Dec. 29, 2009 -- The American Diabetes Association (ADA) is recommending
that a simple blood test currently used to assess whether diabetes is under
control also be used to diagnose the disease.
The blood test -- known as the A1C test -- has several important advantages
over traditional blood glucose testing.
Patients do not need to fast before the test is given, and it is far less
likely to identify clinically irrelevant fluctuations in blood sugar because it
measures average blood glucose levels over several months.
The new guidelines do not call for replacing traditional screening with the
It is believed that around 6 million Americans have diabetes but don't know
it, and another 57 million have prediabetes.
The A1C test may help identify a large number of people in both of these
groups, former ADA president for medicine and science John Buse, MD, PhD, tells
Buse, who is chief of endocrinology at the University of North Carolina,
Chapel Hill, helped draft the new ADA diabetes care guidelines, which were made
"We now know that early diagnosis and treatment can have a huge impact on
outcomes by preventing the complications commonly seen when diabetes is not
well controlled," he says. "Our hope is that people with early or prediabetes
who might otherwise not be tested would have the A1C test."
The A1C test has been used since the late 1970s as a measure of how well
diabetes is managed, but the ADA had not previously recommended it for
diagnosing the disease.
In part, this is because earlier versions of the test were not as accurate
as current versions.
The test measures the percentage of glycated hemoglobin, or A1C, in the
blood and provides an assessment of blood
sugar levels over the previous two to three months.
Hemoglobin is a protein on red blood cells that carries oxygen in the blood.
When blood sugar is too high it combines with hemoglobin.
The more excess glucose in the blood, the higher the percentage of A1C.
Healthy adults without diabetes or prediabetes have an A1C of about 5%.
Diabetes patients with very poorly controlled disease can have levels as high
Under the new recommendations, people with A1C levels between 5.7% and 6.4%
will be considered to have prediabetes and those with levels of 6.5% or higher
will be considered to have diabetes.
Any adult who is overweight or obese (BMI of 25 or greater) with one or
more additional risk factor for diabetes including: having a family history of
the disease, belonging to a high-risk ethnic group (African-American, Latino,
Native American, Asian-American), having high blood
pressure or a history of gestational diabetes.
Anyone who is age 45 or older, regardless of risk factors.
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If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.
People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
Congratulations on taking steps to manage your health.
However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.
Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.
Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.
One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.
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