabetes.Based on fasting glucose results, 143 women (61.91%) had normal glucose tolerance, 82 (35.50%) had prediabetes, and 6 (2.60%) had diabetes. In contrast, using the A1C test, 187 women (80.95%) had normal glucose metabolism, 43 (18.62%) had prediabetes, and 1 had diabetes (0.43%). When fasting blood glucose and A1C were combined, 123 women (53.25%) had normal glucose metabolism, 101 (43.72%) had prediabetes, and 7 had diabetes (3.03%).

Figure 1 depicts women classified as having abnormal carbohydrate metabolism according to at least one of the diagnostic tests.The prevalence of abnormal carbohydrate metabolism by OGTT (gold standard) was 45.89%. However, 20 women classified as having normal carbohydrate metabolism with the OGTT criteria (16% of all these women) were diagnosed as having abnormal carbohydrate metabolism according to the A1C test and fasting glucose criteria (Table 2). In turn, 82, 18 and 18 women classified as having abnormal carbohydrate metabolism by the OGTT criteria (77.36, 16.98 and 16.98%, respectively) were diagnosed as having normal carbohydrate metabolism according to the A1C test, glucose on an empty stomach and a combination of both criteria, respectively.

Overlapping abnormal carbohydrate metabolism by OGTT criteria and A1C test criteria alone or in combination with fasting glucose criteria. A: OGTT criteria and A1C testing criteria (κ coefficient was 0.070, P = .200). B: OGTT and fasting glucose criteria (κ coefficient was 0.841, P = 0.000). C: OGTT and a combination of A1C and fasting glucose tests (κ coefficient 0.669, P = 0.000). D: Women are classified as having IFG versus women classified as having IGT (κ coefficient was 0.141, P = 0.017).

Sensitivity, specificity and positive and negative predictive values ​​of diagnostic tests (A1C, fasting glucose and combination of A1C and fasting glucose) in the study group (OGTT was considered the gold standard)

Sensitivity, specificity, and positive and negative predictive values ​​for A1C, fasting glucose and a combination of both diagnostic tests versus OGTT (gold standard test) are shown in Table 2.

Our results appear to indicate that the A1C criteria alone or in combination with the fasting glucose criteria, while easy to perform, do not reliably diagnose abnormal carbohydrate metabolism in postpartum women. who had GDM.Women who have had GDM are more likely than other women to develop type 2 diabetes later (18) and therefore it is important to reevaluate them. One of the major problems with postpartum reevaluation of women with a history of GDM is that many women are unable to attend their postpartum visits. Thus, a balance needs to be found to reach the large number of women who attend the follow-up visit and to use diagnostic tests that can identify as many people as possible who are at risk for type 2 diabetes.

Once standardized, the A1C test is a very attractive test for the diagnosis of diabetes and prediabetes because it is easy to perform; it does not require prior fasting or glucose overload. Moreover, unlike glucose, A1C remains relatively stable after harvest and has less intra-individual variation compared to FPG (19). The A1C test result reflects longer blood glucose levels and is less affected by recent physical / emotional stress than OGTT.The A1C test may be a solution to the lack of monitoring seen in postpartum GDM women. However, the diagnostic test used must be able to detect abnormalities in carbohydrate metabolism at an early stage.

Using A1C alone, we found that 16% of women classified as having normal carbohydrate metabolism OGTT were diagnosed as having abnormal carbohydrate metabolism, and that 74.47% of women classified as having abnormal carbohydrate metabolism by OGTT were diagnosed as having normal carbohydrate metabolism. metabolism.The A1C test had low sensitivity and modest positive and negative predictive values, although it had high specificity. Thus, the A1C test does not appear to be a good test for abnormal screening of carbohydrate metabolism in postpartum women with previous GDM. The suggested A1C cutoff point was low sensitivity to abnormal carbohydrate metabolism in our study participants. However, this test found higher values ​​for variables associated with increased vascular risk, such as BMI, glucose levels, and lipid abnormalities in women with abnormal carbohydrate metabolism.

In our study, we found that using the fasting glucose test criteria, 16% of women classified as having normal carbohydrate metabolism OGTT were diagnosed as having abnormal carbohydrate metabolism, while 38.3% of women classified as having abnormal carbohydrate metabolism OGTT have been diagnosed as normal carbohydrate metabolism. The fasting glucose test criteria had a fairly high sensitivity and very high specificity, as well as very good positive and negative predictive values.The US National Institute of Health and Clinical Excellence recommends screening with a fasting glucose test at a 6-week postpartum visit (20). However, McClean et al. (21) concluded that measurement of postpartum FPG alone is not sensitive enough in this population to accurately classify the level of glucose tolerance and that OGTT is necessary for early detection and treatment.

Combination of A1C with fasting glucose criteria classified 38.30% of women as having normal carbohydrate metabolism, who were classified as having abnormal carbohydrate metabolism by the OGTT criteria.Sensitivity and specificity were high, as were the positive and negative predictive values, although this combination did not improve the sensitivity and specificity obtained with the fasting glucose test alone. The κ coefficients showed that agreement between OGTT and A1C was very low, although the combination of A1C and FPG increased agreement with OGTT to moderate levels. However, all diagnostic tests found high values ​​for variables associated with increased vascular risk in women with abnormal carbohydrate metabolism, such as BMI, blood pressure (other than A1C), glucose levels, and lipid abnormalities.These results reflect the inconsistency that exists between the various diagnostic tests. Mann et al. (22) showed that if used alone, the A1C test would misdiagnose many patients with prediabetes (classified by fasting glucose test) because they do not have prediabetes. Since cardiovascular risk is associated with abnormal carbohydrate metabolism (23), it is unacceptable to diagnose patients with prediabetes as normal carbohydrate metabolism, because it is very important to identify early conditions predisposing to diabetes.However, a recent study (24) showed that OGTT and A1C agreement is fair in detecting abnormal glucose tolerance among women with a history of GDM, although further research has been recommended to determine the optimal test. Katon et al. (19) stated that when interpreting these conflicting results, it is important to consider the context and timing of the A1C measurement. After reviewing several studies, they suggested that a more restrictive criterion for diagnosing GDM may lead to a better association between A1C and abnormal postpartum glucose.

The current study must be interpreted in the context of certain potential limitations. First of all, each test was performed only once; retesting can enhance results or provide more confidence. In addition, earlier identification of carbohydrate metabolic disorders may also lead to earlier prevention efforts. However, we evaluated these women one year after giving birth because the risk of developing type 2 diabetes has a cumulative incidence that increases in the first year (25).A1C may be affected by hemolytic anemias, although this problem is minimal given the relative rarity of these conditions compared to prediabetes or diabetes.

The respective contributions of pre- and postprandial glucose outputs to A1C levels are controversial. Some authors have suggested that at A1C levels

The strength of the current study is that it includes a relatively large number of postpartum women with a history of GDM, a still pending group, with results from various diagnostic tests and completion of postpartum findings.

Thus, the A1C test significantly underestimated carbohydrate metabolic disorders in women who had GDM. A large percentage of postpartum women with a history of GDM that would be marked as abnormal carbohydrate metabolism of OGTT would in fact be diagnosed as having a normal metabolic status. Our study data appear to indicate that A1C test criteria, either alone or in combination with fasting glucose test criteria, do not provide a sufficiently sensitive and specific diagnosis of abnormal carbohydrate metabolism in women who have had GDM.

This work was supported in part by a grant from the Salud Carlos III Institute (PS09 / 00997). M.M. (Sara Borrell, CD11 / 0030) from the Spanish Ministry of Economy and Competitiveness.

No potential conflicts of interest were reported pertaining to this article.

M.J.P. and M.M. wrote the manuscript, researched the data, contributed to the discussion, and reviewed and revised the manuscript. Corresponding Member and J.C.F.-G. explored the data and facilitated discussion.R.G.-H. examined the manuscript. F.J.T. designed the study, contributed to the discussion, reviewed and edited the manuscript. M.M. and M.J.P. are the guarantors of this work and thus have full access to all data in the study and are responsible for the integrity of the data and the accuracy of the data analysis.

The authors thank Juan Alcaida (IMABIS Foundation) for his technical support in developing their laboratory methods, Ian Johnstone (Carlos Chaya University Hospital) and Raja El Bekey (IMABIS Foundation) for their help in the English version of the text, and Javier Zamora Romero (Ramon Hospital) i-Kajal, Madrid, Spain) and Olga Perez-Gonzalez (IMABIS Foundation) for statistical assistance.

90,000 How to Lower A1C Levels to Control Diabetes – A Guide to Type 2 Diabetes and Insulin – Healths

The A1C test is an integral part of a healthy life with type 2 diabetes: This simple blood test to measure hemoglobin A1C or HbA1C provides information on your blood sugar control

Content

The A1C test is an essential part of living a healthy life with type 2 diabetes: This simple hemoglobin A1C or HbA1C blood test provides information about your blood sugar control over the past few months.The results are similar to assessing how well you are fighting diabetes. By making the most of your daily efforts, you can lower your A1C results and take pride in your hard work.

A1C 101

Unlike blood glucose monitoring, which you regularly do yourself at home, your A1C level is periodically measured by your doctor or nurse in your medical office. During this test, the healthcare professional will use a needle to take a blood sample from a vein in your arm, or prick the tip of your finger with a small lancet.The sample is then sent to a medical laboratory for analysis.

The A1C test lets your doctor know about your average blood sugar control level over the past three months. It looks at how glucose attaches to hemoglobin, a component of red blood cells. Red blood cells live for about three months, so an A1C test can provide such an overview.

Test results are given in percentages. The normal A1C is below 5.7 percent and the accuracy of the test results is 0.5 percent. In general, the goal of blood sugar control is to score below 7% A1C, because below this value there is a lower risk of complications from diabetes.But this number is not realistic for anyone with diabetes, so your doctor may recommend a different target value for you.

Understanding Blood Sugar Control

“I explain that blood sugar is a snapshot and A1C is the whole movie,” says Joyce Malaskowitz, MD, PhD, CDE, diabetes educator and director Health and Wellness Center at Desert Springs Hospital Medical Center in Las Vegas. The A1C shows how you have managed your blood sugar levels over many weeks, thus maintaining the integrity of your diabetes management.

Generally, if your blood sugar rises, your A1C test results will also be high. Lowering your blood sugar to your target level daily over time will also lower your A1C results.

How to Reduce A1C Results

The keys to lowering A1C are the same as lowering blood sugar. “There is no magic in lowering A1C, it can only be achieved through a healthy lifestyle,” says Malaskowitz. “While this advice sounds simple, it can be tricky for some people.”

Indeed, achieving A1C goals can mean making significant, and therefore healthy, lifestyle changes. These changes may take some time to achieve, but they will help you achieve all of your long-term blood sugar goals.

Eat healthy food. A diet rich in vegetables, whole grains, lean protein, healthy fats and dairy products may help control blood sugar in the short and long term.Fruits and vegetables are rich in fiber, and eating more fiber over time is associated with better blood sugar control, according to a study published in the 2012 issue of the journal. PLoS One . You may also need to learn more about carbohydrate counting and portion control. Regular monitoring of your blood sugar will let you know how your body is responding to diet.

Be physically active. Moderate physical activity for 30 minutes for most of the week can help treat diabetes.A combination of aerobic exercise and strength training is generally recommended. Moderate aerobic activity can be easily achieved by brisk walking.

Manage diabetes or depression. Negative emotions, diabetic burnout, and depression can make diabetes management difficult. If you are feeling sad, anxious, or simply unable to cope with your diabetes, tell your doctor. There are many resources that can help you.

Take medication. Taking your doctor’s prescription medication regularly will help you achieve your A1C goals.

Once you achieve blood sugar control, you will end up with lower A1C results and know that you are responsible for your diabetes.

90,000 Diabetes mellitus. The author of the article: endocrinologist Popova Anna Vladimirovna.

02 December 2019

Family Health Magazine

Over the past few decades, the number of people on Earth who are overweight or obese has been growing rapidly.And along with this, the number of
patients with type 2 diabetes mellitus. And this
quite understandable, because obesity, namely
its visceral type, is the main
a risk factor for diabetes. therefore
just as obesity is getting younger, diabetes is also getting younger in recent years. Currently, even at the age of 30-35, diabetes mellitus
Type 2 is quite common!
And the fault is that very visceral obesity. What does this mean? Obesity is called visceral when the amount of fatty tissue in the abdomen increases,
around the internal organs, while the waist circumference in men becomes more than 94 cm,
and women have more than 80 cm.This leads to a number of disorders in the body, which eventually
or later lead to one thing: an increase
the amount of sugar in the blood. And the stronger
obesity is pronounced, the faster it occurs
type 2 diabetes mellitus.
Diabetes mellitus is a disease characterized by an increase in blood sugar in
connection with a lack or incorrect, ineffective work of the hormone that lowers blood sugar – insulin. Distinguish 2
the main types of diabetes mellitus: type 1 and type 2.
In the first type of diabetes, there is an absolute deficiency of the hormone insulin,
why it rises quickly and very high
blood sugar.This type occurs mainly in children, adolescents and young adults before
30 years old, and he has nothing to do with excess
body weight.
In contrast, the second type of diabetes occurs in
mainly in obese people and over 30-40
years, while there is plenty of insulin in the body, but its work to lower blood sugar is disrupted. And obesity is the root cause of these insulin dysfunctions.
Therefore, the main task of doctors in matters
prevention of type 2 diabetes mellitus
is the fight against excess body weight and
obese patients.I don’t think it’ll be news to anyone
that there are 2 basic principles of losing weight: you need to eat less and move more. Indeed, eating less
the number of calories than spent per day,
the person gradually begins to lose weight. Of course, this is easy to say, but quite difficult to do. Especially when it has already been tried
a wide variety of diets, weight loss methods, the thresholds of fitness centers are trampled,
while without much effect. But in recent years, science has developed remarkable
drugs that help people lose weight, and most importantly, maintain the achieved weight.These drugs are in no way
exclude neither a hypocaloric diet nor
physical activity, without this weight loss
simply impossible! But they hold back
a person from overeating, prevent excess absorption of calories, contributing
weight loss. And it is on these drugs that the stake has been placed recently.
many doctors, as a means of preventing the onset of type 2 diabetes.
Naturally, all these drugs are prescribed strictly according to the doctor’s prescription and under his supervision.If, in addition to being overweight, you have become
disturb symptoms such as weakness,
dizziness, dry mouth, thirst, itching
skin, itching of the genitals, poor wound healing, then you just need it urgently
consult an endocrinologist who will prescribe a blood test for
her sugar. Fasting blood sugar
from 3.3 mmol / L to 5.5 mmol / L. If blood sugar is detected above normal
values, then a diagnosis of either diabetes mellitus or a number of pre-diabetic
states.These conditions indicate serious, but still reversible
disorders in the body, and if treatment
started on time, the patient follows all the doctor’s recommendations, and most importantly – if
normal body weight is achieved, then the likelihood of diabetes mellitus
decreases many times. But the sugar itself
diabetes, unfortunately, is already incurable and has
many serious complications.
What to do if you have been diagnosed with type 2 diabetes mellitus? The first
turn – don’t panic! Panic, nervous
experiences, frustrations only aggravate the situation.It is necessary first of all
think about what and how you eat? In other words, you need to start following a special diet that excludes foods containing sugar, flour products,
containing easily digestible (“bad”)
carbohydrates. These include: sugar, jam,
sweets, sugar confectionery,
chocolate, ice cream, fruit juices, sweet drinks, honey, grapes, raisins, bananas,
dates, wheat flour products (buns, loaves, pies, cakes, pastries,
pancakes, pancakes), mashed potatoes, semolina
porridge, rice, kvass, beer, sweet and semi-sweet wines, liqueurs, sweet alcoholic cocktails.Due to the high calorie content (and therefore the ability
increase body weight) exclude fatty foods, such
like butter, oily
beef, pork, lamb,
offal, bacon, mayonnaise, sour cream, cream, cheese more than 30-40%
fat content, dairy products
more than 2.5% fat, fatty
sausage, fatty fish, pates, canned food
in oil, nuts, seeds.
At the same time, “good” carbohydrates (slowly
absorbable) are not completely excluded, but limited.These are cereals (everything
except semolina), black bread, pasta
products, other fruits, unsweetened dairy products up to 2.5% fat.
Can be consumed without restrictions
food: vegetables (everything except potatoes), herbs,
mushrooms, tea, coffee without sugar, mineral
water), lean meat, fish, poultry without skin,
cheese with a fat content of no more than 30-40%,
cottage cheese up to 5%.
In addition to dietary nutrition, the doctor prescribes certain drugs that
reduce blood sugar, thus preventing the development of complications of diabetes.All patients suffering from sugar
diabetes, frequent monitoring is necessary
blood sugar levels. The most ideal
option today is
using a personal blood glucose meter – an apparatus for measuring blood sugar at home. Modern blood glucose meters
accuracy is in no way inferior to laboratory
analyzes, and for the convenience and speed of analysis
they are many times superior to traditional polyclinic blood sugar measurements. In addition, blood glucose meters allow
measure blood sugar not only on an empty stomach
and not only once a day, but as much as
required and when required.Patients with type 2 diabetes
ideally should conduct research
fasting blood sugar daily, and 1 time
a week to do the so-called glycemic profile (this is a measurement of sugar in
blood in the morning on an empty stomach, then after 2 hours
after breakfast, before lunch, after 2 hours
after lunch, before dinner and after 2 hours
after dinner, as well as before bedtime). Wherein
the desired blood sugar values ​​are set by the doctor individually, depending on the specific situation and condition
specific patient.Only so frequent
blood sugar testing provides sufficient information about the degree of compensation
diabetes, that is, the effectiveness of the diet
and medicines taken
sick. And only when sugar is reached
in the blood of the norm with all these measurements, the development of complications of diabetes mellitus can be prevented.
In addition to measuring fasting blood sugar
and during the day, the measurement of glycated hemoglobin (this is hemoglobin, which has attached glucose from the blood serum) is also currently used.Glycated hemoglobin (Hb A1c) shows what blood sugar the patient had
on average over the past 2-3 months. Normally he
should be below 6.5-7%. If glycated hemoglobin exceeds this figure,
then this means that during the last
2-3 months the patient has periodic sugar
in the blood was above normal, that is, diabetes is not
compensated and treatment is ineffective.
But, unfortunately, in life, there are rarely diabetic patients who are fully compensated and whose blood sugar never rises.
above normal values.And with the flow
time sooner or later most
patients still develop complications.
First of all, type 2 diabetes mellitus
causes early onset, development
and aggravation of already existing ischemic heart disease, arterial hypertension, leading to severe vascular
disasters (strokes and heart attacks). In addition, diabetes also causes a number of specific complications in the vessels of the eyes, legs, kidneys,
in the nerve endings of the legs and arms, leading
to trophic ulcers of the skin of the feet, phlegmons
feet, amputations of the lower extremities, blindness, renal failure.All these conditions invalidate patients and often lead to sad endings. And the fault
all this – high blood sugar for a long time! And all this
can be avoided by trying to keep blood sugar within the normal range at all times.
But such a precise control requires a fairly frequent, daily measurement of the level of glycemia (blood sugar). Of course, this will require great moral and
material costs, will require enough
frequent visits to the attending physician, appointments
a certain number of special
drugs, but it’s worth it! After all if
put on one side of the scale those expenses that diabetes mellitus entails, and on
the other – those serious, terrible complications of diabetes that make life so bad
a sick person, then there is no doubt:
diabetes should be treated as early as possible.In this case, you need to try to use all possible methods and medicines so that blood sugar is
as close to normal as possible!
And of course, in the fight against such a powerful enemy as diabetes mellitus, a sick person needs an assistant – his attending physician.

Share on social networks

Page not found |

Page not found |



404.Page not found

Monthly archive

MonTueWedThuFtSaSun

14151617181920

21222324252627

282930

12

12

1

3031

12

15161718192021

25262728293031

123

45678910

12

17181920212223

31

2728293031

1

1234

567891011

12

891011121314

11121314151617

28293031

1234

12

12345

6789101112

567891011

12131415161718

19202122232425

3456789

17181920212223

24252627282930

12345

13141516171819

20212223242526

2728293031

15161718192021

22232425262728

2930

Archives

Jul

Aug

Sep

Oct

Nov

Dec

Tags

Settings
for visually impaired

.