Fasting or Non-Fasting A1C

Q: My husband had a fasting a1c test and today she said the test wasnt run as a fasting A1C, it was non fasting listed in the medical chart. Could the 7.5 be different if they were done for nonfasting, compare to fasting 14 hours?

thank you

A: The A1C test can be drawn fasting or nonfasting. It is an average of all the glucose readings over the past 3 months--maybe a little more heavily weighted by the blood sugar readings over the past few weeks, but not too much. The readings don't change quickly, like our glucose readings using our meters.

Fasting or not, and given the variations in laboratory results, take the reading for what it is---a general idea of how the blood glucose control has been going. If it's causing worries, have the test repeated. Talk to your diabetes educator and your doctor to see if they think it would be best to tighten the diabetes control a little.

Take care, ginny

Fasting Blood Sugar & A1C

Q: Hello,

Thank you for addressing my question!

I have done a few home fasting glucose tests after many evenings of going to the bathroom and came out with different numbers each time. One morning it was 121, the next morning 97, another 105, and this morning 80. Here's my question, when I have my cholesterol and thyroid test done this week they will be doing an A1C. With the numbers up and down, will this one test be able to determine if I'm pre-diabetic or not? My test will be at 9:45 am after an evening fast. I know an A1C gives an average, however if there isn't any previous A1C, what do they compare this one to? I'm thinking if I'm running under 100 the day of the test, how can the test determine weather or not my sugar was elevated on the two previous occasions.

Thanks,
M.

A: M., What great questions!

Lets start with the fasting glucose readings you have done. Normal is generally 70-100. Prediabetes is occuring when fasting numbers are between 100-126. Diabetes is diagnosed when fasting numbers are above 126 on two occasions. You and your physician will talk about your fasting readings, your AIC test and together will decide about a diagnosis of prediabetes and what kind of treatment you may need. There are options of exercise, diet changes and medications.

You are right, the AIC test is an average of all your glucose readings. It is an average of the readings over the past 3 months. The results are given in a percent, with 4-6% being normal. The test is looking at how much of the red blood cells are coated with sugar or glucose. The higher the average glucose has been, the greater the percent of the red blood cell membrane is coated in glucose. In addition to the AIC percent reading, the tests are now coming with a calculated average glucose reading too. Here is an example:

Your AIC is 4.4%. That means only 4.4% of each red blood cell membrane is coated in sugar or glucose. That is a very normal amount. To find your average glucose reading with a AIC of 4.4%, we multiple the AIC by 28.7 which equals 126.28. Now we subtract 46.7 which equals 79.58, which means that over the past 3 months, your average glucose readings were 79. Each day the readings may change a little, but if there isn't a diagnosis of Diabetes, the swings are usually very small.

Please take care and be sure and discuss your test results throughly with your physician, ginny

Diabetes progression and prevention

Q: Ginny,

I have read several obits lately indicating people have died from complications of type 2 diabetes, which I have had for a little over a year. I have my A1c level down to 5.8 and have lost 35 lbs. If I continue to eat sensibly and keep my Alc level in acceptable range will I avoid those complications? Or will my condition worsen?

Thank you for your info,
Judy

A: Judy, You have done a great job! Remember, the leading cause of complications (blindness, end-stage renal disease, and non-tramatic amputations) is not diabetes. The leading cause is UNCONTROLLED diabetes.

We do not know if your body will need more assistance, with more or different medications as time goes on, but your meter will help you. As you test your blood sugar levels you will be able to track whether the numbers continue to be safe. If the numbers become unsafe, you and your physician will be able to decide what the next step for you should be.

Ginny

Future with Type 2 Diabetes

Q: Thanks for giving us this opportunity to ask questions!

My husband (age 57) has had Type II diabetes for about 3 years. He does everything right, monitoring all his levels, lotions his feet every day, exercises regularly, goes to the doctor every 6 months. We are improving our diet (although slowly). My question is: If he continues to maintain this schedule, what will life be like in 10 or 20 years with diabetes?

P

A: Dear P,

Your husband is doing everything right: keeping track of his blood sugar levels and his HgbA1c levels. The studies tell us that people who keep their levels in a normal range have fewer complications. For people who have Type 2 diabetes, the big three areas he needs to watch (with the help of his physician and you) are his glucose levels, blood pressure and cholesterol. Eating well and exercising will help with all three.

Remember, complications do not generally come from diabetes, they come from UNCONTROLLED diabetes.

Good luck to you both! Ginny