Johns Hopkins Study Suggests Consistent Fasting Blood Glucose May Be As Important As A1c
People whose blood sugar varies widely over time, whether they have diabetes or not, may be at increased risk for serious health problems.
Johns Hopkins endocrinologist Justin Echouffo Tcheugui and his research colleagues studied health data from nearly 5,000 people age 55 and older. The study, published online before appearing in the March 2019 issue of the journal Diabetes Care, mined data from patients who were followed through two years of doctor visits where their blood sugar was tested, then five more years after those tests.
We saw an association between fluctuating blood glucose numbers and overall mortality, says Echouffo Tcheugui. Even among people whose blood glucose wasnt in the diabetic range, we saw that people whose levels were inconsistent from visit to visit were at greater risk of health troubles.
The researchers studied data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial , which was designed to learn more about the roles hypertension and high cholesterol play in heart disease. For their study, Echouffo Tcheugui and his colleagues reviewed secondary data that ALLHAT yielded.
They looked at study records from 4,982 patients who had their fasting blood glucose tested three times once during an initial visit and again 24 and 48 months later.
Echouffo Tcheugui adds that the higher risk of death among those without diabetes suggests that FBG may also be an important health predictor in the general population.
What Is The Difference Between Blood Sugar And Urine Sugar
Glucose is a normal component of blood. The normal blood glucose levels are:- Fasting blood glucose level: 70-110 mg/dl Postprandial blood glucose level: up to 140 mg/dl But glucose is not a normal component of urine. Under normal physiological conditions, when blood glucose level is within normal limits, the urine does not contain any glucose. However, under pathologic conditions like diabetes mellitus, when blood sugar level crosses renal threshold , the blood glucose appears in urine. This condition is called glycosuria or glucosuria.Continue reading > >
What Do My Hba1c Results Mean
In general, the following HbA1c ranges indicate whether you have a normal blood sugar level, prediabetes, or diabetes.
- Your blood sugar level is normal if it is below 5.7%
- You have prediabetes if your level is between 5.7% and 6.4%
- You have diabetes if your level is 6.5% or higher
However, there are exceptions to the general ranges above, so itâs always best to discuss your particular A1c test results with your healthcare provider.
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Prevent Type 2 Diabetes
If your test results show you have prediabetes, ask your doctor or nurse if there is a lifestyle change program offered through the CDC-led National Diabetes Prevention Program in your community. You can also search for an online or in-person program. Having prediabetes puts you at greater risk for developing type 2 diabetes, but participating in the program can lower your risk by as much as 58% .
What Is The Difference Between A1c And Glucose
Hemoglobin A1c test measures the percentage of glucose bound to red blood cells in the blood, while glucose test measures the milligrams of glucose per deciliter of blood. So, this is the key difference between A1c and glucose. Blood sugar meters cant check for hemoglobin A1c, but they can check blood glucose.
Moreover, glucose tests require fasting before the test, while the A1c test does not require fasting before the test. Thus, this is another difference between A1c and glucose. In an A1c test, it is necessary to take some blood and send it to the laboratory for assessment. But, in glucose test, it is necessary to squeeze a drop of blood onto the test strip and put the strip into the monitor. Furthermore, A1c measures in percentage while glucose test measures blood sugar in mg/dL.
Below infographic summarizes the difference between A1c and glucose.
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How To Calculate Your A1c
The Hemoglobin A1c test is a blood test used to measure the average blood glucose concentration in your body in the past 1-3 months. For diabetics, this is the standard way of determining how well the diabetes is controlled. An A1c of less than 7% is considered good. Getting the test every 3 months is usually enough. But sometimes you may want to just estimate your A1c level based on the data from your regular self-tests. The formula below could help in this case. Accuracy, of course, could vary depending on how often and when you check your blood sugar. I found it pretty accurate last time I used it. My calculation was off only by 0.1%. This is the same formula GlucoseTracker uses in the app’s dashboard. Glucose in mg/dL: A1c = / 28.7 Glucose in mmol/L: A1c = / 1.59 So, for example, if your average blood glucose level in the past 3 months is 130 mg/dL , your estimated A1c is 6.15%. There are also cheaper devices you can buy that will allow you to do the actual A1c tests yourself, like this one. If you need to do these tests more often, say every month, then it could save you money in the long run as lab tests could get expensive. It may not be as accurate as the lab tests, but my guess is it’s probably good enough.Continue reading > >
Comparison Of A1c And Fasting Glucose Criteria To Diagnose Diabetes Among Us Adults
April P. Carson, Kristi Reynolds, Vivian A. Fonseca, Paul Muntner Comparison of A1C and Fasting Glucose Criteria to Diagnose Diabetes Among U.S. Adults. Diabetes Care 1 January 2010 33 : 9597.
To compare A1C and fasting glucose for the diagnosis of diabetes among U.S. adults.
This study included 6,890 adults from the 19992006 National Health and Nutrition Examination Survey without a self-reported history of diabetes who had fasted 9 h. A1C 6.5% and fasting glucose 126 mg/dl were used, separately, to define diabetes.
Overall, 1.8% of U.S. adults had A1C 6.5% and fasting glucose 126 mg/dl, 0.5% had A1C 6.5% and fasting glucose < 126 mg/dl, and 1.8% had A1C < 6.5% and fasting glucose 126 mg/dl. Compared with individuals with A1C < 6.5% and fasting glucose 126 mg/dl, individuals with A1C 6.5% and fasting glucose < 126 mg/dl were younger, more likely to be non-Hispanic black, had lower Hb levels, and had higher C-reactive protein.
A1C 6.5% demonstrates reasonable agreement with fasting glucose for diagnosing diabetes among U.S. adults.
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A Comparison Of Hba1c And Fasting Blood Sugar Tests In General Population
Go to: Abstract Objectives: Early diagnosis of diabetes is crucially important in reduction of the complications. Although HbA1c is an accurate marker for the prediction of complications, less information is available about its accuracy in diagnosis of diabetes. In this study, the association between HbA1c and FBS was assessed through a cross-sectional population-based study. Methods: A random sample of population in Kerman city was selected. The total number was 604 people. Their HbA1c and fasting blood sugar were tested. The association between HbA1c and FBS and also their sensitivity, specificity and predictive values in detection of abnormal values of each other were determined. The association of HbA1c with FBS was relatively strong particularly in diabetic subjects. Generally, FBS was a more accurate predictor for HbA1c compared with HbA1c as a predictor of FBS. Although the optimum cutoff point of HbA1c was > 6.15%, its precision was comparable with the conventional cutoff point of > 6%. Conclusions: In conclusion, FBS sounds more reliable to separate diabetic from non-diabetic subjects than HbA1c. In case of being interested in using HbA1c in screening, the conventional cutoff points of 6% is an acceptable threshold for discrimination of diabetics from non-diabetics. Keywords: HbA1c, Blood glucose, Diabetics *The adjusted values were computed in a multivariable regression model with sex, BMI and age as independent variables.Continue reading > >
Can A1c Replace Oral Glucose Tolerance Test In The Evaluation Of Patients With Impaired Fasting Glucose
Murilo Veloso Lages,1
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1Endocrinology, Felicio Rocho Hospital, Belo Horizonte, Brazil2Professor of Internal Medicine at Universidade Federal de Ouro Preto, Brazil3Professor of Internal Medicine at Universidade, Brazil
Correspondence: Murilo Veloso Lages, Endocrinology, Felicio Rocho Hospital, Belo Horizonte, Brazil
Received: May 08, 2017 | Published: May 24, 2017
Citation: Lages MV, Lauria MW, Gonçalves DA, et al. Can A1C replace oral glucose tolerance test in the evaluation of patients with impaired fasting glucose? Endocrinol Metab Int J. 2017 4:133-139. DOI: 10.15406/emij.2017.04.00103
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Glycosylated Hemoglobin Or Hemoglobin A1c
Reflects average blood sugar levels over the preceding 90-day period. Elevated levels are associated with prediabetes and diabetes. Individuals with diabetes have an increased risk of a cardiac event. A person with diabetes has the same risk for heart attack as a person without diabetes, who has experienced one heart attack, having a second heart attack. Aggressive global preventive risk reduction efforts, such as lower LDL targets, diet, exercise and blood pressure control, are recommended.
Goal values :
- A range of 5.7-6.4 percent indicates an increased risk for development of diabetes , and lifestyle interventions may be beneficial.
- A value equal or greater than 6.5 percent is considered diabetes.
This test may be measured any time of the day without fasting.
Glycosylated hemoglobin is blood glucose attached to hemoglobin . This test is often called the “diabetes report card.” It reflects the average blood sugar for the two to three month period before the test.
To calculate the average blood glucose level from the HbA1C:
HbA1C level x 33.3 86 = average blood glucose level for the past 90 days. HbA1C can be helpful to track diabetes control over time.
Random Blood Sugar Test
This measures your blood sugar at the time youre tested. You can take this test at any time and dont need to fast first. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.
|140 mg/dL or below||N/A|
*Results for gestational diabetes can differ. Ask your health care provider what your results mean if youre being tested for gestational diabetes.Source: American Diabetes Association
If your doctor thinks you have type 1 diabetes, your blood may also tested for autoantibodies that are often present in type 1 diabetes but not in type 2 diabetes. You may have your urine tested for ketones , which also indicate type 1 diabetes instead of type 2 diabetes.
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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 percentor even higher in some circumstancesmay be appropriate in people who have
- limited life expectancy
Ask The Doctor: What’s The Difference Between Blood Sugar And Hemoglobin A1c
Ask the doctor Q. In your article on blood sugar control, you kept talking about hemoglobin A1c. I measure my blood sugar all the time, but my meter doesn’t have a setting for a percentage reading. Is there a simple connection between blood sugar and hemoglobin A1c? A. I’m sorry we confused you. Blood sugar and hemoglobin A1c are connected, but they are different, too. Your blood sugar meter measures the concentration of glucose in the bloodstream at the instant you prick your finger. The reading is in milligrams of glucose per deciliter of blood, abbreviated as mg/dL. Blood sugar levels vary throughout the day. In people with diabetes, they can range from below 70 mg/dL to above 200.Continue reading > >
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Managing Diabetes After Diagnosis: The Next Step
Diagnosing diabetes gives patients and their health experts the leverage to treat the condition before it leads to serious complications. Namely, patients and their health specialists can achieve normal blood glucose levels by implementing some blood glucose control tips with the right diagnoses. These tips help prevent mild to severe diabetes complications that put patients lives at risk, reinforcing the need for proper and early diagnosis.
There are several ways people diagnosed with diabetes can prevent the condition from getting worse and even help them get better. Body weight plays a major role in increasing diabetes and high blood sugar. So, patients need to adopt proactive management tips that control blood sugar levels and obesity.
Below are some steps that patients can take:
Maintain A Healthy Weight
Work with them to determine how many calories you should be eating. If you need to lose weight, ask them how much weight you should be losing per week to stay healthy.
Crash diets and extreme workout plans may make for entertaining television, but they arent realistic for long-term maintenance. Theyre often unhealthy as well.
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Diabetes: Blood Sugar Levels
Topic Overview Keeping your blood sugar in a target range reduces your risk of problems such as diabetic eye disease , kidney disease , and nerve disease . Some people can work toward lower numbers, and some people may need higher goals. For example, some children and adolescents with type 1 or type 2 diabetes, people who have severe complications from diabetes, people who may not live much longer, or people who have trouble recognizing the symptoms of low blood sugar may have a higher target range. And some people, such as those who are newly diagnosed with diabetes or who don’t have any complications from diabetes, may do better with a lower target range. Work with your doctor to set your own target blood sugar range. This will help you achieve the best control possible without having a high risk of hypoglycemia. Diabetes Canada suggests the following A1c and blood glucose ranges as a general guide. Women with type 1 or type 2 diabetes who become pregnant 2 A1c: 7.0% or less Blood glucose: Fasting and before meals: Less than 5.3 mmol/L 1 hour after meals: Less than 7.8 mmol/L 2 hours after meals: Less than 6.7 mmol/LContinue reading > >
Can The A1c Test Result In A Different Diagnosis Than The Blood Glucose Tests
Yes. In some people, a blood glucose test may show diabetes when an A1C test does not. The reverse can also occuran A1C test may indicate diabetes even though a blood glucose test does not. Because of these differences in test results, health care professionals repeat tests before making a diagnosis.
People with differing test results may be in an early stage of the disease, when blood glucose levels have not risen high enough to show up on every test. In this case, health care professionals may choose to follow the person closely and repeat the test in several months.
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Is Fasting Required For An A1c Test
Blood, or plasma, glucose levels donât remain the same throughout the day. Instead, they fluctuate, especially after a meal. However, this doesnât affect HbA1c testing.
Unlike various other tests for diagnosing or evaluating diabetes, such as the oral glucose tolerance test, fasting is not required with the A1c test. The reason why is simple. This blood glucose test measures your average blood glucose level over the last 90 days, rather than providing a snapshot of your fasting blood glucose level at a particular moment.
For this reason, you do not need to do A1c test fasting, and you can eat and drink as you normally would before the test.
Itâs important to note that the HbA1c test is not a replacement for regular blood glucose monitoring in people with diabetes.
How To Lower Hba1c And Blood Glucose Levels
Adopt a more vegetarian diet, including beans & nuts
Vegetarian diets are inversely associated with the risk of developing type 2 diabetes. In a meta analysis comparing nine different experiments, researchers found that vegetarian diets consistently improved fasting blood glucose and HbA1c. Why? They generally emphasize a diet rich in whole grains, fruits, vegetables, beans, and nuts, and lower levels of saturated and trans fat. Plus, beans often replace meat in these diets by acting as a protein source. Thanks to their high fiber content and low glycemic index , beans stabilize blood glucose and insulin levels. So individuals with type 2 diabetes may notice significantly lower A1c levels if they increase their bean intake to at least one cup per day. Similar to beans, nuts are low glycemic and help regulate blood sugar levels. In a recent experiment, people who replaced some of their food with a serving of nuts saw improved glycemic control and HbA1c levels. On a grander scale, eating nuts has an inverse association with type 2 diabetesthat is, people who include nuts in their daily lives tend to have a lower risk of developing diabetes.
Exercise is a crucial component in managing glucose and insulin levels. It directly improves blood glucose control, increases insulin sensitivity, and helps maintain a healthy weight. Exercise is a very effective tool in preventing the development of type 2 diabetes.
Prep more meals at home
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