Large Trial Compared Usual Tools For Assessing For Diabetes In Adults
The researchers looked at data from 9,000 adults, ages 20 years and older, from the 2005-2014 National Health and Nutrition Examination Survey . The information collected by the research team included body weight and blood test results.
Based on the fasting blood glucose test and the OGTT, 765 patients were diagnosed as having type 2 diabetes . However, only about 27% of these individuals were classified as having diabetes based on their A1c levels, which is how Dr. Villacreses and her team determined that nearly three-quarters of those at risk for diabetes were not aware that they had this chronic disease, and therefore were not receiving treatment.1
“Most worrisome, 73 % of patients would have missed out on early intervention and treatment,” she tells EndocrineWeb. While the A1c test is convenient, ”we recommend that we do not rely solely on this number,” Dr. Villacreses says.
The guidelines for diagnosis and treatment of type 2 diabetes from the American Diabetes Association already advise against relying solely on A1c,3 she says. While the American Diabetes Association guidelines specify that diabetes can be diagnosed based on fasting plasma glucose , the OGTT, or the A1c, our findings confirm that reliance on A1c remains the least reliable method for assessing diabetes risk.
Fasting Blood Glucose Test Or A1c Which Predicts
· Fasting Glucose Vs, A1c Which Is More Accurate? Hello, Ive never been concerned about diabetes before as my fasting blood glucose levels have always been under 100,However, my last fasting glucose test as well as my husbands were both high mine 127, his 140,The doctor had us return for A1c tests which were in the normal range mine 5,6, his 5,5,Based on that, the doctor assumed we had
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A1c Fasting Blood Glucose Chart
Hemoglobin is the molecule within red blood cells.that carries oxygen to the bodys tissues.a small percentage of the hemoglobin has sugar attached to it, and this type of hemoglobin is known as hemoglobin a1c.. the amount of hemoglobin a1c depends on the level of sugar in the blood: the higher the blood sugar the higher is the amount of hemoglobin a1c.. How accurate is your blood glucose meter? a major study found that almost half of meters do not meet the minimum required standards: for blood sugars over 75 mg : accurate within 20%. for example, if your blood sugar is 200 mg , the meter must read between 160 and 240 at least 95% of the time. for blood sugars under 75 mg : accurate within 15 mg.. An a1c of 5.7 percent to 6.4 percent means that you have prediabetes, and youre at high risk for the development of diabetes. diabetes is diagnosed when the a1c is 6.5 percent or higher. fasting plasma glucose test a fasting plasma glucose test requires fasting for eight hours before the test..
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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.
Fasting Glucose Vs A1c
Hello, I’ve never been concerned about diabetes before as my fasting blood glucose levels have always been under 100.However, my last fasting glucose test as well as my husband’s were both high .The doctor had us return for A1c tests which were in the normal range .Based on that, the doctor assumed we had eaten something before the fasting test and said, ‘see you in 3 months’.But we didn’t eat anything. I do have doubts about the fasting results because my doctor uses his own lab.While I know it must be state regulated, we have gotten strange results in the past from this lab.I told my 80-year Mother about it and she showed me several of her blood test results from years ago that showed her fasting glucose levels were as high as 123, however, her last blood test showed 97.So…why did she have such high levels in the past and now her readings are normal?She does not have diabetes.What would cause high fasting glucose other than diabetes or pre-diabetes?I’m very confused and would appreciate any insight into this.Thank you.Continue reading > >
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
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What Blood Sugar Markers Are Reliable
Testing accurately for blood sugar is like putting pieces of a puzzle together. Fasting blood glucose, A1c and post-meal blood sugar are all pieces of the puzzle. But post-meal blood glucose testing is by far the most reliable and accurate way to determine whats happening with blood sugar, and the most sensitive way of predicting future diabetic complications and heart disease.
Ive posted several articles on ChrisKresser.com on this subject. For more on why post-meal blood sugar is a superior marker, read When Your Normal Blood Sugar Isnt Normal . For my recommendations on how patients can measure their post-meal blood sugars at home, and what healthy targets should be, read How to Prevent Diabetes and Heart Disease for $16.
Another useful but underused blood sugar marker is fructosamine. Fructosamine is a compound that results from a reaction between fructose and ammonia or an amine. Like A1c, its a measure of average blood sugar concentrations. But instead of measuring the previous 12 weeks like A1c, fructosamine measures the previous 2-3 weeks. And unlike A1c, fructosamine is not affected by the varying length of red blood cell lifespans in different individuals. Fructosamine is especially useful in people who are anemic, or during pregnancy, when hormonal changes cause greater short-term fluctuations in blood glucose levels.
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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What Does This Mean For People Wondering About Their Diabetes Risk
For individuals who havent received a diagnosis of diabetes, Dr. Villacreses says, one important lesson from these fidings is that ”you should not feel 100% reassured if your A1c number is less than 6.5% that you are do not have diabetes. A test result that is greater than 6.4% defines the beginning of diabetes, so you may have prediabetes or have already progressed to type 2 diabetes.
The sooner you receive a diagnosis regarding your diabetes status, the earlier treatment can begin. This is important because by understanding your risks, and making the necessary lifestyle changes, you can prevent prediabetes from progressing or even reverse the type 2 diabetes.
In addition, she says, patients should feel comfortable asking their doctor about the choice of tests and indicate your desire to skip the A1c, and have one of the other more reliable screening methods, while more time consuming, to determine if you are at risk for pre-diabetes or diabetes.
Dr. Villacreses has received research funding and speaking fees from a variety of pharmaceutical companies but none that pose a conflict in this research. Dr. Christofides has no relevant financial disclosures.
Hemoglobin A1c Outperforms Fasting Glucose For Risk Prediction
- Johns Hopkins University Bloomberg School of Public Health
- Measurements of hemoglobin A1c more accurately identify persons at risk for clinical outcomes than the commonly used measurement of fasting glucose, according to a new study. HbA1c levels accurately predict future diabetes, and they better predict stroke, heart disease and all-cause mortality as well.
Measurements of hemoglobin A1c more accurately identify persons at risk for clinical outcomes than the commonly used measurement of fasting glucose, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. HbA1c levels accurately predict future diabetes, and they better predict stroke, heart disease and all-cause mortality as well.
The study appeared in the March 4, 2010, issue of New England Journal of Medicine.
As a diagnostic, “HbA1c has significant advantages over fasting glucose,” said Elizabeth Selvin, PhD, MPH, the study’s lead author. The A1c test has low variability from day to day, levels are not as affected by stress and illness, it has greater stability and the patient is not required to fast before the test is performed.
The revised ADA guidelines classify people with HbA1c levels in the range of 5.7 to 6.4 percent as “at very high risk” for developing diabetes over 5 years. The range of 5.5 to 6 percent, according to the ADA guidelines, is the appropriate level to initiate preventive measures.
Recruitment And Data Collection
Detailed study procedures have been previously reported. All adults aged 18 years and above who were usually residents in either of the study sites were eligible to participate in the parent study. All households were approached consecutively, and all residents aged 18 years were recruited. Recruits provided written informed consent for each separate study component and could opt out of any component. Venipuncture was conducted after a minimum 8-hour fasting period and whole blood samples were collected in sodium fluoride tubes. Tubes were stored on ice in an insulated cool box and delivered to the laboratory for processing , and glucose analysis was completed within 1hour after processing. Quantitative determination of fasting plasma glucose and HbA1c was performed using the Beckman Coulter Chemistry Analyzer AU480 system according to the manufacturers guidelines.
A1c Versus Glucose Testing: A Comparison Diabetes
· A1C tests measure average blood glucose over the past two to three months, So even if you have a high fasting blood sugar, your overall blood sugars may be normal, or vice versa, A normal fasting blood sugar may not eliminate the possibility of type 2 diabetes, This is why A1C tests are now being used for diagnosis and screening of prediabetes,
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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.
A1c Vs Fasting Glucose Hemoglobin A1c Vs Fasting Glucose
· Since glucose remains attached to hemoglobin throughout its life 90-120 days, HbA1c provides insight into your long term glucose exposure, The higher the glucose in your bloodstream, the more glucose will attach to hemoglobin, thus, the higher your HbA1c,
fasting blood sugar and hemoglobin a1c test
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A1c Is Better Associated With Chronic Complications Than Fpg
Different from National Diabetes Data Group criteria, which were essentially based on distribution of glucose levels within the general population, the 1997 ADA criteria established diabetic glycemic levels by means of their association with retinopathy, the most exclusive and specific diabetes complication. Various observational studies documented that an increased prevalence of nonproliferative diabetic retinopathy can be observed with fasting glucose levels around 7.0 mmol/L and 2-h PG around 11.1 mmol/L . Interestingly, the same studies documented that retinopathy increased with A1C levels around 6.5% . These results were confirmed in a more recent study including almost 30,000 subjects recruited in several countries. Such study clearly showed that prevalent retinopathy started to increase in the A1C category of 6.57.0% . Therefore, a cut point of A1C for diagnosing diabetes with an approach similar to the one used with FPG and 2-h PG is available .
It is well known that cardiovascular disease is the most frequent chronic complication of diabetes, with incidence rates 5- to 10-fold higher than with microvascular disease. For this reason, the association of A1C with CVD can be considered a major issue when discussing the potential use of A1C for diagnosing diabetes. In this regard, it is worth mentioning that, in the general population, FPG is a poor marker of future CVD events, whereas 2-h OGTT and A1C are good predictors .
What Do Your Fasting Blood Glucose And Hemoglobin
· Among other risk factors for type 2 diabetes, hemoglobin A 1c A1C and fasting plasma glucose FPG were collected at baseline and the end of study, It has been suggested that A1C can identify
· The key difference between A1c and glucose is that A1c is the percentage of glycated hemoglobin hemoglobin that is bound with glucose in the blood, while glucose test is a fasting blood sugar test which is done by a glucometer, The presence of glucose in the urine is an indication of diabetes,
Auteur : Samanthi
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A1c Diabetes Test Is A Better Indicator Of Risk
By JoAnne Allen
3 Min Read
WASHINGTON – A test that shows blood sugar levels over a span of several weeks is not only the best way to diagnose diabetes but also may be better at identifying who is at risk of getting diabetes than standard blood sugar tests, researchers said on Wednesday.
In a study involving more than 11,000 people with no history of diabetes, the hemoglobin A1c test more accurately identified people who later developed diabetes than the glucose fasting test, which measures blood sugar levels at one point in time.
The A1c test was also a better predictor of risk for stroke, heart disease and death from diabetes, the researchers reported in the New England Journal of Medicine.
They found that people who had A1c levels at 6 percent or greater were at higher risk for developing diabetes.
A1c has significant advantages over fasting glucose, Dr. Elizabeth Selvin of Johns Hopkins University in Baltimore, who led the study, said in a statement.
Blood sugar levels can vary from day to day and hour to hour.
The A1c test is more reliable, repeatable and allows doctors to track average glucose levels over time. Levels are not as affected by stress and illness, and patients do not have to fast before the test, the researchers said.
Blood Sugar Levels During Pregnancy
The NIDDK states that gestational diabetes is high blood sugar that occurs during pregnancy if you were not diabetic before getting pregnant. Healthy blood sugar during pregnancy can help lower your risk of developing type 2 diabetes later. It can also lower the risk of your baby being born prematurely, at a high birth weight, and having respiratory problems.
Blood sugar and insulin levels during the first trimester of pregnancy tend to be lower than usual, but they rise during the late second and early third trimesters. You can be diagnosed with an oral glucose tolerance test .
These are the steps for the 2-step strategy.
- Drink a solution with 50 grams of glucose about the amount in 1 16-oz. bottle of a soft drink
- Get your blood drawn after 1 hour. IF the value is high, retest
- Fast overnight
- Drink a solution with 100 grams of glucose about the amount in 12 peanut butter cups
- Get your blood drawn immediately and after 1, 2, and 3 hours
Or, your doctor might use the 1-step strategy with a 2-hour OGTT:
- Fast overnight
- Drink a solution with 75 grams of glucose
- Get your blood drawn immediately and after 1 and 2 hours
These are some values to know from NIDKK related to gestational diabetes and healthy blood sugar in pregnancy.
|Time or Situation|
|Baseline: at least 105 mg/dl1 hour: at least 190 mg/dl2 hours: at least 165 mg/dl3 hours: at least 145 mg/dl|
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Biological Variability Of A1c Is Lower Than That For Fpg
When the same subjects have two assessments of the available glucose-related parameters, the correlation is stronger among the individual A1C measurements than among the FPG or 2-h PG measurements. The coefficients of variation of A1C, FPG, and 2-h PG are 3.6, 5.7, and 16.6%, respectively . This reflects of course both biological and analytical variability. However, although the latter was similar for A1C and FPG , biological variability of A1C was severalfold lower than that of FPG . This finding confirms that the two required assessments of FPG to diagnose diabetes can provide quite unreliable information, whereas A1C, especially if measured twice as recommended, provides more robust clinical information.