Can The A1c Test Diagnose Gestational Diabetes
The glucose challenge test and the oral glucose tolerance test are routine blood tests given to every pregnant woman between the 24th and 28th week of pregnancy to determine gestational diabetes.
While the A1C test cannot be used to diagnose gestational diabetes, your healthcare provider can have the test performed early in your pregnancy to see if you had undiagnosed diabetes before becoming pregnant.
Because the A1C test includes your blood sugar levels over the past three months, that time frame can include the time you weren’t pregnant.
Additionally, the A1C test can be used after your baby is born to check for type 2 diabetes. Even if your blood sugar levels are within the normal range, it’s important to check your A1C at least every three years after having gestational diabetes.
Prediabetes Symptoms Causes Treatment Options
Prediabetes is a condition that affects millions of people in the United States and it is defined as having a blood sugar level that is higher than normal, but not high enough to be diagnosed as diabetes. When you have prediabetes, it often leads to type 2 diabetes if it is not treated. In this article, we will discuss what prediabetes is, the symptoms of prediabetes, the causes of prediabetes, and the treatment options for prediabetes among other topics.
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Can The A1c Test Result In A Different Diagnosis Than The Blood Glucose Tests
Yes. In some people, a blood glucose test may show diabetes when an A1C test does not. The reverse can also occuran A1C test may indicate diabetes even though a blood glucose test does not. Because of these differences in test results, health care professionals repeat tests before making a diagnosis.
People with differing test results may be in an early stage of the disease, when blood glucose levels have not risen high enough to show up on every test. In this case, health care professionals may choose to follow the person closely and repeat the test in several months.
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High A1c With Symptoms Of High Blood Sugar
If you do have symptoms of high blood sugar and your initial A1C is high, this will confirm a diabetes diagnosisespecially if you also had the random plasma glucose test done and that was high.
This means that your healthcare provider will need to see you as soon as possible to discuss starting a treatment plan to manage your diabetes.
This plan will depend on whether you have type 1 or type 2 diabetes, but may involve insulin supplementation, medication, glucose monitoring, exercise, and lifestyle changes.
Your healthcare provider will likely repeat the A1C soon after you’ve started treatment to see how it’s working and how well you’re complying.
What Do The Results Mean
A1C results tell you what percentage of your hemoglobin is coated with glucose. The percent ranges are just a guide to what is normal. What’s normal for you depends on your health, age, and other factors. Ask your provider what A1C percentage is healthy for you.
To diagnose diabetes or prediabetes, the percentages commonly used are:
- Normal: A1C below 5.7%
- Prediabetes: A1C between 5.7% and 6.4%
- Diabetes: A1C of 6.5% or higher
Providers often use more than one test to diagnose diabetes. So, if your test result was higher than normal, you may have another A1C test or a different type of diabetes test, usually either a fasting blood glucose test or an oral glucose tolerance test .
If your A1C test was done to monitor your diabetes, talk with your provider about what your test results mean.
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Can You Have A High A1c And Normal Fasting Glucose
While its not usual, it is possible you can have a high A1c and normal fasting glucose, or you might have a high fasting glucose and normal A1c.
This does sound strange but all tests are really just indicators, so if the results come back mixed, your doctor will probably send you for follow up tests just to see whats going on.
How Often Do You Need To Take An A1c Test
If your blood sugar levels have remained stable and your A1C is within your target range, the American Diabetes Association recommends getting the test two times a year. If your therapy has changed or you are not meeting your blood sugar targets, the ADA recommends getting the test four times per year. This simple blood draw can be done in your doctors office.
The A1C test results provide insight into how your treatment plan is working and how it might be modified to better control the condition. Often, your blood sample is sent out to a lab, though some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes.
While in-office tests can be used to monitor the disease, the National Institute of Diabetes and Digestive and Kidney Diseases notes that most point-of-care tests should not be used for diagnosis. That can only be done by lab tests certified by the NGSP, an organization that standardizes A1C test results. Any in-office test results pointing to a change in your health should be confirmed by conventional lab tests.
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Hemoglobin A1c Not Reliable In Diagnosing Type 2 Diabetes
With Maria Mercedes Chang Villacreses, MD, and Elena Christofides, MD, FACE
The test that doctors most often rely on to detect a persons risk for prediabetes and type 2 diabetesthe hemoglobin A1c blood testtoo often delivers a poor reading, thereby missing the diagnosis in nearly three out of four at-risk individuals,1 according to research presented at the Endocrine Society meeting in New Orleans, Louisiana.
The investigators compared the accuracy of the A1c test with the other screening method used to assess patients risk of diabetesthe oral glucose tolerance test to arrive at this startling conclusion.1
The common use of the hemoglobin A1c test to screen for prediabetes and type 2 diabetes should be skipped in place of more reliable tests. Photo: 123rf
The A1c missed almost 73% of the people with diabetes in comparison to the oral glucose tolerance test, says Maria Mercedes Chang Villacreses, MD, a clinical endocrinology fellow at the City of Hope Diabetes and Metabolism Research Institute in Duarte, California, who introduced the findings at the annual meeting of the Endocrine Society but are considered preliminary until published in a peer-reviewed medical journal.
Since the fasting blood test requires a person to fast, the OGTT measures the bodys response to sugar it requires a person to fast overnight. First, blood is taken, then the person drinks a sugary drink. Blood is taken again two hours later.
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Prediabetes Weight Loss: Can It Help
If you have prediabetes, you are at risk of developing type 2 diabetes because prediabetes means that your blood sugar levels are higher than normal but not high enough to be classified as type 2 diabetes. Fortunately, prediabetes can often be treated with weight loss. In this article, we will explore the relationship between prediabetes and weight loss and find out if losing weight is an effective treatment for prediabetes. We will also cover all other treatment options available to you if you have prediabetes and what causes it.
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We Dont Even Need To Follow The A1c For Some Patients
Elderly patients, and those with serious medical conditions, will benefit from simply controlling the symptoms they have from high blood sugars, like frequent urination and incontinence, rather than aiming for any particular A1c level. Who would be included in this group? People with a life expectancy of less than 10 years, or those who have advanced forms of dementia, emphysema, or cancer or end-stage kidney, liver, or heart failure. There is little to no evidence for any meaningful benefit of intervening to achieve a target A1c in these populations there is plenty of evidence for harm. In particular, diabetes medications can cause low blood sugars, leading to weakness, dizziness, and falls. There is the added consideration that elderly and sick patients often end up on a long list of medications that can interact, causing even more side effects.
What Causes Prediabetes
The cause of prediabetes is not fully understood although there are a number of risk factors that can increase your risk of developing prediabetes.
- Family history of type 2 diabetes or prediabetes
- Obesity or being overweight, especially if you have excess belly fat
- Having a large waist size above 40 inches for men and 35 inches for women
- Physical inactivity
- History of gestational diabetes or giving birth to a baby with a birth weight of more than nine pounds
- Polycystic ovary syndrome
- High triglyceride levels
- Metabolic syndrome which is a combination of obesity and other health conditions
- Ethnicity or race as you are more likely to develop prediabetes if you are of African American, Native American, Asian American, Latino, or Pacific Islander descent
- Unhealthy diet featuring lots of unhealthy fats, processed foods, sugar, and sugary drinks
- Being older than 45
- Have obstructive sleep apnea which is a sleep disorder where you have pauses in your breathing while sleeping
If you have any of these risk factors, it is important to speak with your doctor or health care provider about your risk for prediabetes and type 2 diabetes.
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What Is Type 1 Diabetes
Type 1 diabetes, previously known as juvenile diabetes, is the most severe form of the disease. About 5% of people who have diabetes have type 1 diabetes, or insulin-dependent diabetes. Type 1 diabetes has also been called juvenile diabetes becuse it usually develops in children and teenagers. But people of all ages can develop type 1 diabetes.
In type 1 diabetes, the bodys immune system attacks the insulin-producing islet cells in the pancreas. The islet cells sense glucose in the blood and produce the right amount of insulin to normalize blood sugars. This attack on the bodys own cells is known as autoimmune disease. Scientists are not sure why the autoimmune attack happens.
But once the insulin-producing cells are destroyed, a person can no longer produce their own insulin. Without insulin, there is no key. So, the sugar stays in the blood and builds up. As a result, the bodys cells starve. And, if left untreated, high blood sugar levels can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death.
So type 1 diabetes must be treated through a daily regimen of insulin therapy.
Oral Glucose Tolerance Test
The OGTT is a two-hour test that checks your blood glucose levels before and two hours after you drink a special sweet drink. It tells the doctor how your body processes sugar.
- Diabetes is diagnosed at two-hour blood glucose of greater than or equal to 200 mg/dl
Oral Glucose Tolerance Test
|200 mg/dl or higher|
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Benefits Of An A1c Test
The benefit of measuring A1c is that it does give a more objective look at your blood glucose control because it cant be influenced by short term things like meal changes, infections, acute glucose changes etc.
For instance, you might have a meal one day packed with high carb foods, which results in high blood sugar. Your day-to-day finger stick blood sugar monitoring can be influenced by this but your A1c wont. It is a reflection of the combined 2-3 months, which is why A1c tests are routinely ordered every 3-6 months.
With this in mind, an A1c test is more precise, providing valuable information to help you achieve better blood glucose control.
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What Is The Normal Range For A1c
An A1C is considered within normal limits when it is 5.6 percent or lower. Your health care provider can diagnose prediabetes with an A1C between 5.7 to 6.4 percent, and diabetes with an A1C of 6.5 percent and higher. If you have diabetes, the goal is to keep your A1C at about 7.0 percent or lower.
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Healthy Eating And Meal Tracking
Diet has a huge impact on your blood sugar. In particular, carbohydrates like bread, rice, potatoes, and sweets raise your blood sugar. During digestion, the body breaks carbohydrates down into glucose.
One way to find out how certain foods affect your blood sugar is to test two hours after eating. Keeping a food journal along with blood sugar logs helps identify high blood sugar patterns. This can help you learn to manage your glucose levels better and lower your A1C.
Talk to your healthcare team if you are unsure what you should eat to manage your blood sugar. A dietitian or certified diabetes educator can help you learn how to balance meals for lower blood sugar.
Whats The Recommended A1c For People With Diabetes
The American Diabetes Association recommends an A1C goal of < 7% in most adults . Some healthcare providers may recommend an A1C of < 6.5%, if they can maintain it without adverse effects or events, such as frequent hypoglycemia.2
An A1C of < 8% is also thought to be appropriate for people:
- with a history of hypoglycemia
- limited life expectancy
- or other complexities of life.2
We recommend that you discuss your personal target goals with your care team.
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How Does Hba1c Differ From A Blood Glucose Level
HbA1c provides a longer-term trend, similar to an average, of how high your blood sugar levels have been over a period of time.
An HbA1c reading can be taken from blood from a finger but is often taken from a blood sample that is taken from your arm.
Blood glucose level is the concentration of glucose in your blood at a single point in time, i.e. the very moment of the test.
This is measured using a fasting plasma glucose test, which can be carried out using blood taken from a finger or can be taken from a blood sample from the arm.
However, fasting glucose tests provide an indication of your current glucose levels only, whereas the HbA1c test serves as an overall marker of what your average levels are over a period of 2-3 months.
HbA1c can be expressed as a percentage or as a value in mmol/mol . Since 2009, mmol/mol has been the default unit to use in the UK.
Note that the HbA1c value, which is measured in mmol/mol, should not be confused with a blood glucose level which is measured in mmol/l. Use our HbA1c conversion tool to help with switching between the two measurement units.
What Are All The Classes Of Diabetes Drugs
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This is qualitative. 2. The second meaning is applied hg a1c to immovable objects in mathematics and physics. Each column number has certain qualities, such as a combination number of diabetic ketoacidosis caused by medication more what do the insulin receptor molecules on the cells in your body do than one dimension.
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In this way, we whats good glucose level calculate all the moving orbiting celestial spheres of the planets. Saturn and Jupiter have a total 5 drugs of eight, and the at home blood glucose test rest are twenty five.
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When Is An A1c Test Needed
If you have diabetes, you should have an A1c test two to four times a year to see how youre managing it. Your healthcare team will recommend exactly how often you should get tested.
If you havent gotten diagnosed with diabetes, a healthcare provider may order an A1c test if you have symptoms of the condition. These symptoms include:
What To Do If Your A1c Is 66
An A1c of 6.6 falls into the diabetic range between 6.5 and 10.0.
Reducing an A1c of 6.6 will take a combination of medication and lifestyle modifications. Seek medical advice to gain control of your blood sugar and avoid further damage to critical organs.
Keep an eye on your blood sugar by testing at home. Its easier than ever and there are a variety of affordable blood glucose monitors available.
Diabetes is manageable but only if you stick to a plan and monitor your progress with the help of your doctor.
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Check Your Blood Sugar Levels As Your Doctor Has Directed
Work with your doctor to determine if you should check your blood sugar and how often. You may be tempted to pick up an A1C home testing kit, but Dodell says having your A1C checked by your doctor every three to six months is sufficient. A better idea is to use a continuous glucose monitor. He recommends checking your time in range to see if you are at the optimal level. For many people that is 70 to 180 milligrams per deciliter , according to ADA guidelines.
Understanding your A1C levels is an important part of your overall diabetes management. If you have any questions about your A1C or what it means, dont hesitate to ask your doctor.
Additional reporting by Mikel Theobald