How Accurate Are A1c Tests
A1C levels rise well before the clinical onset of diabetes, making early diagnosis possible according to the 2017 Standards of Medical Care in Diabetes by the American Diabetes Association . Sometimes, however, in the early stages of diabetes, blood sugar levels are not high enough to show up as problematic. Testing environments, such as temperature in the lab, equipment used, and handling of samples, can affect the results however, this is more common in the fasting plasma glucose and the OGTT than in the A1C. Strict quality controls and advancements in testing have made the A1C test more precise than in the past, according to the NIDDK. Doctors should be aware of laboratories that use an NGSP-certified method of testing for A1C levels. The NIDDK warns that blood samples taken at home or analyzed in a healthcare providers office should not be used for diagnosis.
There are some health conditions and situations that might skew the results of the test. These include:
- Anemia
- Dialysis
- Blood loss or blood transfusions
Also, the test can be unreliable for people of African, Mediterranean, or Southeast Asian descent, people with a family member with sickle cell anemia, and those with thalassemia. For those who fall into these groups, a healthcare provider might suggest a different test or a specialized A1C.
Blood Sugar Levels Chart
Below chart displays possible blood sugar levels . Units are expressed in mg/dL and mmol/L respectively. Additional topics: What is diabetes? How do you know if you have diabetes? How to test for diabetes? Why is it important to measure your blood sugar levels frequently? Diet for people with diabetes You can also download or print this chart by clicking here. Reference: American Diabetes Association, Additional topics: What is diabetes? How do you know if you have diabetes? How to test for diabetes? What is normal blood sugar level? Why is it important to measure your blood sugar levels frequently? Diet for people with diabetesContinue reading > >
Which Diabetic Supplies Are Covered By Medicare
For those with diabetes, Medicare Part B covers three main areas of diabetic supplies: blood sugar self-testing equipment and supplies, insulin pumps, and therapeutic shoes or inserts. For these areas, Medicare typically covers 80% of the visit and you will pay 20% if you do not have coinsurance. These costs can also go toward the Part B deductible.
Medicare Part B also covers certain diabetic screenings and services.
If you have an insulin pump, Medicare Part B covers the pump as well as the insulin under durable medical equipment instead of as medicine under Part D, explains Lindsey Hudson, APRN, NP-C, and certified diabetes care and education specialist working in Charleston, South Carolina, and a member of the SingleCare Medical Board.
Medicare Part B also covers certain diabetic screenings and services. For the supplies, screenings, and services below, note that Medicare consumers may have to pay coinsurance, copays, and/or deductibles depending on their plan.
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What Is A Normal Blood Sugar Level
The answer to the question what is a normal blood sugar level is as follows:
Fasting normal blood sugarNormal for person without diabetes: 7099 mg/dl Official ADA recommendation for someone with diabetes: 80130 mg/dl
Normal blood sugar 2 hours after mealsNormal for person without diabetes: Less than 140 mg/dl Official ADA recommendation for someone with diabetes: Less than 180 mg/dl
Normal for person without diabetes: Less than 5.7%Official ADA recommendation for someone with diabetes: Less than 7.0%
Source: American Diabetes Association
When Combining Keto And : 2 Intermittent Fasting On Fasting Days Do You Still Follow The Macro Guidelines For Keto
On the two days of fasting, should the 500 calories consumed be of the same macro proportions as followed on the normal keto days? Or can you consume 500 calories of any food without going out of ketosis?
Andrea
I dont generally recommend people to count calories. Fasting means not eating anything at all, so there is no counting macros. Dr. Mosleys 5:2 diet allows 500 calories of whatever you like. But thats his diet, not mine. I advocate intermittent fasting, with no calories.
Dr. Jason Fung
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What Are Normal Blood Glucose Levels In Healthy Individuals
Blood sugar levels can either be normal, high, or low, depending on how much glucose someone has in their bloodstream. Glucose is a simple sugar thats present in the bloodstream at all times. Normal blood glucose levels can be measured when someone fasts, eats, or after theyve eaten. A normal blood glucose level for adults, without diabetes, who havent eaten for at least eight hours is less than 100 mg/dL. A normal blood glucose level for adults, without diabetes, two hours after eating is 90 to 110 mg/dL.
Many factors affect blood sugar levels throughout the day:
- Type of food consumed, how much, and when
- Physical activity
- Menstrual periods
- Alcohol
An ideal blood sugar level for anyone without diabetes or prediabetes, regardless of age, in the morning should be less than 100 mg/dL. Remember, blood sugar levels can fluctuate throughout the day as a result of the factors previously mentioned.
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 After Youve Eaten
Many foods have types of carbohydrates called starches and sugars. When you eat foods with these types of carbohydrates, your body breaks them down into glucose, which is a type of simple sugar, and releases the glucose into your bloodstream. Aside from glucose produced by your liver, food is the main source of plasma glucose.
Two hours after eating, your blood sugar levels rise. They rise more when you eat more carbohydrates, when you do not eat fiber, fat, or protein with your carbs, and when you eat certain types of carbohydrates, such as refined sugars and starches.
These are target values from The Joslin Diabetes Center, which include levels for people with diabetes:
| When Measured |
|---|
Fasting & Elevated Blood Glucose
Type 2 diabetes for 20+ years. Started keto with intermittent fasting in January 2019. Why would my fasting blood glucose numbers during my 18-24-hour fast be elevated, then come down to normal ranges after eating?
Mindy
Fasting can definitely raise blood glucose. This is due to the effect of insulin falling and the rising counter-regulatory hormones including increased sympathetic tone, noradrenaline, cortisol and growth hormone, in addition to glucagon. These all have the effect of pushing glucose from liver storage into the blood. This is normal. If you are not eating, you want to use some stored glucose. The question is this if you are not eating, and your blood glucose went up, where did that glucose come from? It can only have come from your own body . So, its a natural phenomenon, and the fasting now allows your body to use some of the glucose for energy.
Dr. Jason Fung
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What Is Blood Sugar
Blood sugar, or glucose, is the sugar found in your blood that comes mainly from the food you eat. Whenever you eat something, your digestive system breaks it down into smaller components, and one of the major components is glucose.
Glucose is our bodies preferred energy source. Its a necessary ingredient for maintaining the optimal function of your organs, muscles, and nervous system.
If you just ate a meal high in carbohydrates, starch, and/or sugar, your blood sugar will rise high over a normal fasting level. If you just had a meal of healthy fats and proteins, your blood sugar will not rise as high.
Blood sugar after meals that is continuously outside of the normal range can lead to major blood vessel and body tissue damage.
This damage creates toxic compounds called advanced glycation end products .
AGEs are proteins or lipids that are tagged with glucose molecules as a result of continuous exposure to high sugar levels. AGEs accelerate the aging process by depleting your bodys antioxidant stores.
They also wreak havoc in the body by damaging DNA and lead to the development, or worsening, of many diseases including diabetes, atherosclerosis, high blood pressure, kidney disease, and Alzheimers disease.
Fortunately, its very simple to measure the direct effect on your blood sugar of any kind of food, whether its a bowl of greens or a big juicy burger.
Blood Sugar Level Chart By Age
Blood sugar levels tend to rise with age due to an increase in insulin resistance and decrease in insulin sensitivity. In one study by the National Health Institute , each extra decade of age was linked to a 2.7 mg/dl increase in fasting glucose, and a 4.5 mg/dl increase in 2-hour post-prandial glucose levels.
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Why Your A1c Matters
In a nutshell: your A1c is one of the clearest indicators of your risk for developing diabetes complications like neuropathy , retinopathy , nephropathy , and severe infection in any part of your body that requires healing.
For instance, a small cut on your toe could become infected due to high blood sugars, struggle to heal, and become severe enough that the infection could lead to an amputation.
The general guidelines from the American Diabetes Association recommend an A1c at or below 7.0 percent for the best prevention of diabetes complications. Your risk of developing a diabetes complication continues to drop as your A1c drops closer to 6 percent.
Some people with diabetes aim for A1c levels in the 5s and lower especially those who follow strict low-carb diets like the ketogenic diet and the Bernstein diet. However, this hasnt been proven in research as especially necessary, nor is it reasonably achievable for the larger population of people with diabetes.
Its also important to remember that your blood sugar levels and your A1c are just information that tells you whether your body needs more or less of factors like insulin, other diabetes medications, changes in your nutrition, and changes in your exercise.
If you dont like the number youre seeing on your glucose meter or your A1c results, use that number as motivation to make changes in how you safely manage your diabetes in order to get different results.
A1c Goals Should Be Individualized
A1c goals should be individualized based on the individual capabilities, risks, and prior experiences, explains Gary Scheiner, MS, CDE, founder of Integrated Diabetes, and author of Think Like a Pancreas.
For example, we generally aim for very tight A1c levels during pregnancy and more conservative targets in young children and the elderly.
However, Scheiner highlights important factors that could justify aiming for a higher A1c, like hypoglycemia unawareness, which is described as when a person with diabetes no longer feels the oncoming warning signs of low blood sugar. This can put you at significant risk for severe low blood sugars resulting seizures or death. To reduce that risk, you would aim for higher target blood sugar ranges.
Someone with significant hypoglycemia unawareness and a history of severe lows should target higher blood glucose levels than someone who can detect and manage their lows more effectively, adds Scheiner. And certainly, someone who has been running A1cs in double digits for quite some time should not be targeting an A1c of 6% better to set modest, realistic, achievable goals.
Learn how to lower your A1c in DiabetesStrongsA1C Guide.
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What Is Blood Glucose Anyway
Blood glucose, or sugar, is sugar that is in your blood . It comes from the food that you eat foods that contain carbohydrate, such as bread, pasta and fruit are the main contributors to blood glucose. The cells in our bodies need glucose for energy and we all need energy to move, think, learn and breathe. The brain, which is the command center, uses about half of all the energy from glucose in the body.
Now That Youre Checking Your Blood Glucose What Do The Numbers Mean
Depending on your diabetes treatment plan, your doctor or diabetes educator may advise you to check once a week, once a day or up to 10 times a day . But what does it mean when you see a 67, 101 or 350 on your meter? And what is a normal blood sugar, anyway? Great questions! After all, if you dont know what the numbers on your meter mean, its hard to know how youre doing.
The American Diabetes Association provides guidelines for blood glucose goals for people with diabetes, and the goals vary depending on when youre checking your glucose:
Fasting and before meals: 80130 mg/dl
Postprandial : Less than 180 mg/dl
By the way, these guidelines are for non-pregnant adults with type 1 or type 2 diabetes. Children, adolescents and pregnant women may have different goals.
Your blood glucose goals may be different, however. If youre younger, have had diabetes for a shorter amount of time or are not taking any medicine for your diabetes, your glucose goals might be a little tighter, or lower. Likewise, your blood glucose goals may be higher than what ADA recommends if youre older, have diabetes complications, or dont get symptoms when your blood glucose is low.
Bottom line: talk with your health-care provider about the following:
When to check your blood glucose How often to check your blood glucose What your blood glucose goals are
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Why Doctors Order It
A fasting blood glucose test is done to screen for prediabetes and diabetes. It also helps doctors monitor diabetes and determine if medications and dietary changes are having an effect .
Your fasting blood glucose level is the lowest your blood sugar can be because the influence of recent meals is minimized .
Fasting blood sugar is often checked alongside HbA1c , which is a measure of your blood sugar levels over the past three months. The more sugar there is in the blood, the more it will attach to hemoglobin, raising HbA1c .
Taken together, the two offer more information than each test alone. For example, even if your blood sugar levels are very high at one random point, they may have been mostly low over the past couple of months . On the other hand, HBA1c could be higher but your glucose levels at the moment lower.
Apart from diabetes, abnormal levels can point out issues such as insulin resistance, hormonal imbalances, and pancreatic, liver, or kidney disease.
Asknadia: Why Are My Blood Sugar Numbers High
Dear Nadia,
Why are my blood sugar numbers so varied?
I have been experiencing high blood sugar numbers on my glucose meter. They range from 131 on the low end to 534 on the high end. But that was one time. My average numbers are 127 to 231.
Roy G
Dear Roy:
Your varied blood glucose numbers are of concern. I would speak to your healthcare professional immediately to figure out what your real average blood sugar number is. This can be more accurately reflected with an A1C test.
What Your Average Blood Sugar Numbers Mean
A fasting blood sugar of 127 mg/dL is equal to an A1C of 6.1%well below the A1C of 7.0% that the American Diabetes Association recommends for people who want to tightly manage their diabetes. So, if that is in fact your average blood sugar reading, its generally considered a good one.
Regarding the higher number of 231 mg/dL, everybody, non-diabetics included, normally experience a blood sugar spike after a meal. Your average post-meal high of 231 mg/dL is equivalent to an A1C of 9.6%.
Daily Averages
Your daily glucose averages is not going to tell you as much as having your A1C number checked every three months to see what your real average blood glucose level is. This 90-day overview gives you a much better perspective than your fluctuating fasting and post-meal numbers.
Tracking After Meal Blood Glucose Readings
Other Factors
AskNadia and receive her unique perspective on your question.
Email Nadia at AskNadia@DiabetesHealth.com.
Disclaimer:
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Prediabetes Symptoms You Shouldn’t Ignore
More than 86 million people in the United States – that’s 1 out of every 3 adults – are prediabetic, yet 90 percent of them have no idea. If you don’t know you have it you wont be making the changes needed to ward off the full-blown disease.
Prediabetes is when your blood sugar is above normal but not in the range that would be considered diabetes, explains an endocrinologist. A normal blood sugar reading is less than 6 mmol/l greater than 7 mmol/l is considered diabetes. If your 12-hours fasting blood sugar lands somewhere between those numbers, youve qualified for prediabetes.
The easiest way to determine if you have it is to get a simple blood test. A score of 5.9 mmol/l and below is considered normal. Anything between 5.7 and 6.4 mmol/l is considered prediabetes, and 6.4 mmol/l and above is full-blown diabetes.
The American Diabetes Association recommends that everyone age 45 and older get their blood sugar checked – unchecked prediabetes often turns into full-blown diabetes. But it can be hard to tell if you have this borderline condition, because it doesn’t usually cause any symptoms. There is no way to know you have prediabetes without a a blood test.
However, there are certain patterns and changes that can serve to tip you off. Watch out for these sneaky signs, which could signal that you’re headed for prediabetes – or that you already have it.