Beyond Blood Sugar: Testing A1c
More people need to know about the test for A1c -- or glycated hemoglobin -- that has revolutionized diabetes care.
How Low Should it Be? continued...
But it's important to know that not everyone can reach these goals. "I've been delighted with the number of patients I have with A1c levels in the low 6% area," says Paul Jellinger, MD, past president of the American Association of Endocrinologists. "But in some patients who have unstable blood sugar levels, you're content with 7.2% or 7.4%, since that's the best you can do."
Goldstein is somewhat doubtful of the new, lower targets. "I agree that people should strive for the lowest A1c possible," he says, "but most patients can't achieve either the ADA or the AACE goals with current therapies because they're so low. And I think that you have to be careful not to set a goal that most people can't attain."
So what's the upshot? Get your A1c tested regularly and consult with your doctor about what target you should set. In general, aim for below 6.5% or 7%, but understand that it may not always be possible to get there.
Doing it Yourself
At least one at-home test kit for A1c levels has been developed, and more are probably on the way. While it may be somewhat more convenient than trudging into the doctor's office, Goldstein and Kaufman are a little skeptical of their usefulness.
"If A1c levels were something that you had to monitor every few days, a home test would make more sense," says Goldstein. "But A1c is a long-term measure of blood sugars and you don't need to do it very often, maybe every few months. So why do people need to do it at home and why would doctors want them to?"
"I'm concerned about people doing these at home," Kaufman tells WebMD. "I don't want people to start doing A1c tests on their own and then thinking they can skip healthcare visits. It's not a substitute."
Instead, Kaufman and Goldstein recommend that A1c tests be administered in the doctor's office, where other indications -- such as blood pressure, cholesterol levels, and weight -- can also be checked. "People with diabetes need to be seeing their doctors regularly anyway," says Goldstein.
However, Goldstein does see at least one useful application of the home A1c test. "I think it might be good as a home-screening test, like a home pregnancy test," he says, "for people who haven't been diagnosed with diabetes but who are concerned about getting the disease."