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Larry H.

At last an AC1 Number.

49 posts in this topic

After much prodding I have now the results of an AC1 test. Not exactly sure how it relates to my numbers I had been seeing with the meter, but the nurse felt it was within reason. It was a 5.8. That included a pretty good stretch where I was probably getting higher after meal numbers than I was during the summer period, so I would expect it could have been somewhat lower had I had one done then.

Anyway for all those that have prodded me those were the results.

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Here's a link to the conversion chart I use. I like it because it breaks the numbers down more than most charts do.

 

 

 

5.8 is a good number, esp. for someone NOT taking meds. My doc says he likes to start meds if the A1C is over 6.

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Here's the conversion chart I like to use, as it breaks down the numbers more. I have a copy on my bulletin board, and I highlight my A1C results on it.

 

For some reason, this link won't post.... but I go under yahoo and type in printable A1C conversion chart and go under the geocities one.

 

Larry, 5.8 is a good A1C, esp. for someone NOT on meds. My doc encourages patients to begin meds if the A1C stays 6 or over.

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Here's the link:

 

geocities.com/diabeteschart/bloodsugarchart.html

 

And here's a few more:

 

elviradarknight.com/diabetes/a1cnumbers.html

 

diabetestoolbox.com/HbA1c-convert.asp

 

[weird, the board doesn't seem to want to post the links - I'll try them without the www. at the beginning]

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Hi Larry!

 

As the "Chief Prodder" I am glad you had the test done. Knowledge is a wonderful thing. Now, what does that number actually mean?

 

Depending on which chart you use (why they are all different still baffles me) it tells you what your average BG levels have been for the past 90 days (actually, it is a weighted average with emphasis on the past 4 to 6 weeks).

 

An HbA1c of 5.8 is acceptable and not indicative of diabetes according to the various people, organizations, and agencies who make the dignosis criteria. That being said, you are getting close to the upper limit. That explains why the ADA says your numbers are in the Pre-Diabetc range.

 

What do you do with this bit of information? First of all, take a deep breath and recognize that you are not diabetic right now. Next you have to make a decision about how you are going to live the rest of your life. Most of us know that you can bring down this number by further modifications of your diet and exercise patterns. I brought mine down to my current levels (see bottom of my signature block). Yeah, I do this test monthly because I find this to be more significant than the daily testing which I only do once or twice a day at maximum (FBG with the occasional post-breakfast check).

 

December increased my HbA1c numbers a bit (one tenth) largely due to reduced exercise levels influnced by family issues and lousy weather as well as too many parties where I'll admit I strayed from the narrow path. Since I'm over 60 I'm not in a panic and I am in control. Will I become a diabetic? Yeah, it may happen, my father was an undiagnosed diabetic for years (also a functioning alcoholic and heavy smoker). On the other hand, when my father was my age he was dead for over seven years. The thing that I do know, based on the fasting C-Peptide test, is that my pancreas is not producing a lot of insulin as I'm on the low end of normal. Therefore, it takes my body longer to use glucose, therefore I must make sure that I don't put too much in at any given time.

 

You are doing okay Larry. If you like what your results were, then keep on with the program. If you don't like the results -- modify your program and test again (FWIW: I use the Biosafe home test kit which is available from Amazon for about $20/test if you buy a bunch of them as save shipping costs)

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All your post are rather timely. I just got the printed version from the lab of my results today. As one Ronin Just mentioned they do indeed seem to vary.

I looked at it and see they show a "Mean Blood Glucose" of 117.8. According to one of the above charts that comes in at 5.4. However the doctors office called and told me it was a 5.8 reading? I think another member mentioned it was an average in the mid 130's. That was too high for comfort for me.

What surprises me is the notes on the test that say;

 

"Hemoglobin AC1 5.8

Arbitrary guideline:

Near Normal 6.5 to 7.0

Good Control 7.0 to 9.0

Fair 9.0 to 10.0

Poor 10.0

 

These appear to be higher than most I read on this site or other charts?

 

 

I will most definitely normally be watching what I have eaten. Thats the worst part, I have done better than nearly anyone around here I have met with the way I eat. Most just eat what they want and take a pill. What the outcome of that may end up being I am not sure? I usually keep the carbs down best I can. I too though fall short once in a while. Yesterday we had lunch out and I had a spinach salad with a oil dressing. Then I had a very slim slice of chocolate cheese cake.. After a pretty low carb meal last night I tested and at two hours was at 178. A pretty high number for me. Towards bedtime it had dropped to 138. This morning I slept a bit later, which sometimes can be worse or better depending on who knows what.. But I got a 98, so that didn't seem too bad.

 

I am sure I am on my way to type two maybe even if I watch fairly well. But I can't afford to think its ok to go on as before, I tried a modified amount of that after the doctor gave me the "your ok" kind of talk, and my numbers reflected it..

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Well, 5.8 is a good number, Larry! Just remember, Diabetes is a progressive disease. You may be able to stave it off for a time, but eventually, you will "cross that line". Know that it is nothing you did to cause that crossing, that's just the way it is! And know that you DID do all you could to stave it off, as long as possible! You deserve MUCH credit for that! When the time comes, and you can no longer keep it at bay, with diet and exercise. Don't hesitate to start on the meds! They're there to help! Just do as you said, keep a good watch on it, and press on with the doc, if neccessary, when that time for meds comes. If he doesn't see things your way, then find yourself a new doc, who is as concerned with your health, as you are!

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What surprises me is the notes on the test that say;

 

"Hemoglobin AC1 5.8

Arbitrary guideline:

Near Normal 6.5 to 7.0

Good Control 7.0 to 9.0

Fair 9.0 to 10.0

Poor 10.0

 

These appear to be higher than most I read on this site or other charts?

 

Those "notes" are for the garbage can. Normal, non-diabetic A1C is under 5.0. 5.8 is decent control for a DIABETIC, it is not normal and it is not even "good control".

There is one major study where they divided the results into over and under 7.0, SURPRISE under 7.0% had much better long term outlook. So since then 7.0 has been a mantra for certain people including some doctors.

The numbers shown have to go back a long way to a time with only primitive insulins and insulin regimes and before oral meds for type 2. They reflect a treatment program centered around keeping a patient alive in the short term, not long-term freedom from complications.

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Must be a Southern Illinois thing.. My old doctor still thinks 200 after meals is fine.. I thought you all would find those numbers as faulty. The doctors office who quoted these numbers the health department puts out is in yet another small town near. He treated my dad when he was basically dying of pulmonary heart failure and never figured it out.. Funny part is he is a pulmonary specialist.. I am afraid there must be a lot of mis-information out here. It may be why so many just keep eating way too many things they shouldn't and take there little pill.

 

And yes I will most likely face that too. In the year and 4 months I have been around here I can see where my numbers are not as easy kept down as they were after my first weight loss and exercise routines began. No doubt though if my fastings were higher and my after meals were higher when I got here that may have been going on for quite some time and didn't realize it. So getting them down to where they are, even if not the best control, is probably at least a slow down in the progression. Doing pretty good, just not perfect.

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Nobody's perfect! ;) You can only do, the best you can do! And that you are! :)

 

I just posted on another thread about the Medical Community's general lack of knowledge. It is something that irks me to no end, and I find NO excuse for it! Those doctors and such, that you just described, are doing nothing more than guaranteeing thier diabetic patients early deaths ... for no more reason than they refuse to educate themselves. People in general, tend to do as thier docs say. Take their docs word, as if it's the last and final word. Instead of going out and educating themselves. I, personally, never take a docs word as final. I MUST educate myself on things! Which is what lead me to this fine place! :0)

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An HbA1c of 5.8 is acceptable and not indicative of diabetes according to the various people, organizations, and agencies who make the dignosis criteria. That being said, you are getting close to the upper limit. That explains why the ADA says your numbers are in the Pre-Diabetc range.

 

What do you do with this bit of information? First of all, take a deep breath and recognize that you are not diabetic right now.

My recent A1c was 5.7. Does that mean I am not diabetic right now?

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Here's a chart that shows the relationship between A1c and your glucometer tests.

 

A1c chart

 

Holy cow! I finally have an appointment on Wednesday; I'm going to guess mine is going to be between 7 and 8....but then my dad often goes into 300s and 400s and his last one was 7.6 so maybe it won't be quite that bad....

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..... An HbA1c of 5.8 is acceptable and not indicative of diabetes according to the various people, organizations, and agencies who make the dignosis criteria. .....

Mmmm ..... HBA1c is not usually used to diagnose diabetes. But an HBA1c of 5.8% corresponds to average blood glucose of 129 mg/dl. This is higher than the fasting diagnostic benchmark of 125 mg/dl. And blood glucose is usually lower in the morning than it is during the rest of the day, unless of course if you are a diabetic with a strong DP. I know doctors consider an HBA1c of over 6% as diabetic, but I think it would be a mistake to say that an HBA1c of 5.8% doesn't indicate diabetes.

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Mmmm ..... HBA1c is not usually used to diagnose diabetes. But an HBA1c of 5.8% corresponds to average blood glucose of 129 mg/dl. This is higher than the fasting diagnostic benchmark of 125 mg/dl. And blood glucose is usually lower in the morning than it is during the rest of the day, unless of course if you are a diabetic with a strong DP. I know doctors consider an HBA1c of over 6% as diabetic, but I think it would be a mistake to say that an HBA1c of 5.8% doesn't indicate diabetes.

 

I am getting more confused by the moment. What does the Mean Blood Glucose mean on my Test? It says 117.8. They listed the AC1 as you say at 5.8. A chart I down loaded says that 117 range is 5.4. I am totally confused by the numbers, but I agree that it is a Diabetic reading and prone to get worse.

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Larry,

 

The 5.8 A1c is very good and most diabetics would be very happy with it. It does not mean that you are not diabetic. I know that you are diligent about your diet, carb watching, and daily exercise and these things are the reasons for the good A1c results.

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Larry, et al.,

 

I want to chime-in here on one side of the Diabetic/Pre-Diabetic debate -- there is the issue of age. If you visit Larry's profile you will find that he is over 65.

 

Since the inception of the Pre-Diabetic diagnosis (which was intended to capture the young people before they became Type-2 Diabetics) the vast majority of people being diagnosed as Pre-D's are over-50.

 

That being said, there are those (Dr. Bernstein, et al.) who hold that the bodily response to glucose must be exactly the same regardless of your age -- if you are 9 or 99 the criteria is exactly the same -- never over 120 and always-always-always rapidly returning to the low 70's after eating any amount of carbs.

 

The problem I have is that our bodies wear-out over time. The pancreas slows or diminishes in the ability to produce insulin. An inactive body also cannot use the amount of glucose that our society makes available to all people.

 

What I have noted in this thread is that when Larry works on his diet and exercise he manages to keep his BG levels in check albeit not in the perfect range of 70 - 120 at all times. I, like some others contributing to this thread, am concerned for Larry that his highs are quite high. However, as long as he can maintain an HbA1c of 5.8 without medications that is great!

 

I have no idea about Larry's potential life span, but it would seem to me that he is doing okay. Personally, I don't want to see Larry sacrificing quality of life in pursuit of what Bernstein, et al have set as the "perfect profile." Seeking perfection can, and usually does, lead to burnout.

 

Larry, you are doing great! Keep up the good work and don't worry about being perfect. A lot of what you are finding may simply be your age. If you can manage to keep your HbA1c levels where they are, or perhaps a bit lower, you will do fine. Remeber that "the enemy of better is 'BEST!'"

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Ronin,

 

Well thanks for the encouragement.. That is the essence of the support group for me. I think many of us come at this with slightly different ways of interpreting things. There are probably as many also on the net. My original feeling that seeing the results of my Glucose Meter was a fairly good reflection of what was going on was probably correct. Others come at it a little different. I will continue to have the AC1 test and see what is going on.

I also agree that if all I could ever eat was no carbs at all I probably wouldn't make it.. Moderation and eating things in quantities that allows the sugars to remain reasonable are my goals. When I see that something is amiss I try to reverse it to the best of my ability. Should I get to the point where I can no longer see readings that are tolerable I will most likely seek out medical help for that. I wish to avoid it as long as possible..

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I find the term "pre-diabetes" to be totally absurd. It's like saying you are a little bit diabetic. The treatment is exactly the same as it would be for the early stage of type 2 which is exactly what pre-diabetes is.

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Wiseguy, et al.,

 

The diagnosis of Pre-Diabetic is a poor choice. However, it is not an automatic "Early stage Type-2." It all goes to the underlying theory of how diabetes happens. We have the environmental theory that says what you eat can cause the onset of Type-2 diabetes. On the other side are the Genetic thinking people who beleive that your propensity towards diabetes in built into your geneitc structure and all you can do is delay the onset. Both sides have cogent arguments that make sense.

 

As I wrote earlier, the intended purpose of the Pre-Diabetic diagnosis (which is supported by the environmental argument) was to capture young people and stem the tide of childhood Type-2. The law of unintended consequences kicked in and thousands of people over 50 are being swept into this diagnosis. The result is a general panic in the over-50 crowd and some MD's handing out pills without really knowing how to treat diabetes and others telling their clients not to worry. The result has been more heat than light.

 

I can only use myself and a close friend as an example of the result of this diagnosis. The presumption of Type-2 has led MD's to assume that the individual, despite their diet and exercise regimines, are "Insulin Resistant" and that was done without a C-Peptide test. Both my friend and I have very low C-Peptide readings. Whoops, the drugs used to treat Type-2 are to increase insulin sensitivity and don't work on Type-1.5's and only cause problems on those of us with a low-functioning pancreas.

 

Larry has had an HbA1c at our prodding and has found his average BG levels to be "acceptable" in the perspective of controling BG levels for a diabetic. The next question (and the next test for you Larry) is what is your fasting C-Peptide level. If it is high then you are trending towards Type-2, if it is low you are trending towards Type-1.5. This is not a guessing game, it is a test that shows the direction you are headed and therefore tells you what you need to do to slow/prevent the onset.

 

I accept that my diagnosis as Pre-Diabetic is slippery, and I also accept that I am now a member of the diabetic community and as such have to live a life different from my fellow humans who are not diabetic (yet).

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Larry,

The A1C is good, not great, but still good, especially w/out meds. I think that maybe a few small tweeks to your excercixse regimen might do the trick. Working out after your biggest carb meal, (like starting 1-1/5 hours after your meal) might help.

 

the other thing is that your docs lack of knowledge is a little startling. thank goodness you have the sense to advocate for yourself. 200 is not fine, at anytime. He must be "old school". A pulmonary spec. not being to diagnose a heart issue?

 

if it were me, like we recommended before, i'd start looking for another doc - not just for the diabetes aspect, but just in case something else might pop up. Your doc seems like the take an aspirin and call me in the morning type.

 

are you too far from chicago or another metro area w/ good hospitals/docs?

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I am about two hours from any reasonably large metropolitan area. St. Louis being the closest.

So far no one has responded to the Mean Glucose I refereed to on my test results. From what I googled it appears to be a reference point that shows about 15% lower than your AC1 and is the average a person might see on their glucose meter.

Its surprising how many different times are suggested as the length after eating to test. That site said 90 minutes after eating?

Some times I just don't seem to get any relationship between what I eat and what I get on the meter? Last night we had a couple cups of onion soup, a little chicken and turnips an a few pieces of carrot. Low Carb ice cream and I walked and exercised for half and hour.. It came in at 138. Not bad but 20 or more points higher than I got for a sandwich and chips for lunch. It would seem that exercise in general can tend to raise your over all readings?

One benefit of using the Health rider more and for longer periods is that I actually saw a muscle when I flexed my arm while dressing this morning.. that looked good for an old guy!

On the Pre diabetic debate, I don't know what exactly to make of it. We aren't quite yet meeting the type II diagnosis as far as readings go. But yes the numbers come in higher than normal people for sure. When you read the literature, and Wise guy I know you do, then it would appear to say that a percentage of pre-diabetics go onto type II depending on diet and exercise. So does that mean that some won't? I admit mine seems to be creeping higher. I did also see a study last night that related to increased numbers in winter due to the increase in food and less ability to exercise as in summer.

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I am getting more confused by the moment. What does the Mean Blood Glucose mean on my Test? It says 117.8. They listed the AC1 as you say at 5.8. A chart I down loaded says that 117 range is 5.4. I am totally confused by the numbers, but I agree that it is a Diabetic reading and prone to get worse.
A Mean Blood Glucose means it should relate to a Mean Average of your Meter readings. Say you take all of you meter readings for the last 90 or 120 days and add them up and divide by the number of readings, and the result is a Mean Average of your Meter readings. The Charts you are looking at are a conversion of your A1c, a Weighted Average, to your Meter Average, a Mean Average. I use this to see if my meter checks are really giving me a true ballpark idea of what my blood glucose is doing. Sometimes it does not which means I am not enough of the highs or lows depending on the direction of the difference. In other words I may be going high or low while sleeping and not catching them with my meter.

 

You mentioned a difference between charts. It sounds like what you are looking at is a chart for Whole Blood Glucose and a chart for Plasma Glucose levels. Labs measure Plasma and Meters measure Whole Blood. Now the reason it gets confusing is Newer Meters are compensated to display equivalent Plasma readings. Check the booklet that comes with your meter to find out if it displays Plasma or Whole Blood. Then use the appropriate chart to compare your A1c to your meters Mean Average.

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To me if it looks like a duck, walks like a duck, and quacks like a duck... it's a duck. So called pre-diabetes requires exactly the same treatment (diet, exercise, and weight control) as early stage type 2 and it is for life like type 2. If you are diagnosed with pre-diabetes then you will have pre-diabetes your entire life? This is just ridiculous. I have yet to find a study (I don't think one exists) that would provide an estimate on the percentage of those diagnosed with pre-diabetes that are at some later time diagnosed as type 2. I'm willing to bet that the percentage would be very high.

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