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Our office recently received a call asking about a "new" blood test to diagnose diabetes. You may have heard on the news earlier this year that at the American Diabetes Association's annual meeting an international committee of experts announced their consensus that the A1C blood test is an accurate way to diagnose diabetes.
The A1C test, also known as glycated hemoglobin or HbA1C, is a blood test that provides a picture of average blood sugar control for the past two to three months. When you have uncontrolled diabetes, you have too much sugar in your blood stream. The extra blood glucose enters your red blood cells and sticks to the molecules of the hemoglobin.
The A1C measures the percentage of glycosylated hemoglobin in your blood and this gives your doctor an overview of your average blood glucose control over the past 2-3 months. So, the A1C test is not new, it is just that it's now being recommended as a tool to diagnose diabetes.
The A1C helps:
The A1C does not:
Daily self-testing of blood glucose and your log results are important to staying in effective control. The A1C test is used along with your daily blood glucose checks for the best possible control.
Sara J. Carlson, R.N., C.D.E.
Peggy Moreland, R.N., C.D.E.
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Hello, I had my A1C test last month along with a fasting blood glucose test. My A1C was 6.6 and my fasting blood glucose was 107. I was diagnosed with Type 2 diabetes. However, I am iron deficiency anemic and my finger sticks when I have gone to the office have been 130 1 hour after eating oatmeal and it was 79 3 hours after a green smoothie. Should I look at getting a second opinion?
The article says nothing about what readings are good or bad or how to use A1c information at all vs glucose stick tests.
I am a 78 year old woman just diagnosed a diabetic after being treated for breast cancer. My ac1 was 6.4. I was advised to lose weight which is difficult but not impossible. My question is why is my fasting blood sugars in the a.m.as high as 135 an yet 2 to 3 hours after eatin breakfast it is in the 90s? Eileen
I don't see specific information about A1C levels for diabetics. I am concerned because my 96 year old mother is on Actos, blood sugars tested once a week and has an A1c of 4.5. I have noticed mood changes and irritability recently. Could she be experiencing frequent blood sugar lows? She does have some heart irregularities. How should I approach the doctor on this?
Monitoring is the key in beating diabetes
I was diagnosed with type 2 diabetes about an year back. My doctor did not start any medications immediately and advised me life style change. When I was diagnosed, my HbA1C was 8+. But with lifestyle change within 3 months I was below 6.
It is very important in this disease to monitor yourself. I used a web based software to log and monitor my parameters [www.friendofdiabetic.com]. The more you log your parameters, more it acts as a feedback to improve. I don’t think I would have achieved A1C of 6 without monitoring what I was doing.
just to inform taking belviq for 4 months
A1C dropped from 7.0 to 5.9 and lost 25lbs
Susan: Normal range for A1c is 4.0-6.0%. You have diabetes. The American Diabetes Association recommends that your A1c be less than 7% to prevent or delay complications of diabetes.
If my A1c is 7.3 how bad is it?
Anna: We are so sorry. It is difficult watching a loved one neglect him/herself especially when you know the long term consequences of uncontrolled diabetes. Unfortunately there isn't much you can do other than encourage him to get help managing his diabetes.
My son, a 41 year-old male, just went to the endocrinologist about 2 weeks ago. He is a type 2 diabetic and was told that his A1c level is 15! He had not been to the doctor for more than a year before that. He is not currently on insulin, but takes an oral medication. I am terrified about what this means. I have done some research and an a1c level of 15 indicates that his diabetes has not been controlled for a long period of time. My son is pretty secretive and doesn't want me to go to the doctor's office with him. I'm giving him copies of all of the articles I found concerning someone with his a1c level. What else can I do? P.S. I also have a 30 year-old son with diabetes who is insulin dependent. However, he has an a1c level of 6.5. I manage his diabetes care because he is autistic and cannot do it. Any ideas about my 41 year-old son?
can vitamins c and E cause higher a1c levels taking vit c250mg (417%dv) and vit e 200u(667%DV) or what causes very high a1c when bs around 180
I would like information on hemoglobin variants test vs hemoglobin A. My A1c was 7. My concern is this a false result,I am a black person.
A1c of 10.6 indicates that diabetes medication (probably insulin) needs to be started, along with self-monitoring the blood glucose, exercise program and diet instruction. The American Diabetes Association states the target range for the A1c be 7 or less.
i went to the dr today and my ac1 was 10.6 what appens next
I am a 58 year-old woman and there is a history of diabetes in my family. last A1C was 6.1. I was not technically overweight but have lost 7 lbs since then. Previously, with my weight a little lower, my A1C has been 5.7-5.9. I have a daily vigorous yoga practice, but do better when I also have time to walk or swim. I am trying to see whether I can make a difference in this over a 3-4 month period, but I wonder, will I be able to prevent full-blown diabetes? I have been "pre-diabetic" for about 5 years. I am hoping to forestall or prevent the need for constant taking and balancing of medication. I'm a little afraid. I had one parent with "mild" diabetes that was undetected for a long time and very bad symptoms. Another has never been overweight and tightly managed medication and has no complications. But i am not ready to be old and tied to drugs and doctors.
I just turn 63 years and diabetes does not run in my family. I recently had blood work done and the A1C came back 6.8 I am very concern. Does this call for a change in diet.
My blood test showed a Haemoglobin A1C of 5.9%. The serum glucose was 83 mg/dL. Does this mean I am prediabetic? Marie
I have just been diagnosed with Type 2 diabetes. I was given a glucose reader to test myself. How do I react to a high reading? Is there something I should do? It was not explained to me.
my dr. said my os should be under 180 whatdoes that mean
Joanie, Prednisone can cause the blood glucoses to rise in some non diabetic people. Hopefully, the Prednisone therapy is short term and after the treatment the blood glucose will return to a normal range.
I had a nerve in my arm pinched during gynecological surgery. Afterward I was given this AIC test and a thyroid screening. My results were a 5.9 for the AIC. I never had more than an 84 on the fasting glucose test. I was prescribed prednisone a month prior to the test and take multivitamins containing both C and E.
Would prednisone and the supplements cause a higher than normal reading? The lab used had a cutoff of 5.6. I'm starting to wonder if this is more junk science to flag people for "treatment" they don't really need. Quite frankly I don't want or need the AMA riding herd over my dietary choices if I'm not actually diabetic. This disease does not run in my family.
For over 2 yrs my A1C has been excellent. The reason for the testing is a neurologist said I had diabetic neuropathy in my feet and lower legs. Even 4 months ago my A1C was great. Now 1 week ago glucose tolerance showed diabetes. I am confused. How can I have neuropathy from something I supposedly do not have and the tests backing it up. Now just after great results a glucose tolerance shows diabetes. How does this happen?
endocrinologist wants me to have an A1C test again because he suspects I suffer from low blood sugar. What result should I expect from the AIC test if it comes back saying yes, I hve low blood sugar. AIC 3, 4, etc
I do not have diabetes. When my doctor went over my blood work today she said my serum glucose was 100 and my A1c was 6.0. My last glusose was 91 and I did not have a A1c test.How bad is this? She is making me feel I now have diabetes. I have gained 12 pounds in one year. I feel if I can lose the weight that I might be in the normal range.
How about if my A1C is 95mg/dl do I have diabetes and what stage
Charles: Here is a conversion chart from diabeteschart.org that also has a conversion formula you can use if you want to. http://www.diabeteschart.org/bloodsugarchart.html
Can you provide a conversion chart from home blood testing results to A1c results? I keep track daily of my blood sugar but can not find a conversion chart that gets me close to what my expected A1c results will be. Or can you give us a conversion formula that we can plug in our average home testing for 120 days to an A1c result?
Kathy: If your A1c is 6.9% and your blood sugars as stated, you have diabetes. We recommend that you see your provider for treatment.
hi i'm concerned about my blood sugar levels. Last year's blood panel indicated possible diabetes. I don't remember what my a1c was, but was told that I was prediabetic. I occasionally tested, took alot of things out of my pantry, switched to good fats, got rid of all saturated and trans fats. Well I've recently tested for about 2 weeks, high levels even after having a chicken sandwich on low carb bread and a cup of tomato soup. fasting level was 134 Wed and A1C was 6.9. The nurse told me i was prediabetic, she wouldn't even look at my diary with what i ate and blood sugar readings. I think I need to get a second opinion. One night it was 339 after dinner. I don't have health insurance, so where I go is limited. i went to the low cost clinic. i hate going there, the people are rude, don't listen to you, nad rush you out before you get your needs addressed!!!
Extensive blood work and urinalysis 1/17/2011, fasting showed: A1c at 5.7, blood glucose 87, Insulin level 27... 71 yrs female. slight hypertension, lipid panel all in range. Normal weight, normal BMI as per charts. Concerned about high insulin level. What can cause the high insulin level? thanks for your comments.
I recently was diagnosed with peripheral neuropathy had 1 surgery in 08 for tarsal tunnel on 1 foot now also my sugar level is elevated and diabetes runs in the family (5) cannot work due to the neuropathy.trying to get free info on the diabetes factor.....its a one day at at time for me i have a good neurologist and pain meds of course....i miss working but cannot...just hang in there....i have family friends and my faith in god.
Cindy, you are correct, the A1C test is a weighed mean, meaning the last month of bg's does impact the reading more. There is a fructosamine test that reflects a couple weeks of glucose control.
My understanding is that the A1C test gives an indication of average blood glucose levels over past 3 months. But that it is weighted to the most recent weeks. So doesn't it make sense to test A1C more often than every 3 months. If I test each month, won't I have better view of how my diabetes management is going?
I recently received my blood test results of which I never saw before. I am a 59 year old female with RA controled with Remicade and Methotrexate. I have family history (maternal grandmother). My A1C was 6.0 and Mean Plasma Glucose 135. My physician has not spoke to me about these results. Should I be worried. I recently quit smoking after 40 years and have gained about 20 lbs. I am 5'10" and weigh 163?
Donna: There are 2 tests used to diagnose prediabetes:
•The fasting blood glucose – a glucose blood test measured first thing in the morning before you eat. A normal fasting blood glucose is between 70 – 100 mg/dL (3.8-5.5 mmol). You have pre-diabetes if your fasting blood sugar is 101-125 mg/dL (5.6-6.9 mmol)
•Oral glucose tolerance test – a person's blood glucose is checked after fasting and again 2 hours after drinking a glucose-rich drink. Normal blood glucose is below 140 mg/dl(7.7) 2 hours after the drink. In pre-diabetes, the 2-hour blood glucose is 140 (7.7) to 199 mg/dl (11.0). If the 2-hour blood glucose rises to 200 mg/dl (11 mmol) or above, a person has diabetes.
Is a value of 5.7 on the A1c indicative of prediabetes? Does that mean my pancreas is not functioning normally and I will be prediabetic or diabetic for the rest of my life? Or could that be a fluke and I might be normal?
My A1C test was 6.9. I'm self testing for the past few days and my scores vary from 104 to 149 using a blood glucose monitoring device-sticking myself. What is considered safe or normal?
Dear Mayo Nurses: My last A1c was performed in the Dr's office and was a rapid result test. Is this finger stick test just as accurate as a blood draw at a hospital lab??? By the way, my last result was 6.8, down from riding in the 7's. I have had IDDM for 20+ years, and I am beginning to experience some negative complications. Diabetes is no fun, and only for the strong at heart. I must rise each day to face new challenges. Thanks. Keep up the great work at MAYO.
My doctor doesn't think I need an A1C level taken. I dont want to be a hypochondriac but if I have a family history of diabetes, a glucose level of 111 and a raise in my AST to 64 and ALT to 78 wouldn't it be a good idea to check it out? I have also been having pains in my extremities that I forgot to tell her about. Be honest, am I trying to find a problem that isn't there?
Gary, A1c can be lowered through diet, exercise and medication.
Can you lower your A1c? mine is 6.1
What if a 68 year-old patient's fasting blood sugar or glucose lab work has NEVER been over 90 (several readings in the last year), but her A1C is 6.2. Thank you.
Patty, the estimated average glucose for an a1c of 12.5 is 309 mg/dl or 17 mmol/L. Have your husband see his health care provider as soon as possible.
My husband has a a1c of 12.5 How bad is that?
How bad is a 7.9 reading? I am sick of going back and forth to the doctor. I would like to just ignore the whole thing.
I am located in India. I have been a diabetic for the past 6-7 years. I am taking antidiabetic medicines such as Metformin and Daonil (Glibenclamide). Besides I also keep up my physical activities. Three months ago my A1C test result was 5.6% , but when I tested just a couple of days ago, it has risen to 7.6%. I am worried. Although my post prandial glucose levels are well under control, my fasting sugar levels are quite outside the normal range (130-150 mg/dl). What advice do you have for me?
Thanks for listening to me.
Marie: Normal range for the A1c test is 4-6%.
What is the normal range for the A1C test?
Suzanne - 107 sounds more like a regular glucose result, which at 107 is perfectly normal. Better check w/ your doctor again about your symptoms. Even diabetics have normal glucose levels; one random test wouldn't make a diagnosis.
My A1C test result is 107. does this mean i have diabetes? or am i prediabetic? I have several classic symptoms ie., thirsty, frequent urination, blurry vision, neuropathy in my toes, tired...
Thank you for your very informative answer. I believe, based on what my father told me, he only did the OGTT test. I will ask him about any other tests that were performed and look at his test results (file) when we are there for Christmas. I don't think he has changed his diet or exercise routine much yet he continues to get readings within the acceptable range using his meter....so much so that he doesn't test daily.
I understand what you say about age and it makes sense. I also want to see exactly when the original tests were done. He had knee replacement surgery in July so some increase in inactivity before that may have had an effect on his levels if the testing was done prior to or immediately after that. It's something I will include when determining if he should be tested further.
I can confirm - he's one of the healthiest, most active 88 year olds you'll find....both in mind and body. We all intend to follow-up on this information so we can keep him that way for many more years.
Kris: Diabetes is diagnosed in one of three ways: a fasting plasma glucose (FPG) test level of 126 mg/dL or above, an oral glucose tolerance test (OGTT) that measures blood glucose after a person fasts at least 8 hours and 2 hours after the person drinks a glucose-containing beverage (A 2-hour glucose level of 200 mg/dL or above can mean the person has diabetes), or a random or casual plasma glucose level of 200 mg/dl or higher. A second test is recommended to confirm diagnosis.
Beth, diabetes is officially diagnosed by two fasting readings over 126 mg/dl (American Diabetes Association). Self monitoring of blood glucose is just one point in time and generally the A1c is also used to evaluate control. See Peggy's above blog. Many times if diabetes is a new diagnosis and the pancreas is still working pretty well, a small change in diet and activity will get the blood glucoses in normal range. That does not mean the diabetes has gone away but is under control. At 87 years of age, age is a big indicator for developing diabetes. That's because the pancreas wears out in the aging process just like everything else.
Will our questions ever get answered?
is the a1c test used for the diagnosis of diabetes? if i failed my 3 hour gtt but passed the a1c test does this mean i am diabetic?
My 87 yr old father was recently diagnosed with Type 2 diabetes and given a blood glucose monitor. In the three weeks since he has been testing, his sugar level has never been outside of the normal range. We were shocked at the original diagnosis as he is very healthy and active. Would it help to get this test?
Eleanor, the A1C test is a nonfasting blood test and eating prior to the test will not effect the results of the test.
Should you eat before taking the A1C test?
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