Care to guess my A1C?

Reply

tylersydney replied on Sat, Sep 19 2009 9:54 PM

rated by 0 users

6

Reply

Ron AKA replied on Mon, Sep 28 2009 11:11 PM

rated by 0 users

tylersydney:

6

You were very close. I got my result today and it was 6.2. I find that kind of disappointing as formulas to calculate A1C from average BG would suggest more like 5.1. Further I don't really have room to lower BG without getting a lot of lows. I run quite close to the edge as it is.

It does highlight the issue that for the same average BG value the resulting A1C is different from person to person. This Study looked into the relationship. It appears in the graph below, from the study, that for a 99 BG (which I what mine was), the resulting A1C can vary from about 4.9 to 6.3. Unfortunately I seem to come in right at the high end of the range.

This seems to be another good reason for not relying too much on the A1C. If I was to try and force an A1C of 5, I would be into many lows.

Reply

Madman replied on Tue, Sep 29 2009 9:28 AM

rated by 0 users

heard an interesting tidbit recently. The more acidic the body, the lower the A1C will be for a given blood sugar level.  Now, that's not to say we should all run out and pump ourselves full of acidifying foods....

I am of the opinion that the higher blood sugars are still doing damage even though they may not be attaching themselves to the hemoglobin molecules.

It might be one explanation for the personal variances in A1c's though.

Reply

Ron AKA replied on Tue, Sep 29 2009 1:47 PM

rated by 0 users

Madman:

I am of the opinion that the higher blood sugars are still doing damage even though they may not be attaching themselves to the hemoglobin molecules.

I agree that the real measure is the actual BG's. I probably don't have an over acidic diet. Perhaps I need to get back to eating more grapefruit.

Reply

shortie replied on Thu, Oct 1 2009 9:53 PM

rated by 0 users

Acidity....hum......I used to drink a shot glass of very expensive balsamic vinegar every day when I was first diagnosed as diabetic a few years back.  Maybe I best restart that plan?   I do eat a lot of tomatoes and tomato sauce and vinegar based dressings......grapefruit is a no no for me tho because of Lipitor, but oranges also are acidic.....hum.....

shortie

Reply

jen1229 replied on Fri, Oct 2 2009 7:45 AM

rated by 0 users

There is another reason for me to resist Lipitor or other statins.  I can't winter without grapefruit.  I bought a bag of apples last week.  I just love the Granny Smith apples.  I'm still waiting for the results of my Blood tests which were taken last week but the woman who runs the tests was on vacation.  Hopefully, they will arrive today or tomorrow. I'm anxious to see what my A1C is.  My meter average is in the 160s.

Have a great weekend everyone. 

Reply

Ron AKA replied on Fri, Oct 2 2009 10:42 AM

rated by 0 users

I have never worried too much about the grapefruit and statin thing. It tends to increase the concentration of the statin in the body, so depending on where your cholesterol is, that is not necessarily a bad thing. I take Crestor and there is no warning in the prescribing informaton about it. The Lipitor PI says the effect becomes significant only when you consume more than 40 oz of the juice per day. A half a grapefruit is no where near that of course.

What is interesting is that at least with Crestor race can make a huge difference. A US study found that average statin concentrations in asian people for the same dose were double that of others.

Reply

drLaurie replied on Sat, Oct 3 2009 1:02 AM

rated by 0 users

Congrats on your 6.1, Ron.  No matter the disappointment, that's a good a1c.

Looking at your graphs, I sure understand your disappointment with that great number.  While 7 tests a day feels like a lot, I've come to realize the great variations that occur "between" tests.

A few years ago, my CDE suggested that I not only test before/after meals, but also 2hrs and 3hrs after.  With a good a1c, it's typically the case that overnight BG is in a reasonable range and that the "excursion from normal" is the post-prandials. 

Did I understand you right that, for an identical set of BG measurements, individual a1c readings can vary widely?  I didn't realize that and wonder if it simply reflects the period of time that one's BG is at that value.  One person could be at 70 for 12 hours and at  250 for 1 hour; testing once at each level.  Another person could be 70 for 1 hour and 250 for 12 hours and test once at each level.  Those actual BGs are radically different, but the meters would show the same results.

Notice also how a given value can be celebrated or cursed, depending on one's prior expectation.

Reply

dana replied on Thu, Feb 18 2010 2:28 AM

rated by 0 users

One of the reasons I and most medical professionals love the A1C as a guage of how diabetics are truly managing their diseas is it is totally objective.  We can easily cheat when we test - don't test after a snack, wait a little longer to test after a larger than usual meal.  Also, different foods turn to glucose at different rates, protien slows the process for carb eaten at the same time.  If you wore a 24 hour continueous meter for 90 days, your meter results would probably match your A1C for that 90 day period.  But sporadic daily testing will probably always be off and the A1C is the better test.

Dana

Reply

Ron AKA replied on Thu, Feb 18 2010 4:38 PM

rated by 0 users

I've concluded that the A1C is a poor substitute for actual BG readings, and it is simply a quick and dirty approach used by medical professionals that either don't trust their patients, or won't take the time to look at the multiple readings.

The underlying problem is that A1C is just an indicator of blood glucose and not a very accurate one. From the study link that I posted earlier which includes the graph below. You can see the variability of the data from one individual to the next (each dot is an individual). For example for all those that kept actual BG average to 150, their measured A1C varied from 5.7 to 9.0. Even though all of these individuals are achieving the same results, how will they be judged by a doctor that sees them as 5.7 compared to 9.0? Suspect the 5.7 person will be praised, and the 9.0 will be chastised.

Just my thoughts,