E veryone who's had diabetes for a while is aware that there's some sort of relationship between their blood glucose (BG) levels and the results of their hemoglobin A1c (A1C) test. If someone's BGs are completely normal for the last three months, it's probably safe to assume that the A1C, if measured today, would be normal. But the reverse is not true: a normal A1C doesn't mean all the BGs the past three months have been normal: that might have been the case, but it's also possible, and indeed likely, that the BGs were a mixed bag, some high, some low, and some normal. For whatever it's worth, the A1C has become the "gold standard" lab test for measuring diabetes control: the lower the better; the usual advice is to aim to get your number under 7 (per one organization's recommendation) or 6.5 (per the recommendations of some other organizations).
A recent publication ( Translating the A1C Assay Into Estimated Average Glucose Values ) examined the relationship of the A1C assay...
Republished with permission of Amy Tenderich of DiabetesMine.com
For at least three consecutive years now at the annual ADA Conference, we keep hearing about a rumored switchover from the A1c as the gold standard average glucose measurement. Instead, we'll get something new and supposedly easier to understand: a new measure that more closely reflects the mg/dL (and international mmol/l) numbers we all get on our home glucose meters. This new test is now dubbed the eAG (estimated average glucose).
One of the big news announcements Scientific Sessions this week was the results of a large international study that supposedly underscores the accuracy of the eAG. In this 10-center study, 507 volunteers with diabetes had their A1c translated into eAG readings and compared with their running daily BG results, if I understood the press materials correctly. "Study investigators found a simple linear relationship," the ADA press release states.
Also stated: "Patients find it difficult ...
Does your hemoglobin A1c level not appear to agree with the average meter readings you get at home? You're not alone.
There are numerous reasons your A1c might appear to be higher or lower than what you were expecting. The most common reason is related to the fact that your A1c reflects an average blood glucose (BG) level. You can have a lot of highs but also a lot of lows and end up with a relatively normal A1c, the same as you'd have if you kept your BG levels normal all the time.
But this isn't the only reason for variation.
The A1c depends on glycation of the hemoglobin in your red blood cells (RBCs). Glycation means adding glucose, and the higher your BGs are, the more glucose you'll add to the hemoglobin.
Anything that affects the lifetime of your RBCs, which are assumed to live 120 days, will affect the A1c. If you give blood or have some kind of internal bleeding, or if you have a hemolytic anemia, you will lose some of the older RBCs cells wit...
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