Imagine that your last hemoglobin A1c result was 5.9. Now it's time for a new test, and the results show that your A1c is 6.1. Does this mean your control has gotten a lot worse?
We have to remember that all these lab tests we get are subject to all kinds of errors. First, they're performed by human beings, and all human beings occasionally make mistakes.
When I was first diagnosed, my hemoglobin A1 (the old test that didn't break down into A1c) was 16. This was equivalent to an A1c of about 13. Obviously not good! I was put on metformin and given the standard dietary advice.
I drastically reduced my food intake, especially starches and sugars, went back for another test in several weeks, and then saw my doctor. He said my A1 hadn't changed. I told him that was impossible. "If it had gone from 16 to 14, I'd believe you, but it's impossible that it hasn't changed when I've changed my diet so much ( read more about dietary changes for diabetes here) . My fastings ...
Some people think that when it comes to diabetic complications, the only thing that matters is your hemoglobin A1c level (A1c) . This is the test that is supposed to measure your average blood glucose (BG) level over the past several months.
High BG levels form what are called advanced glycation end products, or AGEs, and these long-lived products seem to gum up the works and cause diabetic complications, as well as normal aging.
Because it's an average, you can get the same A1c result if you have a constant BG level of 100 mg/dL (an unlikely event, but I'm using it to simplify), or if you spend half your time at 50 and half your time at 150 mg/dL. Because most studies of complication rates, for example the famous Diabetes Control Complications and Trial (DCCT), use only the A1c as a measure of control, many people think that's all that matters.
In fact, that's not true at all. Since then, some studies have suggested that the amount of glucose variability is as important as, or more im...
How accurate are the hemoglobin A1c tests (which I'll call just A1c) that most of us with diabetes get about 4 times a year? The A1c is supposed to tell us what our average blood glucose (BG) level has been over the previous several months, and it has provided information that was lacking in the early days of diabetes treatment.
However, researchers have now begun to dig deeper into the meaning of the A1c test to try to explain why some people's A1c doesn't seem to agree with their daily BG measurements.
We should have an approximate idea of how well we're controlling just by measuring our BG levels with our home meters. But the meters only tell us what the BG level is at the time we test. Even if we test 8 or 10 times a day, there are times when we're not testing, especially overnight.
And not everyone can afford to test even eight times a day. For instance, Medicare thinks that people on insulin need only 100 strips a month, enough to test about three times a day. For people ...
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