![]() They examined findings from four large diabetes studies that included almost 30,000 people, and made four very important (and welcome!) new guidelines around blood sugar control. I have seen firsthand how enthusiastic attention to the A1c can be helpful as well as harmful for patients.Īnd so have experts from the Clinical Guidelines Committee of the American College of Physicians, a well-established academic medical organization. While all this sounds very orderly and clinically rational, in practice it hasn't worked very well. If the levels still weren't at goal, then it was time to start insulin injections. But if patients didn't meet those target A1c levels with diet and exercise alone, then per standard guidelines, the next step was to add medications, starting with pills. We as doctors were supposed to first encourage diet and exercise, all that good lifestyle change stuff, which is very well studied and shown to decrease blood sugars significantly. Generally, clinical guidelines have recommended an A1c goal of less than 7% for most people (not necessarily including the elderly or very ill), with a lower goal - closer to normal, or under 6.5% - for younger people. These cells last for about three months, so, the A1c is thought of as a measure of blood sugars over the prior three months. One easy, accurate way for us to measure a person's blood sugar over time is the hemoglobin A1c (HbA1c) level, which is basically the amount of sugar stuck to the hemoglobin molecules inside of our blood cells. Uncontrolled type 2 diabetes (also known as adult-onset diabetes) is associated with all sorts of very bad things: infections, angry nerve endings causing chronic pain, damaged kidneys, vision loss and blindness, blocked arteries causing heart attacks, strokes, and amputations… So of course, it made good sense that the lower the blood sugar, the lower the chances of bad things happening to our patients. However, when it comes to blood sugar control in diabetes, we have tended to treat the number, thinking that a lower number would equal better health. Maintaining a healthy and balanced diet and getting regular exercise will help get your HbA1c levels under control."Treat the patient, not the number." This is a very old and sound medical school teaching. It's important to know your results and talk to your diabetes team about them. The longer your HbA1c level is high, the more you’re at risk of developing serious complications. if you’re feeling very stressed or you’re depressed.if you’re taking other medicines, like steroids.Your HbA1c can change for lots of reasons, including: Most people with type 2 diabetes should aim for a HbA1c of 53mmol/mol or lower. Your GP or diabetes team will work with you to decide what target HbA1c is best for you. If more than 58mmol/mol, discuss with your GP. This lets your healthcare team know if they need to change your treatment or medicine to manage your levels better. The test is sometimes called haemoglobin A1c or just A1c. ![]() you’re having problems managing your blood sugar levelsĪn HbA1c test is also used to diagnose diabetes, and to check your levels if you’re at risk of developing diabetes.You may need to have it checked more often if: It will be checked as part of your routine check-up. The HbA1c test gives your average glucose over a number of weeks. Your glucose meter test tells your blood glucose at a particular time. The HbA1c test is a blood test that is usually done by your GP or diabetes care team. This means you’re more likely to develop serious problems with your: Red blood cells are active for around 8 to 12 weeks, which is why readings of HbA1c are taken quarterly.Ī high HbA1c means you have too much glucose in your blood. Your body cannot use the glucose properly, so more of it sticks to your blood cells and builds up in your blood. It is made when the glucose (sugar) in your body sticks to your red blood cells.
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