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mwahal

Total Glycohemoglobin (GHb) vs Hemoglobin A1C (HGB A1C)

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mwahal

Hi all,

 

I was referred here by a long time user. I have a question about "Total Glycohemoglobin" and "Hemoglobin A1C". I read on the webmd and other places. Seems like both are measuring the avg of the blood sugar over a period of 6-8 weeks.

 

My A1c numbers for Jan 09 was 6.0, April'09 was 5.9 and then suddenly 7.2 in september'09. My jan'10 numbers were also 7.2. I got 3rd degree treatment from my PCP both times that how I let this happen -- jump from 6 to 7.2 . If I dont manage, she may have to give me more medication. I am on Janumet 50/500 since 2008, twice a day. Since my numbers were good in jan and april, I switched to 1 tab a day after jan 09. Since sept was 7.2, I sort of paniced and went in 2 tab mode again along with more strict diet and little bit more excercise. The jan '10 numbers were also 7.2, though trigly had dropped to 160 and HDL had jumped to 45. My PCP was still on my case left and right that how did you let it go up to 7.2. All along my fasting numbers were between 85 and 99.

 

Today I checked my jan 09, apr 09 and sept 09 reports (I dont have a copy of my jan 10 report). I was looking at the A1c numbers and fasting numbers.

 

Seems like that my lab switched from Hemo A1C to Total Glycohemoglobin in september. Suddenly the numbers are different ! The normal range for HGB A1C for healthy adult is 4.8 to 5.9%, 6-7% risk of diabities and 7%+ is diabetic. The normal range for Total glycohemoglobin for healthy adult is 3.9 to 7.3, 7.3 to 9 is risk and > 9% is diabetic.

 

Since the test is different, the numbers will differ. My PCP should have caught it and advised accordingly. Since my jan '10 report didnt have A1c numbers when I met her, she got the numbers later and left on my voicemail. The message and tone she left sort of created a panic/turmoil since last 3 weeks. Strict carb counting, daily 1hour gym, not that I'm complaining :) .. Lost 4 lbs in 3 weeks.

 

Just wondering if anyone had similar experiences. Also, with these numbers, should I be even taking any medication ? Since reducing/cutting dose didnt make any difference. I'll be more stricter in carb/calorie counting and maintain regular gym, that is not going to change.

 

Thanks

Mudit

 

References

WebMD Total Glycohemoglobin-GHb

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mwahal

I did talk to her and I dont think she is admitting mistake. She is telling me that it should be below 6.5 for diabetic. I remember she said exact same thing when I used to get Hemo A1C test that keep it below 6.5. I think if she admits, its invitation of law suit.

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REDLAN

I have found a Diabetes Care abstract where they compared GHB to HbA1c.

 

In normal individuals GHB and HBa1c were very similar. In people with diabetes, the GHB value was about 25% higher than A1c. This is almost exactly the increase you experienced. A 25% increase of 5.9 works out to be 7.3. Seems your doctor should allow for this.

 

[For your next visit you could print off the abstract and show her - should stop her trying to persuade you to take unnecessary medication]

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mwahal

@Redlan

 

Thanks for the information -- so basically I'm still at 5.9 though I should work it to get it towards 5.5 or lower.

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Satish

My blood test results today had the following clarification for my HbA1c numbers:

 

=== StartQuote ===

On September 6, 2005, Quest Diagnostics changed the calculation based on Hemoglobin A1c from an estimation of mean whole blood Glucose to an estimation of mean plasma Glucose. This was done at the recommendation of the American Diabetes Association. Mean plasma Glucose levels will be generally 10-20% higher than mean whole blood Glucose levels.

GlycoHemoglobin A1c (HbA1c) reference ranges: <6 (non-diabetic), <7 (goal), 8> (additional action suggested)

=== EndQuote ===

 

My HbA1c today was 9.1, which is high. But I started measuring my blood glucose exactly a week back, even though I have been taking Metformin for 3 years now. With dietary changes alone I have seen my glucose numbers drop in one week. (Fasting 103-108, and 2 hour after a meal to 120-147 range. Feedback is a wonderful thing!) Now I need to add 30 minutes of exercise 5-7 times a week. I am already looking forward to my next HbA1c test. :)

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