never a straight answer...opinions??

[1type2go]

I,ve always wondered if one (like myself ) was to continually run lows through out the day [BG 4]and at night [2.5] although running high at times (myself in particular running 14s,...two or three times in a week, and once in a while, hitting 18 or 20!! )but correcting the high quickly and effectively and back down with in an hour

Could this cause a false A1C

Other wise ; if I never went low (below 4 )and combated the highs once a day effectively ****would this result in a higher A1C or nothing worth worrying about.

pls pls pls any comments much appreciated

Thanx Donovan

[Metermaid]

I've wondered that exact thing...I will be watching if anyone has any input.

[BlueSky]

.... Could this cause a false A1C ....
What is a "false" A1c? As usual, you would get an A1c that is the average of the high and the low blood glucose levels.

[marked]

I think a1c is very limited in it's value. At best a pointer.

This disease is about what your last blood sugar was and what your next one will be. If they are acceptable, it was a good day.
Mark

[ant hill]

I,ve always wondered if one (like myself ) was to continually run lows through out the day [BG 4]and at night [2.5] although running high at times (myself in particular running 14s,...two or three times in a week, and once in a while, hitting 18 or 20!! )but correcting the high quickly and effectively and back down with in an hour

Could this cause a false A1C

I think that you need to back off some basel. :)

[Gary_W]

It is just an average from what I gather.

If your blood glucose is either 3 or 18 and nothing in between, it is still possible to get an HBA1c of 8 ish. I know 'cos I've been there. It's not a false number, but it does not tell the full story as to how awful you feel.

I think you need to have a reasonable HBA1c and do this without too much of the bouncing. If you can....

[KCP]

From what I have also discovered lately it also depends on how long you ran high for. If you run at 16 for 6 hours, once a week then you are likely to run a higher aic. But if you deal to the high quickly, and bring it down within 2-3 hours then you will only affect a1c in a smaller way than if you ran high for longer... Fomr what the last doc told me anyway :s

[Evermont]

The expression "area under the curve" comes to mind. There is a pharma-wiki (http://en.wikipedia.org/wiki/Area_under_the_curve) on it - similar concept. Also a math thing (http://hyperphysics.phy-astr.gsu.edu/Hbase/integ.html).

I've not heard it expressed this way, but I synthesize from what I've learned, that it's a function of both the amplitude and the duration of the agent of damage that is important. A1c does a decent job of measuring that even if it is heavily weighted to the later half of the 3 month window. Just my guess but if A1c says it's bad, it's bad. I've heard of a few things that can make A1c read lower than one might expect though. Resveratrol interestingly, and bloodletting which is understandable as examples.

[Real4]

It is just an average from what I gather.
"Average" has specific mathematical/scientific meanings - on any of the exact meanings of "average", HbA1C isn't an average. It would be better to say that the HbA1C "reflects" the blood glucose levels over the recent period rather than it is an average.

[1type2go]

[quote]I think that you need to back off some Basel.

Jeff; I'm thinking about it ,....working on my Basel requirements!


I'm starting to think about this question and I believe ........:D
If I carried on never dropped below a BG level of 5 and continued with higher BG levels twice a week such as 14-16

who am I trying to kid ...I hit those highs four times a week :o
my A1c of 6.2 as of last Dec. Would it not be higher, say..... with a guess of 6.5 or 6.7??

FALSE as in salting the mine:D or sweetening the deal {pardon the pun if you will}
This is not, in any way, to put pressure on anybody else if BG levels normally sit higher (relative to the individual)

I am just thinking I should have a better handle on this :o

[Subby]

"Average" has specific mathematical/scientific meanings - on any of the exact meanings of "average", HbA1C isn't an average. It would be better to say that the HbA1C "reflects" the blood glucose levels over the recent period rather than it is an average.

This may be a fair point but I think it's important to go on and make this distinction. Be careful not to automatically correlate "blood glucose levels" with "good blood glucose control/low impact of diabetes". By this I mean that yes it is a useful indicator of overall long term impact of blood sugar levels but cannot inform about fluctuations, or the actual impact of very high or very low blood sugar episodes (which can be substantial, and effect the long term as well).

In other words, you can be damaging your health, in both minor short term, and major long term ways, with your high and low blood sugars, and it is possible the HbA1c test won't inform of this meaningfully, or may seem OK. It is NOT the be all and end all.

So to answer the original question Donovan, your HbA1c will always be "true" as far as showing the amount of glycosylated hemoglobin present in your blood, and this will be a reflection of your ups and downs. But this number is not always meaningful or accurate as to how the disease may be affecting you. The primary thing to worry about is not the way your blood sugars affect your HbA1c, it's back to the basics of staying steady and avoiding those highs and lows as much as you can. Real improvement will generally show in HbA1c, but not always, very important issues like avoiding occasional very low hypos, probably won't be "reflected" meaningfully in the HbA1c.

[shiftzor]

It’s a bit like the anorexic kid who puts weights in her pockets or drinks lots of water to gain weight before a "way in". Yes you could cheat the system and run very low for a few weeks to get that A1c down but you would only be cheating yourself. Doctors rely so much on A1c at least at my GP they do, however it shows that the better doctors actually want to see your bg tests. That can build a better picture but I don’t even think they are that accurate. I had a high A1c with according to the software a high test average of 6mmol/l. I don’t think without having a CGM to get the full 24/7 picture you will ever truly know what happens to your bg, but at least it helps to remove some of the guess work ;).

[1type2go]

OH MAN

I used to think my testing was so biased because I tested when there was a feeling that was odd and would reflect only my lows or highs ...besides the pre meal tests (I'm testing about 10 times a day -7:AM..10:PM and the odd night test) and I always put my trust in the HgA1c.

I think I will now start to recognize the important of the daily tests

Thanx Donovan

[Subby]

Living with diabetes seems to be a constant lesson. Good on you for being in the fight there, Donovan. Taking that many tests shows that you are already doing a lot to try and tackle this beast. You could take some "regular" tests like pre and 2hr post meals for a week or so, then seperate them from all the others. That way you get one picture that you can be sure is not reactive to how you feel (I know exactly how you feel). And that you can use to adjust dosages more effectively.

Take it easy mate.

[JediSurfer]

Yes the AC1 can be totally wrong as to what is happening day to day. Beleive it or not I can pretty much get my AC1 results to any number I desire. 30 years of fine control gives me that power. AC1 means nothing to me. My day to day control is the most important thing for me. Docs love AC1's but they are not the ones who are diabetic.

[1type2go]

Got it :thumbsup:

I was trying to get my intake up to 3500 cals a day 200 of protein ,350 from carbs and trying to keep under 100g of fat so I guess A1c of 6.2 was good.


I can't belive how great responses are on the forum and I'm glad I just found the weight lifting...or exersize threads.

Doing better now ,keeping under BG of 10 ,DROPPED my night time Lantus to 12u

Thanx for all on this,pls add if you have more on this

Donovan

[ant hill]

Good on ya Donavan! :D That's great news.