When is it Misleading? By Adithi Gandhi and Jeemin Kwon Why we use A1c, what values are recommended, and what impacts A1c — everything from anemia to vitamins Want more information just like this? Sign Up Now! Click to jump down to a section: What is A1c and why is it used? What is an A1c goal for those with diabetes?
How does age affect A1c? Where is A1c misleading or potentially inaccurate? Conditions and factors that impact A1c What is A1c and why is it used?
What is an A1c goal for those with diagnosed diabetes? Examples of CGM include: Abbott FreeStyle Libre real-time and Freestyle Libre Pro blinded Dexcom G5 real-time Medtronic Enlite real-time and Guardian Sensor 3 real-time and iPro2 blinded Senseonics implantable Eversense CGM real-time If CGM is not available, taking frequent fingersticks with a blood glucose meter — when waking up, before and after meals, and before bed — can also indicate when blood sugar levels are going low, high, and staying in range.
Non-glycemic factors that can affect A1c: While there are many unsuspecting factors that can impact A1c, the information in the table below is not meant to invalidate the A1c test. Condition What is the impact on A1c? How to test for this condition Untreated anemia due to: Iron deficiency Vitamin B deficiency Untreated anemia can misleadingly increase A1c values due to decreased production of red blood cells.
If anemia is treated, A1c can go down. To test for anemia, ask your healthcare provider about taking a complete blood count CBC test. Asplenia : decreased spleen function The spleen is involved in the production and removal of red blood cells. This may lead to misleadingly increased A1c. Asplenia can be identified by MRI, echocardiogram, chest X-ray, or a screening test.
Let your healthcare provider know if you have recently received a blood transfusion. Cirrhosis of the liver : chronic liver damage that leads to scarring Cirrhosis, in addition to affecting response to glucose-lowering medications — including insulin — may misleadingly lower A1c values.
Ask your healthcare provider about a liver examination. Genetic blood disorders Hemoglobinopathy results in abnormal hemoglobin Thalassemia lower production of functional hemoglobin Depending on the abnormal form of hemoglobin, hemoglobinopathy can result in either increased or decreased A1c values. Hemolysis : rapid destruction of red blood cells Hemolysis may misleadingly lower A1c values due to the shortened red blood cell lifespan.
This condition may be caused by an inappropriate immune response and artificial heart valves. Untreated hypothyroidism: low levels of thyroid hormone Hypothyroidism may misleadingly increase A1c, while treatment with thyroid hormone can lower A1c. Some people who are newly diagnosed could have levels over 9. Lifestyle changes and possibly medication can lower levels quickly. For someone who has long-standing diabetes, levels rise above 9. As blood sugar level rises, so do A1C levels.
Poor diabetes control or a need for medication adjustments might cause higher A1C. Diet changes, daily exercise, or medication adjustments might quickly lower A1C.
Poor diabetes control does not always mean a patient is doing something wrong. But there are other reasons why levels might be high. As previously mentioned, other health conditions can cause skewed results. These include kidney disease, anemia, liver disease, asplenia, blood loss, hypothyroidism, uremia, and sickle cell anemia. Other factors that might lead to a high A1C level include increased age, pregnancy, and gestational diabetes.
According to one study , 3. This group is more likely to have other risk factors for Type 2 diabetes and cardiovascular disease. Researchers found that the following groups were more likely to have an elevated A1C without having a diagnosis of diabetes:.
When it comes to the numbers, there's no one-size-fits-all target. A1C target levels can vary by each person's age and other factors, and your target may be different from someone else's.
A1C test results are reported as a percentage. The higher the percentage, the higher your blood sugar levels over the past two to three months. The A1C test can also be used for diagnosis, based on the following guidelines:.
Another term you may come across when finding out your A1C is eAG. However, an A1C level that is safe for one person may not be safe for another. For example, keeping an A1C level below 7 percent may not be safe if it leads to problems with hypoglycemia , also called low blood glucose. Less strict blood glucose control, or an A1C between 7 and 8 percent—or even higher in some circumstances—may be appropriate in people who have.
Estimated average glucose eAG is calculated from your A1C. Some laboratories report eAG with A1C test results. The eAG number helps you relate your A1C to daily glucose monitoring levels. Even though A1C results represent a long-term average, blood glucose levels within the past 30 days have a greater effect on the A1C reading than those in previous months.
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Scientists are conducting research to learn more about diabetes, including studies about A1C. For example. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses.
Find out if clinical trials are right for you. Clinical trials that are currently open and are recruiting can be viewed at www. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public.
Why should a person get the A1C test? How is the A1C test used to diagnose type 2 diabetes and prediabetes? Is the A1C test used during pregnancy? Can other blood glucose tests be used to diagnose type 2 diabetes and prediabetes? Can the A1C test result in a different diagnosis than the blood glucose tests? Why do diabetes blood test results vary? How precise is the A1C test? How is the A1C test used after diagnosis of diabetes? What A1C goal should I have?
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