What factors affect the A1C test?

Question

My husband is type 2 and has been taking Metaformin. His numbers average around 110, but recently had a fasting test that resulted 140. And his A1C was 7.4. We are not sure what is causing all this as he watches his diet and is "required" to exercise regularly. He is also a long-distance road biker. He's 5'4" and 140lbs

Answer 1

I'm sure you already know that Hemoglobin A1c is a used as measure to see how well a person is keeping his or her diabetes under control. However, if there has been a recent change in diet or treatment, the A1c may not be an accurate measurement of diabetic control.

"Glycated hemoglobin measurement is not appropriate where there has been a recent change in diet or treatment within 6 weeks. Likewise the test assumes a normal red blood cell aging process and mix of hemoglobin subtypes (predominantly HbA in normal adults). Hence people with recent blood loss or hemolytic anemia, or hemoglobinopathy such as sickle cell disease are not suitable for this test. The alternative fructosamine test may be used in these circumstances and it similarly reflects an average of blood glucose levels over the preceding 2 to 3 weeks."

Answer 2

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Answer 3

I think a better question is what affects blood glucose levels. I have found that even if you are watching what you are eating, taking medicne properly and really concentrating on your diabetes - levels are sometimes elevated.

What brings this on? Typically stress and sickness. If your husband has had a lot of stress over the past 3 months (which is the timeframe that an a1c checks) the levels of glucose could be elevated.

Good luck.

Answer 4

HbA1c test is to see how a person has been controlling their BM's over the previous 12 weeks.

Regular highs or lows will affect this result.

7.4 is actually a good result. I'm from the UK, so I don't understand the other results too well, but as for the HbA1c, it's not a bad result. Mine averages around 10 at the moment, which obviously is quite bad, but my Drs and I are working together to sort it out.

If you're worried at all, go see your GP, he or she will be able to give you advice to put your mind at ease. If you feel their advice is not satisfactory, get a second opinion.

Answer 5

Before people are diagnosed with diabetes, they will suffer from "prediabetes" which the ADA categorizes as people with an A1C between 5.7 and 6.4. People with prediabetes have abnormally high blood glucose levels which causes similar symptoms to diabetes. An A1C of 5.6 is borderline and consequently you may experience symptoms that may lead you to believe you have diabetes. Diet and exercise during the prediabetic phase when successful can delay the onset of diabetes in most patients and help control blood glucose levels. (pharmacy student)

Answer 6

HA1c test should be 7 or below. An HA1c of 7.4 is not acceptable. It indicates an average blood sugar for a 3 month period of approximately 160. Now, no one wants a blood sugar average of 160.

When you say that your husband has been watching his diet, I am wondering how he is doing that? Is he watching his calories? Is he watching his carbs?

My husband has been a diabetic for over 25 years. He faithfully saw his doctor every 3 months and was getting worse and worse. 5 years ago they put him on insulin - he was up to 43 units of insulin a night. He gained a tremendous amount of weight (he was up to 270 pounds), he could not hardly walk with out pain because of the neuropathy in both his feet, he was irritable all the time, sleepy, and had lost interest in life.

I did an extensive amount of research on the subject of Type II Diabetes and found that watching your diet means that you need to count your carbohydrates daily. 15 grams of carbohydrates equals 1 carb. My husband and I eat 5 to 7 carbs a day. We used to eat between 40 and 60 carbs a day - we didn't know how bad that was for us - we hardly knew what a carb was for goodness sake.

I have put together a program and I teach Type II Diabetics how to take control of their disease. I have one client that was at 85 units of insulin when she starte with me 7 months ago. She is now down to 22 units a night and her doctor is ecstatic at her progress. She has lost 22 pounds - she could only gain weight before - never lost anything.

Oh by the way, my husband has been insulin free for the past 3 years! he has walked in 2 -5K races, he is taking only half of his oral hypogylcemic meds, his HA1c is 6.6 (it was 11), he is full of fun, he has taken up his saxophone after 40 years of not playing and plays in a band, he has come back to life.

Our program works wonders - it is through motivation, education and accountability.

I am sure your husband's problem is because of the carbs he is eating. Try this, cut out all potatoes, bread, cereals, fruits, pasta. Try it for a period of 2 weeks - see what happens - tell your husband to be sure to check his blood sugars frequently throughout the day - I am sure they will be much lower than usual. He needs to be careful so that he doesn't develop hypoglycemia (low blood sugar). It usually isn't a problem if he is not on insulin - He absolutely must check with his doctor before doing any change in his diet - tell his doctor you want to try a low carb diet plan for at least 2 weeks to see if it is going to help him - get the doctors approval and any advice he/she feels is necessary. The change will absolutely astound you and probably his doctor!

Good luck and God bless you both!

Answer 7

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