A1c test Unreliable?

It is amazing at how little exercise one must do to increase insulin sensitivity, and lower blood sugars.

Walking around a short block after each meal is often enough to make sugars much better.

Taking some fish oil, well quite a bit of fish oil like at least four grams also helps.

Cholesterol lowering drugs, and some hypertension drugs help to cause diabetes in people who were otherwise just on the edge, but could eat nearly anything.

There has been a rumor going around that corn sugar, versus Cane Sugar, helps to drive diabetes rates.

A1c or HbA1c reflects the average blood glucose level over the past 2 months. So, taking a single glucose level will not always reflect the A1c level. A1c is a useful guide because it doesn't require the patient to have fasted to get a reasonably accurate diagnosis.

Prediabetes is a term used by many docs who are familiar with diabetes. All it means is that your blood glucose is climbing and if you don't do more diet and exercise things you are going to need to go on some kind of medication. FDA and the insurance companies don't recognize it as a term, but you will find articles if you do a PubMed search.

Idamtnboy, thanks for your post. I agree that the doc is wrong to discount the A1c test and my 100plus home tests as being "not accurate for you". The lab glucose will run low if not run shortly after the lab draw. I will follow a lower carb diet and continue to monitor as it gives feedback as to how your body reacts. Your advise is like my 95 y/o mom, "everything in moderation".

After an annual blood test, I received a call from my doctor that said my glucose level had increased from 106 last year to 130. I'm not surprised, as my wife's hobby is baking new dessert recipes. I can resist anything but temptation. The doc told me to substitute veggies for potatoes and rice and he wants to do the A1c test in three months. So, I have been meaning to cut out whites, breads and sugars anyway. My reason for this post is that I drink 1 to 2 Zero cokes each day and I saw a post that mentioned sugar substitutes were not good for diebetics. Does anyone have any information regarding diet drinks? Thanks.

The best diet drink is plain water--by far!
I believe that tests have shown the sweetness imparted by artificial sweeteners has an undesired effect on metabolism.
I know of no testing done with stevia (rebiana)
If you can drink unsweetened, or very lightly sweetened green, white, or herbal tea, it might be almost as good as plain water--and a tasty alternative!

SMenasco wrote: Does anyone have any information regarding diet drinks? Thanks.

Came across this link about 5 minutes after reading your post!! It is on the local TV station news web page.

http://english.inserm.fr/press-area/die ... i-diabetes

Dr Robert Lustig talks about sugar substitutes (found in diet drinks and many foods) in his new book "Fat Chance" : http://tv.msnbc.com/2013/01/08/an-excer ... at-chance/

He basically says that the message the brain sends to the pancreas to get ready to release lots of insulin when we eat something sweet happens in the same way whether what we eat contains sugar or sugar substitutes. The difference is that when the promised sugar doesn't arrive (in the case of a sugar substitute) we often feel a compulsion to eat more to take advantage of the insulin that is ready and waiting to be released. He really doesn't like any of the substitutes, not even stevia.

I use Honey, to replace sugar in my life, and never would use sugar subs.

1, 000, 000 honeybees cant beewrong. I try to keep "Better living through chemistry", off my dinner table. Jim

Kitatonic wrote:Thanks for the replies.Should I call this "impaired glucose tolerance"? My c-peptide and insulin levels were normal, but I'll recheck on the timing. I had read Chris' column as to possibly having longer lived RBCs, so the A1c is falsely elevated, no doctor seems to discuss this as a possibility. Just curious if any other apnea sufferers have the same experience with a falsely elevated A1c.

Check your CBC results for the value of MCV (mean corpuscular volume).

If this is elevated, then the red blood cells are hanging around your system longer.

Get and keep a copy of all your lab work. Doctors normally don't review pior history very often so you need to. You will be able to see trends especially trends that are still in the so-called normal range but tending higher or lower.

kitatonic - may I suggest that you pay a visit to the ADA message boards as well. The Type2 forum is particularly informative and I frequent both there and here.

Just briefly, the A1C is only a kind of guide. The statement that an A1C number is an average of such-and-such a BG number is just that - an AVERAGE. This means that if your A1C number indicates an average of 105 BG, then it also means that your BG could go as low as 70 and as high as 500 - or even more extreme than this. Unless you are using a CGM, there's no way to tell what your BG is 24/7.

I rarely discuss diabetes here, except if someone else raises the issue, nor do I discuss OSA there, HOWEVER I am starting to see a pattern with my always-frustrating fasting BG numbers.
My fasting numbers are the only ones I have no explanation for and have tried everything anyone has ever suggested to remedy this.

Now that I have a Zeo, there seems to be a correlation between my fasting BG number and quality of sleep the night before.
I still have a long way to go in my experimenting, so don't have any definitive conclusion as yet.

Cheers,
xena

JDS74, my MCV always runs 97 (nl=80-100), so the RBC may have longer is collect glucose. Still my fructosamine test, which is not RBC dependent, was slightly high twice.

Just before this elevated A1c, I was chewing sugar-free gum while reading. I think the severe OSA and the induced insulin response from artificial sweeteners, created the insulin resistance.

Kitatonic wrote: Just before this elevated A1c, I was chewing sugar-free gum while reading. I think the severe OSA and the induced insulin response from artificial sweeteners, created the insulin resistance.

I suppose that's possible. I have contended for years though, that rather than obesity and excess intake of carbohydrates being the cause of diabetes, that there may be a deeper common root cause for both diabetes and obesity. I really wonder if something like the minute quantities of chemicals in processed foods may be impacting our metabolism, albeit over a long time span which makes it difficult to establish a cause/effect relationship. But, with the power the food industry holds, the practical problem of producing enough food for everyone without using chemicals, and the market distaste for less than perfect looking fruit and veggies, we may never find out.

The various A1c values being reported for you may have more to do with the lab and less to do with you.
Laboratory blood tests report a value and a range. Look at your tests and see if they are all done at the same lab and all have the same ranges.

Suppose you have, as I do, one lab result of 5.8 with a range of <6.0 and
A second lab result of 5.5 with a range of <5.7

These two results are pretty close to the same. The lab(s) have tested using different reference criteria and/or different lab protocols. To compare results when the reference ranges are different is a little tricky but it can be done. I have had to convert all my lab test results to be able to compare one with another because different docs have used different labs or the same lab changed their protocol for individual tests.

One other thing to remember is that even if the lab divided your blood sample and ran the test twice using the identical protocol, even then the reported values will have some variation.

JDS74 wrote:The various A1c values being reported for you may have more to do with the lab and less to do with you.
Laboratory blood tests report a value and a range. Look at your tests and see if they are all done at the same lab and all have the same ranges.

Suppose you have, as I do, one lab result of 5.8 with a range of <6.0 and
A second lab result of 5.5 with a range of <5.7

These two results are pretty close to the same. The lab(s) have tested using different reference criteria and/or different lab protocols. To compare results when the reference ranges are different is a little tricky but it can be done. I have had to convert all my lab test results to be able to compare one with another because different docs have used different labs or the same lab changed their protocol for individual tests.

One other thing to remember is that even if the lab divided your blood sample and ran the test twice using the identical protocol, even then the reported values will have some variation.

Both labs had the same A1c range and reported the same number, 5.8 twice in the one lab and 5.5 twice in the other lab. Apparently there's many methods to test A1c, and I agree it is likely to be the lab with the 5.8. My lab glucoses and home tests would average to a A1c of 5, not even 5.5. Meanwhile, I'll further cutdown on the milk , carbs and almost eliminate artificial sweeteners, and report the results in 6 months.

Thanks for so many replies and great insights!

Kitatonic wrote:Both labs had the same A1c range and reported the same number, 5.8 twice in the one lab and 5.5 twice in the other lab. Apparently there's many methods to test A1c, and I agree it is likely to be the lab with the 5.8. My lab glucoses and home tests would average to a A1c of 5, not even 5.5. Meanwhile, I'll further cutdown on the milk , carbs and almost eliminate artificial sweeteners, and report the results in 6 months.

If you haven't seen this take a look at it. Can't vouch for the author's qualifications, other than he has done a lot of research about diabetes for himself. The article is interesting. As I said earlier don't get too uptight about trying to bring your A1c number down, but do keep it as stable as you can. You are well within the normal range. http://www.mendosa.com/blog/?p=366

Here's a quote from the web page.

I asked how they knew if the people they tested didn’t have diabetes. “Because we did fasting glucose tests on them, they had no prior history of diabetes, and none of them were obese,” Curt replied.

So what were their levels? They ranged from 4.5 to 6, Curt replied. That’s at plus or minus 3 standard deviations.

I am certainly no statistician. But Curt tells me that it includes about 99 percent of the values.

The range is narrower — 4.7 to 5.7 — at plus or minus 2 standard deviations. This includes about 95 percent of the values.