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Jonathan_R

A really close way to calculate A1C yourself

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I've tested this against ACCU-CHEK: A1C calculator and it's with in 100th of a percent close.

 

(BGL+77.3)/35.6

 

Reference: Calculating A1c from average BGL

 

The formula I posted is the closest, and the best one I have found. That is, with out getting overly complex. I saw some ones where you needed a med degree to work it.

 

Don't I wish!

 

96 + 77.3 =173.3 173.3/35.6 = 4.867

 

Actual A1c 5.4

 

Here are some of my actual numbers and A1c's

 

138 A1c 6.9

99 A1c 5.7

96 A1c 5.4

90 A1c 4.9

 

All I can say is If I know my average, I can predict my A1c within .1

 

-Lloyd

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Don't I wish!

 

96 + 77.3 =173.3 173.3/35.6 = 4.867

 

Actual A1c 5.4

 

Here are some of my actual numbers and A1c's

 

138 A1c 6.9

99 A1c 5.7

96 A1c 5.4

90 A1c 4.9

 

All I can say is If I know my average, I can predict my A1c within .1

 

-Lloyd

 

I used this, ACCU-CHEK: A1C calculator to check my work. The problem is, it only goes as low as 100.

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I used this, ACCU-CHEK: A1C calculator to check my work. The problem is, it only goes as low as 100.

 

That's because an AVERAGE reading of below 100 isn't healthy for anyone. From the calculator, you can extrapolate that a non-diabetic A1c is anything less than 5.9%, so I'd daringly suggest there's actually no benefits to pushing for anything lower than that.

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Jonathan, not sure what your aim is here. Is this a way to perform those rough calculations instead of use an online calculator like the one you mention? Or are you looking for "real" or "improved" accuracy to predict or replace A1c tests?

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It was very accurate for me, less than .1 difference. That's weird cause I think the number of measurements and the moments when you measure can make a pretty big difference in avg BG.

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Jonathan, not sure what your aim is here. Is this a way to perform those rough calculations instead of use an online calculator like the one you mention? Or are you looking for "real" or "improved" accuracy to predict or replace A1c tests?

 

It's so if your doing a log or spreadsheet or away from the computer/internet, then you can calculate your A1C. If I wanted "real" I would have posted the medical formula. I didn't feel to many would have understood it, so I didn't. Can't say it's "improved" either. It's just what I said.

 

My A1C, according to the formula, for the month of July, is 7.6351, which compared to the accu-check A1C calculator is pretty accurate. I only reference the accu-check calculator because I have their meter and to check the formula. That's it.

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Ah I see... thank you for clearing that up. Fair enough if you want indications away from the internet. But, as mentioned, there is one problem with any A1c calculation based on BG tests - and that is that there is no guarantee of a representative scatter, of actual blood sugar over the period, from the tests. That simply cannot be guaranteed. As long as that's clear... it's just part of the mathematical reality if the data - there are variables you simply cannot account for.

 

That doesn't mean it's necessarily "useless" to do so, I am not disparaging your thread or idea. Just that, just as warned at the Accucheck site, none of these extrapolations are to be taken as anything more than a potential indication of what an A1c test might actually be. It could be really accurate this time. It might be less so next time.

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Ah I see... thank you for clearing that up. Fair enough if you want indications away from the internet. But, as mentioned, there is one problem with any A1c calculation based on BG tests - and that is that there is no guarantee of a representative scatter, of actual blood sugar over the period, from the tests. That simply cannot be guaranteed. As long as that's clear... it's just part of the mathematical reality if the data - there are variables you simply cannot account for.

 

That doesn't mean it's necessarily "useless" to do so, I am not disparaging your thread or idea. Just that, just as warned at the Accucheck site, none of these extrapolations are to be taken as anything more than a potential indication of what an A1c test might actually be. It could be really accurate this time. It might be less so next time.

 

Exactly right. An A1C is supposed to be an average of many blood sugar levels anyway. The more, the better.

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That's because an AVERAGE reading of below 100 isn't healthy for anyone. From the calculator, you can extrapolate that a non-diabetic A1c is anything less than 5.9%, so I'd daringly suggest there's actually no benefits to pushing for anything lower than that.

 

Even the ADA acknowledges that lowering one's A1c below 6% may reduce the risk of suffering microvascular complications; the ADA recommends 7% out of concern that diabetics striving for "normal" A1cs run too high a risk of hypoglycemia. Defending ADA's A1c Target:

It is important to be clear about exactly what each group maintains in its published guidelines. AACE states simply that its goal is ≤ 6.5%.1 ADA not only states that its goal is <7%, but also notes that it is critical to include the following “key concepts in setting glycemic goals”:

 

The goals should be individualized.

 

Certain populations such as the elderly, young children, and pregnant womenrequire special considerations.

 

Less intensive goals may be appropriate in those with a history of significant hypoglycemia or hypoglycemia unawareness.

 

More stringent goals (i.e., a normal A1C of <6%) may further reduce the risk of microvascular complications at the cost of increased risk of hypoglycemia.2

 

ADA suggests that one should strive for the lowest A1C appropriate for the patient based on these concepts.

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Even the ADA acknowledges that lowering one's A1c below 6% may reduce the risk of suffering microvascular complications

 

Precisely. What I'm saying is that once you've got an A1c below 6%, there's no point trying to drive it any lower. If your A1c is 5.9, there's no point whatsoever in trying to get it down to 5.2% or whatever.

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Exactly right. An A1C is supposed to be an average of many blood sugar levels anyway. The more, the better.

 

Well, kind of... but not really. I feel like we are chasing around a bush or something a bit here... I'm just going to go back to basics if that's ok...

 

HbA1c is a test that measures the amount of glycated hemoglobin in your blood. Glycated hemoglobin is a substance in red blood cells that is formed when blood sugar (glucose) attaches to hemoglobin.

HbA1c: MedlinePlus Medical Encyclopedia

 

It's specifically measuring the state of elements your blood. The result is something that once translated, correlates to an average blood sugar. And a figure we can take meaning from in itself.

 

So, yes you are right, that a HbA1c result indicates an average blood sugar level for the last three months.

 

But, lots of blood sugar levels extrapolated into a potential HbA1c result, is not an "A1c". That process can only ever be approximate (whether close or not), given pretty much any reasonable use of BG testing. It just can't replace the real thing. And without the real thing, you can't really check how closely it predicts the mark.

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Precisely. What I'm saying is that once you've got an A1c below 6%, there's no point trying to drive it any lower. If your A1c is 5.9, there's no point whatsoever in trying to get it down to 5.2% or whatever.

 

Three advantages are gained when you have very tight control (low standard deviation and a low A1c).

 

1. When you make a mistake, your numbers are still ok.

If I forget to take my metformin at a meal, for instance, 2 hours later I will be 120 to 125, instead of about 90 - 95. Still ok.

 

2. Meal spikes don't take me over 140, usually.

 

3. High variability, in and of itself, is an increased risk for complications.

 

I'm a little bit low, in the 60's, 2% of the time. In the 50's only about twice a year.

 

Non-diabetics go in the 60-s, as tests with a continuous glucose monitor reveal.

 

My average of 96 is perfectly safe for me, my doctor agrees.

 

For a volatile T1 likely it would not be a good idea to go that low, as they would be likely to suffer from hypoglycemia.

 

-Lloyd

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Three advantages are gained when you have very tight control (low standard deviation and a low A1c).

 

The advantages are purely from a low standard deviation rather than a reduction in A1c. If you have a low standard deviation and an A1c of 5.9, there are no benefits to reducing that A1c any further.

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Last I met with my endo, they did not want me below 200. I have a tendency to crash when below 200. Or at least I used to. Because of this board, I am getting better. This month is off to a rough start, but I'll get it. Currently, my standard deviation is 350. That's right, 350. In the last couple days I have had 3-4 hypoglycemic attacks, and several spikes (usually following the hypos).

 

I am finding out that excersize make a huge difference in my insulin sensitivity. My average is still 205, but that's because of rediculas lows. I am also finding out that I am incredibly sensitive to any sort of change. It has huge impacts on me, and lasts for days.

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The advantages are purely from a low standard deviation rather than a reduction in A1c. If you have a low standard deviation and an A1c of 5.9, there are no benefits to reducing that A1c any further.
Such an absolute statement -- do you have absolute proof?

 

Purely from a common sense point of view I would argue that there is a good reason why the fully function BG management system in a healthy body works to maintain the BG within a given range... that range would -- I understand -- result in an A1c closer to 5% than 6%

 

Of course that may not be achievable for everyone with D... maybe it is harder for some with Type 1 than Type 2... and yes there is a risk of hypos when using insulin... and yes tighter control can be too onerous for some to manage... BUT the YMMV rule implies that what does not work for you may work for others.

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Purely from a common sense point of view I would argue that there is a good reason why the fully function BG management system in a healthy body works to maintain the BG within a given range... that range would -- I understand -- result in an A1c closer to 5% than 6%

 

From a common sense point of view, I would argue that a non-diabetic A1c would be healthy full stop. Wouldn't you? That's the where I'm deriving my proof.

 

The point of any diabetes treatment regime is to achieve as near normal blood sugar levels as possible - because people with normal blood sugar levels do not experience complications relating to their blood sugar.

 

So if you have what is classed as a non-diabetic A1c with a tight standard deviation, then congratulations - you've achieved normal blood sugar levels. Job done.

 

The question of acheivability doesn't even come into it and I don't know why you're even bringing it up. Do you not agree that if you have non-diabetic BG levels, you have essentially eliminated the risk of high-blood sugar related complications?

 

Of course, this only works if we agree that 5.9 is indeed an acceptable non-diabetic A1c (and I have absolutely no doubt you don't agree). But if we do (or accept another arbitrary figure), then logic dictates there's no point for someone with diabetes with a non-diabetic A1c to strive for a even lower one.

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This has nothing to do with picking some arbitrary level.

 

So you maintain that an A1C of 5.9% -- with minimal deviation -- is the normal healthy non-diabetic level? Can you please cite some research which backs up this figure because unless you can prove that point, I still don't see how you feel justified in making such absolute statements as "there are no benefits to reducing that A1c any further".

 

Try doing the math: 24 hours in a day, 3 meals a day, BG spike at a conservative maximum of 140mg/dl for a conservative 8 of those 24 hours, the other 16 hours lets use a very conservative 100mg/dl... that comes to an average/mean BG of 113mg/dl or an A1C (according to the converter here on DF) of 5.4% and that is using conservative numbers which I am convinced -- from my own reading -- are too high for a normal healthy non-diabetic.

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So you maintain that an A1C of 5.9% -- with minimal deviation -- is the normal healthy non-diabetic level?

 

No, Accu-Chek does. Read the whole thread, not just little snippets that catch your eye.

 

From the calculator, you can extrapolate that a non-diabetic A1c is anything less than 5.9%, so I'd daringly suggest there's actually no benefits to pushing for anything lower than that.

 

There you go.

 

from my own reading -- are too high for a normal healthy non-diabetic.

 

Given your evidently selective reading habits, I'd wager that this isn't exactly proof of the need for a lower A1c. We've already discussed that people without diabetes can in fact have quite elevated BGs shortly after consuming carb dense foods so I'm not even convinced that non-Ds actually have minimal standard devations, especially since the insulin release mechanism in people with diabetes is based on a feedback loop that requires elevated BG.

 

Finally, you're obscuring the point I'm making. Once again, I'm arguing that there's no real point aiming for an A1c lower than the top end of non-diabetic. Fine, let's take 5.4 as the cut-off point instead of 5.9. So in that case, I'm saying once you have an A1c of 5.4, there's no point actively trying to get it any lower.

 

Admit it, your real issue is with the numbers suggested by the calculator, but because you're feeling personally aggrieved by the fact I don't agree with you that low-carb is the only way for everyone (odd how suddenly you're trying to bring YMMV into this all of a sudden), you're trying to shoot me down for simply reporting what a calculator written by someone else said.

 

Are you honestly saying that someone with diabetes with a non-diabetic A1c needs to improve their BG control? Because my position consistently through this is that they don't, and yet you seem to disagree.

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Please let's keep this civil and refrain from the personal snipes such as "selective reading". I may be raising objections to your arguments but I believe I have made no personal observations about the way you make them.

 

---

 

Are Accu-Chek now the final arbiters in all things BG related?

 

Finally, you're obscuring the point I'm making. Once again, I'm arguing that there's no real point aiming for an A1c lower than the top end of non-diabetic. Fine, let's take 5.4 as the cut-off point instead of 5.9. So in that case, I'm saying once you have an A1c of 5.4, there's no point actively trying to get it any lower.

 

I am not trying to obscure your point -- my objection is how you feel justified in making such an unambiguous, unequivocal and absolute statement as "there are no benefits to reducing that A1c any further". You were the one who used 5.9% as the cut-off point -- are you now allowing that perhaps there is some room for flexibility here?

 

We clearly do not have substantial data to be able to say unequivocally what is the healthy non-diabetic A1C level -- this is why I raised an objection to your statement being absolute while based on an unknown.

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Of course I can accept the statement "...there's no real point aiming for an A1c lower than the top end of non-diabetic" my objection is to what that level is.

 

We've already discussed that people without diabetes can in fact have quite elevated BGs shortly after consuming carb dense foods so I'm not even convinced that non-Ds actually have minimal standard [deviations]...
I am included in this "We"..? I don't see such a discussion here in this thread nor do I recall being in one previously? I do recall threads where this has been discussed and what sticks in my mind are posts from people such as PrincessLinda who test her husband on occasion... IIRC his BG seems to stubbornly refuse to spike no matter how much sugar he eats.

 

For the sake of suggesting a reasonable non-diabetic pattern I would draw your attention to this graph posted previously by BlueSky

 

2070d1173679093-normal-blood-glucose-graph-cgms-normal.jpg

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I had an a1c of 4.5 once. I got bilaterally cellulitis on my arms from receiving 3 amps of D50 during one of my 3 ER visits for hypoglycemia that year. I wish people would stop focusing so much on ultra-low a1cs as the gold standard of control.

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I had an a1c of 4.5 once. I got bilaterally cellulitis on my arms from receiving 3 amps of D50 during one of my 3 ER visits for hypoglycemia that year. I wish people would stop focusing so much on ultra-low a1cs as the gold standard of control.
I am sorry that you had problems but are you saying that it is impossible to achieve a normal A1C without hypos?

 

Where in the above posts do you see the term "ultra-low a1cs"?

 

Surely IF a normal A1C can be achieved without hypos or obsessive control then it is something worth striving for?

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On the discussion about non-diabetic folks and post-prandial spikes

At a diabetes technology conference a few years ago, I saw a "presentation of concept" for a three day continuous (actually every 15 minutes) glucose meter.

In a preliminary trial with healthy adults with perfect glucose metabolism: BMI under [25], FBG under 100, two hour glucose on a 100 gram GTT under 140, who then wore the monitor: 80% of the readings were under 100, and none was over 140. That is 20 hours out of 24. That is, within an hour or just a little more, after every meal the glucose was back down under 100.

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