What Should My A1c Goals Be?

Whether you’re noticing symptoms of blood sugar spikes becoming more frequent or you simply want to learn more about your glucose, understanding what optimal A1C levels are and what affects these levels can help you make better choices for your metabolic health. 

In this article, we’ll review what the A1C test measures, who it may be helpful for, and how you can set goals for improving your A1C level.

The A1C Test: What is it? 

HbA1C is a medical term that refers to glycated or glycosylated hemoglobin. Hemoglobin is a protein found within red blood cells, and glycated hemoglobin refers to the hemoglobin that is attached to glucose. 

The lifecycle of red blood cells spans from about 8 weeks to 12 weeks, so your A1C levels are a reflection of blood glucose levels over the past three months.

An A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin, and since it measures the average value over a three month period, it can help uncover trends in your overall glucose levels.

Why Should I Get the A1C Test?

Measuring glycated hemoglobin through the A1C test is a valuable tool in understanding the bigger picture when it comes to your body’s glycemic control. Because red blood cells live for up to three months, the A1C test can provide helpful insight into the bigger picture of your body’s glycemic control as well as metabolic health.

Whereas the finger prick method of testing your blood sugar captures a snapshot of where your glucose levels are in that exact moment, the A1C test estimates a two to three month average of your blood glucose values.

While the finger prick test may shed light on how your blood glucose levels fluctuated when you skipped breakfast that morning, for example, it won’t provide much insight into your overall glucose trends. 

Alongside the A1C test, a continuous glucose monitor can allow for real-time tracking of glucose over large windows, capturing not only the fluctuations the A1C may miss, but also the trends over time that the single finger-stick may miss.

Diagnosing Prediabetes and Type 2 Diabetes With the A1C Test

HbA1C levels are used as a diagnostic tool for diagnosing type 2 diabetes (as well as prediabetes). The A1C test is generally the preferred method of screening for and diagnosing diabetes for several reasons, including:

• It does not involve special instructions or requirements (such as fasting). 
• It can be done at any time of the day. 
• The results are not altered by acute factors such as stress or exercise.
• It is considered more convenient than the oral glucose tolerance test and the fasting plasma glucose test.   

The A1C test can also have a nearly identical sensitivity for predicting diabetic retinopathy. This means the test can be a valuable tool and effective in “picking up” how likely someone may develop diabetes-induced retinopathy. 

It’s interesting to note that in some cases the A1C test can detect glucose levels that correspond to diabetes where the fasting blood glucose test has failed to do so, and vice versa.  

Using A1C for Elevated Blood Glucose Levels

If your A1C is elevated, you’ll want to work with your doctor or a medical professional to set an A1C goal based on your individual health needs. Your doctor may specify a certain value based on where your levels currently are and advise certain lifestyle changes that may be helpful in lowering your A1C value over time.

Many lifestyle and dietary changes can take time to have any observable impact on your blood glucose levels. As you and your doctor work to improve your blood glucose levels, you may want to make sure you are regularly monitoring your A1C.

Certain medications for diabetic glycemic control have been observed to take effect in less time for some people. If you have elevated A1C levels, you may want to discuss this option further with a medical professional to determine the best options for you and your health.

Limitations of A1C

It’s also important to understand the limitations of the A1C test. For example, some conditions such as anemia can alter the turnover of your red blood cells, leading to more glucose exposure and higher A1C levels as a result.

Other factors such as certain medications, high alcohol consumption, or even blood transfusions have all been observed to falsely elevate A1C levels in some cases. Conversely, factors such as pregnancy, vitamin C, or vitamin E ingestion have been observed to cause falsely decreased A1C levels reflected in tests.

If you’re concerned about your A1C levels, you may want to consider pairing this test with other forms of glucose measuring and discuss your results with your doctor.

What are the Updated Guidelines for A1C?

According to the ADA, a diagnosis of diabetes can be made if HbA1C levels are 6.5 percent or higher. Ranges between 5.7 to 6.4 percent are considered high risk for diabetes. Individuals with HbA1c levels between 6 and 6.5 percent are considered an even higher risk, and may be advised to undergo other forms of testing by the doctor.

An A1C level below 5.7 percent is considered normal. Some practitioners may set an “optimal range”, however, there isn’t strong evidence to support any one range as being optimal at the present time. 

This is because the A1C test may be prone to certain inaccuracies, and various factors such as chronic blood loss or more serious conditions such as splenomegaly can influence the results and lead to false results. This may be one reason why, as discussed earlier, other tests can be more effective in diagnosing diabetes (although each has their own drawbacks). 

For example, some research has suggested that HbA1C levels that read between 6.0 to 6.5 percent may have a relatively higher rate of false positive or false negative readings and should be combined with other lab values for full assessment, such as a fasting glucose reading.

A1C Target: What Should my A1C Goals be? 

Your A1C goals will depend on your current A1C levels, lifestyle, and current nutritional habits. These goals are typically set by you and your doctor after discussing these factors and determining what a realistic goal should be. Your doctor may also help you determine a realistic timeline for reducing your A1C levels. 

Ideally, your goal may be to bring your A1C levels within the normal range, and ultimately work towards keeping it between 5 to 5.4 percent. 

Understanding A1C Percentages 

Your A1C is calculated using the following formulas:

• As a percentage: A1C = (Estimated average glucose(mg/dL) + 46.7) / 28.7 
• As a measurement of mmol/mol: A1C = 10.929 * (A1C(%) – 2.15)

Check out our A1C calculator here.

A1C Goals for Those Without Diabetes 

If you’re in the very high risk group for developing diabetes (A1C levels between 6 to 6.5 percent), your initial goal may be to reduce your A1C enough to fall outside of the prediabetes threshold, which ranges from 5.7 percent to 6.4 percent.

For those that are around the upper limit between 5. 5 to 5.7 percent, you may want to aim to gradually lower your levels to the optimal range of 5.4 percent or lower.

A1C Goals for Those with Diabetes

The ADA recommends that individuals with diabetes aim for an A1C level of less than 7 percent. If you’ve been diagnosed with type 2 diabetes, you should work with your doctor to implement healthy lifestyle habits that may help your blood sugar response. 

Below, we’ll take you through some evidence-backed tips that may help lower your A1C.

How can I get my A1C down quickly?

In general, there is no quick fix when it comes to lowering your A1C levels. Oftentimes, the most sustainable way to achieve normal HbA1C levels is to incorporate a variety of effective lifestyle habits, dietary changes, and in some cases medications that your doctor has prescribed for you.

Lifestyle habits that can help optimize your blood glucose levels include: 

• Walking after eating
• Getting high quality sleep 
• Reducing stress 
• Getting appropriate amounts of exercise for your health.  

Dietary changes that can help optimize your blood glucose levels:

• Incorporating more fiber (different types of fiber have different health benefits)
• Including healthy fats
• Figuring out the right macronutrient ratio for you

It may take several weeks to months for these changes to reflect in your A1C levels. 

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What is the Best A1C Level?

Most of us living with diabetes as well as the doctors who treat us have always assumed that lower blood glucose levels would protect us better from the complications of diabetes. In the past two decades several studies showed a linear relationship between blood glucose, as measured by A1C levels, and worsened health.

But now, several recent A1C studies have shown a J-shaped relationships, in which at the lower end some bad things happen, at the center things are better, and at the top end things are terrible. While linear relationships are the rule in observational studies, U-shaped and J-shaped curves aren’t uncommon, and some authors lump both of these shapes as U-shaped.

All of the studies relating A1C levels and ill health — the earlier ones and the recent ones alike — are observational. They study correlations, which aren’t proof, because other confounding factors that the researchers didn’t take into account could have been the problem.

5.4-5.6 Seems Safest

The first of these newer studies showing that a very low A1C level is unhealthier than a higher one came out in the February 2015 issue of Diabetes Care. This analysis of the German National Health Interview and Examination Survey 1998 that studied about 6,300 people for about 12 years indicated that people with an A1C level of 5.4 to 5.6 had the lowest risk of excess mortality.

Because this result puzzled me so much, I asked Dr. Richard K. Bernstein for his reaction.

“These A1c measurements were made years ago in Germany,” he replied, “before international agreement on how it would be measured. The modern elution method would likely give considerably different results. It is even possible that several different methods were being used at different sites during the study.”

A1C and Dementia

Even more recently, however, I came across a similar finding for a specific complication of diabetes — dementia. While the study itself, which I reported here last month, doesn’t report the finding, the author subsequently stated that “very low HbA1c levels were associated with increased risk of developing dementia. ”

What’s the cause and what’s the result is the question, Dr. Naveed Sattar commented. “In people who have very low blood glucose levels, below guideline levels, I suspect that there are other reasons that they are sick and their A1C is low because of this and that then leads to dementia,” this professor of metabolic medicine at the University of Glasgow, says.

Recommended Targets

A1C target levels are based, of course, on minimizing the complications of diabetes and take into consideration the levels that people without diabetes have. But the targets vary widely.

The latest recommendations of the American Diabetes Association in its current “Glycemic Targets” for most people is a level below 7.0 percent. The ADA adds that we may have “more stringent A1C goals such as below 6.5 percent” if we don’t take diabetes drugs that can cause hypos. The ADA doesn’t say here what they consider a normal A1C level to be.

The ADA’s recommended A1C level is one extreme. Dr. Bernstein stands at the other extreme. “A truly normal HgbA1C ranges from 4.2 percent to 4.6 percent,” he wrote in Dr. Bernstein’s Diabetes Solution (fourth edition, page 57). On several later pages of this book, Dr. Bernstein states that this should be our blood glucose goal.

Normal Levels

I haven’t been able to find any studies that support either extreme. One small study that I discussed in “The Normal A1C Level” here several years ago indicated that a normal level is probably between 4.7 and 5.7.

This study is in fact consistent with an ADA study in its journal Diabetes Care by a group of a dozen of our most well known diabetes researchers who set out to define what our A1C levels would be if we were for all intents and purposes cured of diabetes. This “consensus group” of experts defined cure as complete remission for a long enough time that the risk of recurrence is very low. Specifically, they determined that this A1C level is one in the normal range for at least a year without taking any diabetes drugs of ongoing procedures. That level, they write, is 5.6.

New Goal Levels

On a very low-carb diet we can easily bring our A1C level down to 5.6. Personally, my level has stayed close to 5.5 in dozens of tests for the last eight years on such a diet and without using any diabetes drugs. But until now I longed to bring my level below 5.0, much closer to Dr. Bernstein’s recommendation.

I wonder now, however, whether a level of about 5.5 might be the safest. While nobody knows for sure what the best A1C level is, it seems clear that it for our safety we must keep it below 6.0.

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How to create the perfect online drug delivery service? AIC company on vc.ru

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Kepma A1C Acoustic Guitar

Description of the Kepma A1C Acoustic Guitar

The Kepma A1C is an affordable, entry-level six-string acoustic guitar, perfect for learning to start, playing at home, or on the go. The instrument features a Grand Auditorium body, which is equipped with a single cutout and has a balanced and rich sound with good volume.

The top is made of Sitka Spruce, which resonates well and saturates the sound with harmonics and overtones, making it brighter and louder. The back and sides are made of sapele, and the neck is made of nato wood. Both of these materials belong to the mahogany family and have a soft tone similar to it. The fretboard and tailpiece are made of rosewood.

Scale length reaches standard 25.6 inches. The neck features 20 frets with white dot markings, and the 12th fret has a company logo inlay. The nut, made of ABS plastic, is 1.69 inches wide. The neck itself is equipped with a convenient “C” profile. The truss rod deflection adjustment nut is located on the heel of the neck.

The pegs and pickguard are also made of durable ABS plastic. Cast chrome pegs provide stable action. Kepma steel strings are fitted from the factory in . 012 – .053 gauges. Finally, the body and neck have a spectacular white plastic binding.

Kepma A1C Acoustic Guitar Features

• Entry Level 6 String Acoustic Guitar
• Grand Auditorium body with single cutout
• Sitka spruce top, sapele back and sides
• Nato neck, rosewood fretboard and bridge
• Scale length 25.6 inches
• 20 frets with white dot inlay
• Cast chrome tuners

Kepma A1C 9 acoustic guitar specifications0015

90 130 Sitka spruce

901 30 yes, double

Construction
Type	acoustic guitar
Number of strings	6 901 27
Orientation	for right-handers
Strings	metal, Kepma (gauge .012 – . 053)
Body
Body Style	Grand Auditorium Single Cutout
Top
Bottom deck	sapele
Side	sapele
Piping
		“C”
Fingerboard material	Rosewood
Nut material	ABS plastic
Nut Width	1. 69″ (43mm)
Scale	25.6″ (650mm)
Frets	20
Inlay	white dots, logo at 12th fret
truss rod	standard
truss nut	neck heel
binding 90 127	yes
Fittings
Bridge	rosewood
Pegs	ABS
Tuners	lit.
Pickguard	ABS plastic

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Return and exchange of Kepma A1C acoustic guitar

Constantly improving the work of the company and striving to provide the best service, Audiomania offers unprecedented conditions for the exchange of defective goods! If you find a manufacturing defect, you can exchange the purchased acoustics or electronics within a month after the purchase!

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