Facts And Definition Of Hemoglobin A1c
- Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin that is bound to glucose.
- The blood test for HbA1c level is routinely performed in people with type 1 and type 2 diabetes mellitus.
- Blood HbA1c levels are reflective of how well diabetes is controlled.
- The normal range for level for hemoglobin A1c is less than 6%.
- HbA1c also is known as glycosylated, or glycated hemoglobin.
- HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose.
- High HbA1c levels indicate poorer control of diabetes than levels in the normal range.
- HbA1c is typically measured to determine how well a type 1 or type 2 diabetes treatment plan is working.
Use This Chart To View A1c Values And Comparable Blood Glucose Values:
| A1c | |
|---|---|
| 12% | 298 |
A note of caution: the A1c measurement is not always accurate. For example, if someone has certain type of hemoglobin mutations , is severely anemic , iron deficient or is being treated blood transfusions or medications to increase the production of new red blood cells, the A1c test may not be accurate.
If your finger-stick blood tests give an average blood sugar that is much higher or lower than your A1c test, ask your doctor if the A1c is the right test for you. An alternative test to the A1c is a fructosamine test. Unfortunately, the fructosamine test and the A1c are not interchangeable because they are measuring different things. The fructosamine test reflects the average blood sugars only over a 2-3 week period.
Which Is More Dangerous Blood Sugar Too High Or Too Low
A persons blood sugar levels can be high, but can also below, depending on their lifestyle and diet. Which is more dangerous?
Blood sugar is medically the definition of the amount of sugar content or glucose substances in the blood. Maintaining sugar levels in the body is not only important for diabetics, but also for healthy people.
Because normal blood sugar levels are important for your bodys performance and health. If it is too high or too low, there will be a disturbing complaint. Know which conditions are more dangerous so you can be more alert.
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Language Matters In Diabetes
Words make a difference when youre talking about diabetes. Thats especially true in the context of blood sugar levels and how someone manages their health.
Here are some suggestions on language choices when talking with someone about their blood sugars and glucose levels.
- Try to avoid using terms like good or bad for higher or lower blood sugars.
- Instead, try to not tie value judgments to these numbers. Think about them as just numbers, in range or not, and pieces of data to help make a decision in diabetes care. Sometimes glucose numbers are too low or too high, and its helpful for the person with diabetes to understand why those glucose fluctuations are happening.
What Are Some Top Tips For Lowering A1c
Your A1C score is a helpful tool, Dodell says, but it is not the only indicator of how healthy you are.
For example, you could hit your A1C goal but still have wide fluctuations in your blood sugar levels, which is more common among people who take insulin. Youll need to bring these day-to-day fluctuations under control, since they can lower your quality of life and increase your risk of complications, he says.
Think of your diabetes as you would a job, Dodell says. It takes work, but the time and effort you put into it can result in good control and an improved quality of life. The key to reaching your A1C goal is trying to follow a healthy lifestyle, he says.
Making these changes can help you improve your day-to-day blood sugar management and lower your A1C.
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How Are ‘normal’ A1c Levels Defined
The major laboratories that test our levels often say that the normal range is 4.0 to 6.0. They base that range on an old standard chemistry text, Tietz Fundamentals of Clinical Chemistry.The Diabetes Control and Complications Trial or DCCT, one of the two largest and most important studies of people with diabetes, said that 6.0 was a normal level. But the other key study, the United Kingdom Prospective Diabetes Study or UKPDS, which compared conventional and intensive therapy in more than 5,000 newly diagnosed people with type 2 diabetes, said that 6.2 is the normal level.
Those levels, while unsubstantiated, are close. But then comes along one of my heroes, Dr. Richard K. Bernstein, the author of the key text of very low-carb eating for people with diabetes, Dr. Bernstein’s Diabetes Solution. Dr. Bernstein himself developed type 1 diabetes in 1946 at the age of 12.
“For my patients…a truly normal HgbA1C ranges from 4.2 percent to 4.6 percent,” he writes on page 54 of the third edition of that book. “Mine is consistently 4.5 percent.” Then in his July 30, 2008, telecast he reiterated that as far as he has been able to determine, a normal A1C is 4.2 to 4.6.
What Dr. Bernstein says is normal is so at odds with the other experts that at least a year ago I determined to find scientific proof of what a normal A1C level actually is. It turned out to be a lot more difficult to find than I ever imagined.
How Often Should You Have An A1c Lab Test
Your healthcare provider may order an A1C test every three months to monitor diabetes treatment changes, such as adjustments to medications, insulin pump settings, or other areas of diabetes self-management. If your blood glucose is within range and stable, your healthcare provider may only order the test every six months.
If you have not been diagnosed with diabetes, sometimes A1C is used along with other measures to help diagnose diabetes. It may also be used as a baseline measurement for people with a strong family history of diabetes or other risk factors to see if levels are increasing over time.
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How Is Hemoglobin A1c Measured
The test for hemoglobin A1c depends on the chemical charge on the molecule of HbA1c, which differs from the charges on the other components of hemoglobin. The molecule of HbA1c also differs in size from the other components. HbA1c may be separated by charge and size from the other hemoglobin A components in blood by a procedure called high pressure liquid chromatography . HPLC separates mixtures into its various components by adding the mixtures to special liquids and passing them under pressure through columns filled with a material that separates the mixture into its different component molecules.
HbA1c testing is done on a blood sample. Because HbA1c is not affected by short-term fluctuations in blood glucose concentrations, for example, due to meals, blood can be drawn for HbA1c testing without regard to when food was eaten. Fasting for the blood test is not necessary.
As mentioned previously, normal levels of HbA1c are less than 6%, so a measurement over 6% is considered high. For many people with type 1 and type 2 diabetes, the goal is to keep the HbA1c levels under 7%, since keeping levels below 7% has been shown to delay the complications of diabetes.
Many laboratories report a calculated eAG along with every HbA1c results. This is a correlation of the HbA1c levels with the average blood sugar level. For example, a HbA1c measurement of 7% corresponds to an eAG measurement of 154 mg/dl.
Normal Hemoglobin Hgb A1c And High Blood Sugar Means One Or All Of These:
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A1c Results And What The Numbers Mean
| Diagnosis* | |
|---|---|
| Diabetes | 6.5 percent or above |
When using the A1C test for diagnosis, your doctor will send your blood sample taken from a vein to a lab that uses an NGSP-certified method. The NGSP, formerly called the National Glycohemoglobin Standardization Program, certifies that makers of A1C tests provide results that are consistent and comparable with those used in the Diabetes Control and Complications Trial.
Blood samples analyzed in a doctors office or clinic, known as point-of-care tests, should not be used for diagnosis.
The A1C test should not be used to diagnose type 1 diabetes, gestational diabetes, or cystic fibrosis-related diabetes. The A1C test may give false results in people with certain conditions.
Having prediabetes is a risk factor for developing type 2 diabetes. Within the prediabetes A1C range of 5.7 to 6.4 percent, the higher the A1C, the greater the risk of diabetes.
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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What Do Your A1c Results Mean
The A1C test measures the glucose in your blood by assessing the amount of whats called glycated hemoglobin. Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin, Dr. Dodell says.
According to the ADA, an A1C level below 5.7 percent is considered normal between 5.7 and 6.4 signals prediabetes and over 6.5 percent indicates type 2 diabetes. For many people with type 2 diabetes, the goal is to reduce A1C levels.
Your A1C goal is specific to you. Several factors come into play, such as your age, how advanced the diabetes is, and whether you have any other health conditions. If you can keep your A1C number below your goal which, for many people with diabetes, is less than 7 percent, says Dodell you can reduce the risk of complications, such as nerve damage and eye problems.
What Medicine Do You Take For Diabetes Type 2
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How To Lower A1c
If your A1c test shows that your levels are too high, your doctor will tell you to lower it. Here are some useful tips on how to do that:
Whats Considered A Normal Glucose Level
Your doctor will likely test your blood glucose levels as a screening test for diabetes during a standard yearly check-up. Additionally, many people track their glucose at home with an over-the-counter finger-prick test. When you check blood glucose , either at a doctors office or with a home finger stick glucose monitor, the results are in milligrams of glucose per deciliter of blood.
One of the most common glucose measurements is fasting plasma glucose or fasting blood glucose , and its found by checking blood glucose levels after not having any calories at least eight hours before the test. According to the American Diabetes Association , people can be classified into three categories depending on their fasting plasma glucose levels: normal, prediabetes, and diabetes. To be considered normal, fasting glucose must be under 100 mg/dl.
Of note, CGM devices measure interstitial glucose levels compared to blood/plasma glucose levels measured in the FPG tests. While interstitial glucose and blood/plasma glucose levels correlate highly, they are not precisely the same, and diagnoses are not made from interstitial measurements.
Below is a summary overview of data about 24-hour glucose trends in nondiabetic individuals wearing CGM to gain a better understanding of whats normal.
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Will Oatmeal Lower Your Blood Sugar
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What Causes Low Blood Glucose In People With Diabetes
Low blood glucose levels can be a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. Taking these can lower your blood glucose level.
Two types of diabetes pills can cause low blood glucose
- sulfonylureas, usually taken once or twice per day, which increase insulin over several hours
- meglitinides, taken before meals to promote a short-term increase in insulin
The following may also lower your blood glucose level
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