I recently received an interesting question (which I paraphrase below): Nondiabetics' mean blood sugar level is around 83 mg/dl, whereas our teachers and the ADA recommend keeping it between 80 to 120 mg/dl. This is allowing patients to leave it >30% higher than where they could have been with better control. Is this not the reason of having a lot of vascular and neurological complications? Are the advisors giving loose and harmful advice? Is there a way to have a real fact and clinical study to base the advice for the benefit of people afflicted with diabetes? My answer: The concern about targeting normal values for blood glucose and A1C in people with diabetes has always been the issue of provoking hypoglycemia if aiming for normal values. Recently, there's been an additional concern identified when aiming for perfection: In patients with T2DM plus cardiovascular disease (or cardiovascular risk), aiming for lower values of A1C (below 6) increased the risk of death compared to aiming fo...
Read David's first update from the Scientific Sessions here!
San Francisco -- Yesterday I was wearing Band-aids on six of my fingers. I had my A1C tested six times in one day with five different systems. I'm in San Francisco at what is probably the only place in the world
where I could have this bloody experience. It's the annual Scientific
Sessions of the American Diabetes Association. The consistency of the results of these six tests is good news for
people with diabetes. Each of these tests claim to be certified by the National Glycohemoglobin Standardization Program (NGSP) or comparable to it, and the closeness of the results confirm these claims. But my higher numbers from a year ago was bad news for me. At last
year's ADA in Chicago only three booths offered A1C tests. My results
varied from 4.6 with Bayer HealthCare's A1CNow+ to 5.1 with Siemens Healthcare Diagnostics' DCA 2000+ Anaylzer to 5.3 with the Bio-Rad in2it A1C Anaylzer . Those results for a person with typ...
I recently saw the following question:
My granddaughter’s HgbA1c was elevated to 10. Her glucose readings have been normal. Why does she have this elevated reading?
It seems obvious at first glance that either the elevated HgbA1c is wrong, or the glucose readings are misleading. I’ll assume that your granddaughter has a diagnosis of diabetes, and that the glucose readings you describe are being done by her with a home glucose meter, rather than being done in a commercial laboratory. You don’t describe her as being a child, teen, or adult, but the issues are mostly age-independent.
As you are aware, the glycosylated hemoglobin test (called by various acronyms including HgbA1c and A1C) has a normal range well below your granddaughter’s value of 10. In people without diabetes, the value is usually about 5; for people with diabetes, most endocrinologists would want to see the value below 7. So, based on her value of 10, one would assum...
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