Is The A1c Test Accurate For Everyone
Since the A1C test has been made available , is has become a common way to measure glucose control. However, in the last several years some questions have been raised about potential limitations of A1C:
- Is the A1C accurate for everyone?
- It may not be accurate for some people, including people of African-American descent, people with liver and kidney disease, or with some anemias and sickle cell disease.
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.
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.
What Are Normal Blood Sugar Levels
You might want to measure your blood sugar before meals to get a baseline, and then two hours after your meal to measure your normal blood sugar level. Your doctor might also suggest measuring blood sugar before bed to be sure you have been eating well throughout the day and can go to sleep with peace of mind.
These are considered within the range of normal:
- Less than 140 mg/dl if you do not have diabetes.
- Less than 180 mg/dl if you have diabetes.
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Levels In People With Diabetes
Measuring glucose levels after meals is important not just for diagnosis, but in the treatment of diabetes too. Results obtained during home testing can reveal whether you need an insulin shot to move excess sugar out of your blood and into cells.
Non-fasting sugar levels among adults with type 1 diabetes should be:
- Before meals: From 90 to 130 mg/dL
- After meals : Less than 180 mg/dL
- At bedtime: From 90 to 150 mg/dL
Non-fasting glucose levels among adults with type 2 diabetes should be:
- Before meals: From 70 to 130 mg/dL
- After meals : Less than 180 mg/dL
- At bedtime: From 90 to 150 mg/dL
It is possible to get a falsely high A1C result. This is most likely to happen in someone with low iron levels, kidney failure, or liver disease. Certain medications or vitamin supplements like vitamin E can also increase your A1C levels. Stress and poor sleep habits can also play a role in elevated A1C levels.
What To Expect On The Day Of Test
When you are getting your fasting sugar levels checked, it is natural that you would want to be prepared for the same. Your fasting blood glucose level will be tested with a common blood draw from the vein.
- The lab technician will clean the area on the inner side of the elbow to disinfect and sterilize it so that any infection can be prevented.
- They will then tie a band around the upper arm that will pump up the veins with blood and make them more prominent
- Then, a new and clean needle will be inserted into the vein to draw some blood into a vial.
- They will remove the band and the needle and will put some pressure on the site of insertion to restrict any bleeding. They may also seal the area with cotton and a band-aid.
- They will write down your personal information on the vial so that the label will help them distinguish your sample from othersâ
Once this process is done, the technicians will send your blood sample for testing to the lab. They will let you know when the results will be provided based on the type of blood test.
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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 > >
Diabetes Testing In Children
Many children have no symptoms before they are diagnosed with type 2 diabetes. Most of the time, diabetes is discovered when a blood or urine test taken for other health problems shows diabetes.
Talk to your doctor about your childs risk for diabetes. If your childs blood sugar tests are higher than normal, but not yet at the level of diabetes , your doctor may instruct you in specific diet and exercise changes to help your child avoid getting diabetes altogether. Children with type 2 diabetes or prediabetes are almost always overweight or obese.
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How To Do An A1c Conversion
Here’s how to convert your blood sugar readings into an A1C percentage, according to the ADA and diabetes educators:
Step 1. You’ll want to have a substantial number of blood glucose readings ready to analyze. To truly find out your average blood sugar, you should measure it at different times of the day, Cox recommends. For instance, if you always measure your blood sugar in the morning before you eat, you may not know that your blood sugar is going too high or low at other times in the day. Talk to your doctor about how often to measure your blood sugar each day and when.
Step 2. Add up all the readings you’re using for the conversion. Note the resulting number.
Step 3. Divide the number from Step 2 by the total number of readings you took to reach that number. For instance, if your Step 2 total is 18,000 and you had 100 readings, your math is: 18,000 divided by 100 = 180. This is your average glucose level for the 100 readings.
Step 4. Add 46.7 to the average blood glucose reading from Step 3. If your average reading was 180, your math is: 180 + 46.7 = 226.7.
Step 5. Divide your answer from Step 4 by 28.7. Using the same example as above, your math is: 226.7 divided by 28.7 = 7.89. This means you have an average hemoglobin A1C of 7.89 percent.
You can also use the ADA‘s online conversion calculator to do the math for you.
Start An Exercise Plan You Enjoy And Do It Regularly
Find something you enjoy doing that gets your body moving, whether its taking your dog for a walk, playing a sport with a friend, or riding your bike.
The ADA recommends getting 150 minutes of moderate exercise per week, says Jordana Turkel, a certified diabetes care and education specialist and registered dietitian at Park Avenue Endocrinology & Nutrition in New York City. Different types of exercise can lower your A1C by making your body more sensitive to insulin, Turkel says. She encourages her patients not to go more than two days in a row without exercising and to aim for two days of strength training per week.
Be sure to check with your healthcare provider before embarking on an exercise plan, though. Together, you can come up with an individualized plan.
And if you monitor your blood sugar daily, check it before and after exercise. As the ADA explains, exercise improves insulin sensitivity and lowers your blood sugar levels. In certain circumstances, though, stress hormones produced during more intense exercise can also increase blood sugar levels. In addition, other factors, such as what you eat before exercise and the timing of your workout, may also affect your numbers.
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Understanding The Range Of A1c
Now that you have an estimate of your A1C, check if youâre at risk for diabetes by comparing your result to the tolerances used by both the ADA and CDC:
If your estimated range falls anywhere above 5.7%, get ahead of the risk early. Take control of your health and start monitoring your glucose more closely with a CGM.
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Why Was My Hba1c Result Higher/lower Than The Result Given By The Calculator
In addition to the reasons given just above, there are some other practical reasons which may explain difference between the calculators estimate and your lab results. We will look at a few of the more common reasons for differences.
If you take a relatively high proportion of your blood glucose tests at the same time of day, eg upon waking, the HbA1c result the calculator gives will give a decent reflection of your early morning results but may not so well represent your blood glucose levels at other timers in the day.
Similarly, if you take more before meal, rather than after meal, readings, the HbA1c result given by the calculator will give a better reflection of your before meal results than after meal ones.
Typically, most peoples after meal results are higher than their before meal results, so if you take significantly more before meal results than after meal readings, you may find that the calculator gives you a lower result than your lab test result will.
How To Lower A1c Level
Your doctor will tell you to lower your A1C levels if your test shows they are too high. Here are a few pointers to get you started:
- Consult your doctor about medicine. Make sure youre following the doctors instructions when taking them. Mention any other medications youre taking for different ailments, as they could interact.
- Check your blood sugar levels more frequently and make sure youre using the suitable treatments . If you believe this is a problem for you, seek professional treatment.
- Increase your physical activity. You dont have to train to be an Olympic athlete, but you should strive to include a few short walks in your daily routine. Every step is crucial!
- Attempt to reach and maintain a healthy BMI .
- The BMI is the most fundamental indicator, but you should also consider your waist-hip ratio. A large amount of visceral fat has been related to an increased risk of diabetes and heart disease.
- Maintain a healthy, well-balanced diet. If youre overweight, dont go over your daily calorie restriction, and attempt to eat even less. Say goodbye to processed meals and sweets.
If you follow those recommendations, your hemoglobin A1C levels will almost certainly improve.
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What Do The Results Mean
A1C results tell you what percentage of your hemoglobin is coated with glucose. The percent ranges are just a guide to what is normal. What’s normal for you depends on your health, age, and other factors. Ask your provider what A1C percentage is healthy for you.
To diagnose diabetes or prediabetes, the percentages commonly used are:
- Normal: A1C below 5.7%
- Prediabetes: A1C between 5.7% and 6.4%
- Diabetes: A1C of 6.5% or higher
Providers often use more than one test to diagnose diabetes. So, if your test result was higher than normal, you may have another A1C test or a different type of diabetes test, usually either a fasting blood glucose test or an oral glucose tolerance test .
If your A1C test was done to monitor your diabetes, talk with your provider about what your test results mean.
What Does The A1c Test Measure
When sugar enters your bloodstream, it attaches to hemoglobin, a protein in your red blood cells. Everybody has some sugar attached to their hemoglobin, but people with higher blood sugar levels have more. The A1C test measures the percentage of your red blood cells that have sugar-coated hemoglobin.
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Fasting Is Not Needed For A1c Assessment And No Acute Perturbations Affect A1c
Plasma glucose levels are not stable but rather vary throughout the day, mainly in postprandial periods. Although it is believed that fasting glucose levels are reproducible across days, a number of acute perturbations of glucose homeostasis have been described. Acute stress can increase endogenous glucose production substantially and impair glucose utilization. People who are worried about blood sampling or experience a stressful situation in the hours preceding blood sampling can have an increase in fasting glucose concentration. On the contrary, exercise can decrease glucose levels, and an evening or early-morning session of physical exercise can affect the level of fasting glycemia. Moreover, most individuals do not pay attention to the request or are not asked to consume a diet with at least 200 g carbohydrate in the days before testing glucose. Some individuals do not abstain from food in the 8 h before testing, thus arriving to the laboratory in the postabsorptive rather than fasting condition. In addition, smoking or taking certain medications can adversely affect fasting glucose. The lack of appropriate preparation for glucose testing makes FPG less reliable for diabetes diagnosis, with results sometimes falsely elevated and sometimes apparently normal. On the contrary, A1C is not influenced by acute perturbations or insufficient fasting. Indeed, A1C can be measured anytime, irrespective of fasting or feeding.
When Will I Get The Results Of The Test
You will receive the results of this test within hours. The glucose fasting normal range will also be mentioned on the report for you to check. However, visiting your doctor to get an accurate interpretation of the results would be a better idea. Before diagnosis, it would be best to get your blood tests done by a lab.
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Why Do I Need An Hba1c Test
The Centers for Disease Control recommends A1C testing for diabetes and prediabetes if:
- You are over age 45.
- If your results are normal, you should repeat the test every 3 years.
- If your results show you have prediabetes, you will usually need to be tested every 1 to 2 years. Ask your provider how often to get tested and what you can do to reduce your risk of developing diabetes.
- If your results show you have diabetes, you should get an A1C test at least twice a year to monitor your condition and treatment.
You may also need an A1C test if you have symptoms of diabetes, such as:
- Feeling very thirsty
- Having more infections than usual
