A1c

[mickeyd]

I had never heard of A1C until about 5 years ago when I found out that I was a type 2 diabetic. Since that time, Hemoglobin A1c and I have gotten to know each other.

I started out with a reading of 5.9 in Jan 2005 and, as of last Jan, I was up to 6.6 even though I take Metformin, watch my diet and exercise regularly. Then I went to the lab in August and my A1c is down to 5.9 again! My doc says "Congrats. Sometimes it goes down. You must be livin' right." Though I'm delighted at the improved #, I have not taken any action to cause this result. I just continue to do the same thing regularly. Why the change ion my Hemoglobin A1c?

Can any of you medical folks shed any light on my situation?

 

[TomCat]

Did you lose any weight?...that is one of the best ways to lower A1c...in the same boat...Tom

 

[mickeyd]

Did you lose any weight?...that is one of the best ways to lower A1c...in the same boat...Tom

Steady @ 230#

 

[rkser]

Although A1c depends on your diet, weight, calorie intake, exercise etc., do not rule out some degree of laboratory error or say the given margin of error particular to that test.

In any case, way to go, keep it up

 

[LOL!]

Right on the variation in test results. No self-respecting scientist would take one measurement and draw a conclusion from that. You have to have many repeat measurements. I don't know how they do the A1c test, but in theory they should run several tests from the same blood sample and take the average of those tests. I doubt they do that. And then why not draw blood every week for a few months and run the analyses.

Presumably there have been studies which say that A1c doesn't change much over the course of a month, so that drawing blood every week is useless. Nevertheless, numbers vary naturally.

I am not a physician.

 

[Rich_by_the_Bay]

HgbA1C ("glycohemoglobin") gives an estimate of your blood glucose over the previous 4 weeks or so. It is not a precise test but is getting better every year. Mostly we don't use it for diagnosis but the tendency is to do so more and more as the technology of the test improves.

In the better studies, it seems that as you approach about 5.7 or slightly above, your risk of diabetic complications begins to approach that of the general population, assuming such complications have not already manifest themselves. The metformin is a great step 1 treatment, nice because it doesn't carry a risk of low blood suger.

Weight loss remains a life-saver even if your readings are OK; it carries its own risks separate from those of hypoglycemia. Don't let up.

 

[oldtrig]

I wonder why my Doctor will not order an A1C on me. I was using another Doctor until 2005. My A1C back in 05 was 5.9. I was never diagnosed but I know I am diabetic. I have a meter and see the reading. Fasting is 90 and below. After meals with high carbs makes my B/S go in the 180's and stay there until I walk. I can bring it down most of the time by walking but when I really cheat it will not come down as quick. Steroid shots will also make it soar. I had a shot two years ago for my hip and I checked 2 hours after a meal and it showed 240. Being on medicine with cortisone in it could make an A1C give a higher reading ? oldtrig

 

[Zathras]

I am guessing he won't order an A1C as you are not diagnosed. Without the diagnosis first, I am guessing (emphasis on guessing) that insurance won't cover the test.
Rich, does that sound plausible?

 

[oldtrig]

You could be right. I still would like to know what my current A1C is. I have not been very good with my diet in the last year so I would like to know how it has affected me. My first A1C that I know about was 5.9. I worked hard with exercise and diet and a year later they tested and it was 5.0. I asked for the A1C the next year and it was 5.2. Because of those lower numbers the Doctor said another would not ne necessary for the time being. The doctor I used five years ago must have thought something was going on with me or he would have never done the A1C to begin with. I was thinking of buying one of the home tests and seeing what the results were . Anyone use one of those ? I know that I have high B/S spikes during the day because I have tested. How long the numbers stay high I do not know. My B/S returns to normal in the morning usually in the high 80's so I assume Doctors do not address a problem like mine. oldtrig

 

[harley]

You can get A1C tests at Walmart (and other pharmacies). I use them fairly regularly, because while my daily fasting numbers can be all over the place, my A1cs tend to be pretty consistant and I like to know where I am. There used to be home tests, but they went off the market, I think because of unpredictable results. They seemed pretty accurate to me. The ones I use now you have to take the blood and send off the package to a lab. Again, the tests seem to be pretty much in synch with what I get back from the tests by my Doc.

I also use the Cardiochek home cholesterol tests. I really like to know what to expect before I go to the doctor.

 

[Zathras]

Please note, I am NOT a doctor, just a diabetic
My understanding is that an A1C reading around 5-6% is optimal in non-diabetics.
So if you think you have diabetes, have your doctor do some additional tests.
Everybody's blood sugar levels spike. Typically this is after a meal or snack.
Your body produces some insulin to balance that out, but it isn't a light switch, it takes some time for the insulin to do it's thing and for the blood sugar levels to return to normal.
If you really want the A1C test, tell your doctor that you understand insurance may refuse it and you will pay for it out of your own pocket.
If that isn't the issue, ask him exactly what is.

 

[oldtrig]

How about this one
Walmart.com: Bayer A1CNow SelfCheck At-Home A1C System, 2 Test Kit: Home Medical

 

[harley]

Never seen that one in a store. I'll have to ask the pharmacist about it. The mail-in ones are not bad. You send the kit in, and they let you check the results online in a week or so. But doing it all at home would be better.

 

[mickeyd]

How about this one
Walmart.com: Bayer A1CNow SelfCheck At-Home A1C System, 2 Test Kit: Home Medical

I've never heard about these kits. Are the results as accurate as a lab test? Are there any comparative test results? Sounds like an economical way to get your testing done.

 

[harley]

I've been doing some research into the Bayer A1CNow since oldtrig posted it. It's just recently come out, and they don't have it in either of the nearby WallyWorlds yet, but they should be in soon. The news blurbs make it sound very accurate. The old ones I used to use before they got pulled off the market were accurate, so I suspect these will be at least as tight. Looking forward to it.

The one thing I haven't found out yet is whether you can get refills and continue to use the same tester, like you can for cholesterol with the CardioChek kits. That would be nice.