Tuesday, January 31, 2006

THE TRUTH BEHIND HbA1C

Most of us with Type 1 Diabetes are familiar with HbA1C. This test shows a 6-12 week pattern of blood sugars and is widely use as a predictor and evaluation of "how well the patient is doing" by the Medical Profession. Basically, Glucose binds with the protein Hemoglobin to give us glycosilated hemoglobin. It is now generally felt that those with Diabetes should have a HbA1c of 7% or lower, but not higher since that would mean poor control with "high blood sugars".
The thing that is wrong with this type of test to be used as a Predictor of Control is that the person could have very high blood sugars (300mg/dl and above) for 2 weeks and then have very low blood sugars 50 and below( as in the case of Hypoglycemia) for the remaining balance of the month or two.
Since HbA1C shows a median or average of the numbers.....the percentage might appear as a HbA1C of 7% and the Healthcare Providers are saying "how great and what a good job you are doing" to the patient. In reality however, the person's blood sugars are fluctuating between extremes and while the HbA1C shows "good numbers", the reality is not very good. Again keep in mind that the only thing that is measured, is the average of all the numbers and not the fluctuations that can and does occur on a daily basis.

2 comments:

Sandra Miller said...

Absolutely. I think it's so important to look at the A1c in concert with bg readings over the same 3-month period.

Of course, this is only useful if you're doing frequent bg checks (our son checks a lot and we do a number of overnight tests because both highs and lows present major problems for him-- lows, for obvious reasons; highs, because of bedwetting).

Otherwise, you'd probably miss some of that volatility you describe here.

aaron said...

I totally agree. I'll sometimes have a pretty good a1C even though I know I've had a bunch of high blood sugars. However, I do feel it's better than nothing. In high school I seldom had an a1c below 11 or 12 so I'm happy for my 6.6 even though I know it's not the most accurate thing in the world.

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I do not give up my Autonomy,especially to the Medical Profession. Passionate, Creative, Able to see Beauty within Simplicity, I Am Not A Diabetic, rather I have Diabetes (there is a big difference between the two on many levels).Type 1 Diabetes since 5 years of age. Belief in G-D