• January 21, 2020

STONE: The go-to lab test for managing diabetes - Odessa American: Levi Stone

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STONE: The go-to lab test for managing diabetes

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Posted: Sunday, January 12, 2020 4:30 am

According to the Centers for Disease Control and Prevention (CDC), more than 100 million U.S. adults are now living with diabetes or “prediabetes.”

The disease continues to be a major health problem which leads to a lesser quality of life, various disabilities, and even death when left untreated. Most often, it can be managed through increasing physical activity, diet, and the use of medication and/or insulin to control blood sugar levels.  Regrettably, many people don’t take advantage in addressing modifiable risk factor to prevent full blown diabetes. 

Fortunately, there’s one particular lab test to help you and your medical team to manage diabetes before it manages you.

Glycated hemoglobin (also known as hemoglobin A1C, or simply A1C), is a very compelling, very trusted and very accurate lab to help determine a patient’s average blood glucose levels over a span of the previous 60 to 90 days. 

Clinicians rely on the test to help establish benchmarks to diagnose and treat from, but also to confirm if lifestyle modifications are being followed and working. A powerful tool to outline how well, or poorly, blood glucose is being controlled, it also prevents people from trying to stretch the truth a bit.

You know, those patients who try to play catch up in doing everything right just a few days or even a week from seeing the doctor in hopes their labs and checkup come back “good.” 

The A1C captures the good, the bad, and the ugly, reflecting a truer reflection of blood glucose maintenance over time.

If you already monitor blood sugar readings at home, your glucometer may have an option to show what your average reading is compiled from previous measures. Do understand, this is not the same as an A1C, nor should it be counted as a replacement to this very important lab.

Monitoring blood glucose levels at home only captures that particular moment if time and that’s mostly when it’s going to be on the lower end of your readings (such as in the morning, before meals, and at bedtime). 

The A1C reflects the average of your blood glucose 24 hours a day over the span of two to three months. It catches what regular monitoring cannot, which is the highs, lows, and everything in between.

How the A1C blood test works is by looking at specific changes to hemoglobin in relation to how it interacts with glucose in the blood. Hemoglobin is a type of protein in the blood that allows oxygen to be carried by red blood cells to organs and tissues throughout the body. 

When glucose enters the blood stream when we eat and drink glucose containing foods, it glycates (linking up) to hemoglobin. The more glucose we take in, results in more glycated hemoglobin as well, and thus the higher the A1C reading will be. 

This is where those daily decisions in choosing an apple or an orange over an entire chocolate ice cream sundae really make a difference and become very important.

So, once you’ve set that appointment to get your A1C checked, it’s a good idea to prepare ahead to know what the results mean and what to ask your primary care provider based on the findings. 

According to the American Diabetes Association, a normal A1C is less than 5.7 percent. A range from 5.7 percent to 6.4 percent is in the “prediabetes” range and anything 6.5 percent and over is considered diabetes. 

To better understand how these percentages translate into average blood glucose readings, an A1C of 5 percent is 97, 6 percent is 126, 7 percent is 152, 8 percent is 183, up to 14 percent, which is 355. 

Keeping in mind a normal fasting blood glucose should be in the range of 70-110, you can start to see the overall picture of how daily blood glucose monitoring coincides with an A1C test and what to shoot for.

Typically your provider may order an A1C twice during a year, but can be more often or less depending on how well your diabetes is being managed. Other things to consider, when having A1C blood work, are factors that may interfere with the accuracy of testing.

People with anemia (low red blood cell counts), those taking large amounts of vitamin C and/or E, have kidney or liver disease, or have high cholesterol levels are all factors which can skew A1C results. It’s important to share this information with your doctor ahead of time before testing. 

A1C testing is an effective tool for you and your doctor to help beat diabetes. Take advantage and encourage others to do the same in finally reversing one of healthcare’s biggest challenges.

Odessa, TX

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