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Carol_42

Fasting Scores vs A1C Scores

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Carol_42

Now I'm going to really show my ignorance.  I'm at that predicament right now where the more I learn about diabetes, the more I realize I don't know.  I've been at this forum for about a week now, listening and internalizing all the excellent comments that are presented.  I hear terms like, "eat to your meter", along with lots of talk about Fasting scores, & GB testing and watching carbs and fats.  And I brush my forehead with a big, "Whoosh".

 

I'm confused.  I see Fasting scores and A1C scores as two variables of this disease.  Apparently they are different and have their own personalities and concerns.  Right?  If I use the glucose meter and test strips, will that give me only A1C scores?  If so, then how do you arrive (or test) for Fasting scores?  And what exactly does Fasting scores mean?

 

I'm pre-diabetic (A1C 5.9).  Should I be concerned with Fasting scores?  My self-talk keeps reminding me to concentrate mostly on walking and losing weight, but to also concentrate of watching what I eat and portion size.

 

I feel like I'm a little frustrated today.  Maybe it's the weather.  It's been raining for days.  May we all have an excellent week.

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Cora

You bg (blood glucose) meter will give you your  bg level. And a1c is worked out in the lab. It is a %. It represents the % of your hemoglobin cells that have glucose stuck to them (sugar is sticky and sticks to things). A non-diabetic person has a percentage in the 4s or low 5s. There is a complex calculation involved in converting the a1c percentage and that bg number will represent an average of what your glucose has been for the last 3 months (the life span of a hemoglobin cell). It is a bit more heavily weighted towards the last 6 weeks.

 

Using the calculator under the "tools" at the top of the page, your a1c of 5.9% means (roughly - it's not absolutely accurate) that your average blood sugar over the last 3 months has been about 132. This means that some of the time you are lower than this, but that also, you are often higher than this, which is not entirely "normal".

 

Keep asking those questions. You will get it all sorted out soon enough.

 

 

eta:  to my mind, you should worry a bit more about after meal numbers, rather than fasting. The pp (post prandial = after meals) numbers will affect your a1c more and will also give you a better idea of how well you are actually doing. The carbs in the meal will affect your bg and often your fasting is the last to go out of whack.

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samuraiguy

Fasting blood glucose is tied directly to A1C in that it is the time you should spend most of the day and is why non-diabetics average an A1C of 5 (under age 40), because no matter how many carbs they consume they are back to baseline (under 90 mg/dl) within 2-3 hours and their FBG averages under 85 mg/dl consistently. If you want to get your A1C lower then the closer you can get your numbers, especially FBG, to match non-diabetic numbers the better.

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Hammer

Your fasting glucose level is the reading you get on your meter when you have been fasting for at least 4 hours.  When you haven't eaten for at least 4 hours, there is no food that is being digested and released as glucose into your bloodstream.  Since there is no "extra" glucose being released into your bloodstream from food, that just leaves glucose that your liver is constantly releasing to give you energy.  That glucose level is what is considered a baseline level since that amount of glucose is the level that is being maintained in your bloodstream when you haven't eaten anything for at least 4 hours.  Since a type 2 diabetic is insulin resistant, that fasting glucose level remains higher than a non-diabetic's fasting glucose level because a non-diabetic isn't insulin resistant, and that allows the non-diabetic's blood cells to take in more of the glucose that is in their bloodstream.  Insulin is required to transfer glucose from the bloodstream into the blood cells, but if you are insulin resistant, not all of the insulin that is being released is used properly, so some of that glucose floating around in your bloodstream is unable to transfer into the blood cells.  This extra glucose that is floating around in your bloodstream is the high reading you get on your meter when you do a finger prick test.

 

The A1C test is an average of the glucose levels in your bloodstream over a 90 day period.  An average means that it is a mix of every fluctuation in your glucose levels....from the highest to the lowest, and everything in between over a 90 day period.  When you do a finger prick test to check your glucose levels, you are only seeing one reading in one second in time, not over a 90 day period.  If you test 30 minutes later, you will get a different reading.  Since an A1C test measures all of the varying levels of your glucose levels over a 90 day period, it is a better indication of what's happening to your glucose levels on a continuing basis.

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dowling gram

You have some good replies explaining the difference between fasting and A1C. Eat to your meter means--You test before you eat and then at 1 hour and at 2 hours. The before gives you a baseline, 1 hour should give you the highest reading and at 2 hours you should be close to your baseline. If it isn't then go over what you ate that had a lot of carbs and cut down or eliminate it from your diet. If you eat too many carbs it may take 3 or 4 hours for your blood glucose to come down

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Carol_42

Wow and gulp!  Me thinks I will need to read and reread these messages over and over a few times.  Spoken with timidity, "Thank you".

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jwags

You use your meter to do fadting and after meal bgs. This is how we manage our diabetes day by day. My goal is fastings 80-100 and after meal bgs 100-130. Your HbA1c is a lab test that gives you a 3 month average of glycation. although there is a convention chart, my HbA1 c rarely correlates with my meter averge. I think I am just a high glycator. Mine always comes in much higher.

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Fraser

Sorry but I disagree you the definition of fasting BG seen here. Fasting BG is when you have not eating anything for at least 8 hrs,

Which could be over night (like first thing in the morning, or any time you have not eaten for at least 8 hours.

Anything other than that is a random BG reading, ( meaning non fasting) . You can do a random test before meals and at period of times after.

Only true fasting numbers are used to dx diabetes.

 

That is what I was brought up to beleive.

 

Another note A1c test have been traditionally done in a lab. But with the new generation test kits they can be done at home or in a doctor's off ice without a lab.

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meyery2k

cb - There is a lot to learn but the good news, is you have a lot of time to learn it.  While ignoring diabetes can prove to be a fatal mistake, it takes a long time for it to do the damage.

 

The meter takes a snapshot of what is happening right now.  This is good for testing after you eat and when you first wake up because it lets you see what is happening right now. 

 

The A1C, on the other hand, gives an overall approximation of what your BG has been for the past 90 days or so.

 

Both are important.  It is entirely possible to have a good A1C number and yet be spiking after meals to toxic levels of glucose for short periods of time.  Both are used to help determine how well diabetes is being managed.

 

It is really a case of the right tool for the right job.

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LaRue

Sorry but I disagree you the definition of fasting BG seen here. Fasting BG is when you have not eating anything for at least 8 hrs,

Which could be over night (like first thing in the morning, or any time you have not eaten for at least 8 hours.

Anything other than that is a random BG reading, ( meaning non fasting) . You can do a random test before meals and at period of times after.

Only true fasting numbers are used to dx diabetes.

 

That is what I was brought up to beleive.

 

Another note A1c test have been traditionally done in a lab. But with the new generation test kits they can be done at home or in a doctor's off ice without a lab.

 

However Fraser, my fasting BG, while eating keto, will be under 100 anytime I go 8 hours without eating, Except for my morning BG, due to DP. So not all "true fasting" numbers are equal.

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Fraser

Sorry I did not. mean all fasting numbers were equal, just all fasting numbers need to include 8 hours or more with out eating.

Whether it be in the morning or late afternoon., as I mentioned.

Obviously for you a fasting test may be more accurate later in the day.

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Kit

However Fraser, my fasting BG, while eating keto, will be under 100 anytime I go 8 hours without eating, Except for my morning BG, due to DP. So not all "true fasting" numbers are equal.

 

Actually in my mind, that is precisely one of the reasons for testing first thing in the morning, to see what kind of jump DP may be adding to that morning number.

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Hammer

Wow and gulp!  Me thinks I will need to read and reread these messages over and over a few times.  Spoken with timidity, "Thank you".

Cbokay, that's why we're here, to try and answer any questions you have.  If we say something that you don't understand, say so and we'll try to explain it better.  We are here to help. :)

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Carol_42

Cbokay, that's why we're here, to try and answer any questions you have.  If we say something that you don't understand, say so and we'll try to explain it better.  We are here to help. :)

It's 3:00 a.m. and I am up and wide awake.  I'll be so glad when I get this sleep apnea hours back to normal.   

 

I've been rereading all these messages again.  And I've decided to order the Relion (sp) meter and strips from Walmart today.  Just our of curiosity, do insurance companies pay for glucose meters?  My doctor (soon to be replaced) is allowing me until April 11th to get my weight and A1C levels down a tad. 

 

Can A1C levels go down or up (substantially) within 3-months?  I thought this disease was slow progressing.  Maybe I've missed something.

 

Thank you everyone for being there.

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Carol_42

cb - There is a lot to learn but the good news, is you have a lot of time to learn it.  While ignoring diabetes can prove to be a fatal mistake, it takes a long time for it to do the damage.

 

The meter takes a snapshot of what is happening right now.  This is good for testing after you eat and when you first wake up because it lets you see what is happening right now. 

 

The A1C, on the other hand, gives an overall approximation of what your BG has been for the past 90 days or so.

 

Both are important.  It is entirely possible to have a good A1C number and yet be spiking after meals to toxic levels of glucose for short periods of time.  Both are used to help determine how well diabetes is being managed.

 

It is really a case of the right tool for the right job.

Yee-gads, will I ever get it?  I am so perplexed right now.  I'm getting ready to order the meter from Walmart.  When I receive it, I'll be here for guidance.

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jwags

Yes, HbA1 c's can go up or down. Sometimes if it goes up you may need to add more med or change your diet or exercise. I like to keep my fasting below 100.

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Seagal

The meter & strips are used daily to monitor your blood glucose (b.g.) (eat to your meter).

 

Your A1c (lab blood test or Home A1c test) will be a result of what your system has done for three months.  As Cora said, heavily weighted in the last six weeks.

 

You will/should see a difference in your A1c when you have your labs done in April, IF you make dietary changes from pre-dx.

 

Try not to be overwhelmed, we have all been where you are now.  One day soon, you will be answering questions and helping a newly dx. :five:

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meyery2k

Yee-gads, will I ever get it?  I am so perplexed right now.  I'm getting ready to order the meter from Walmart.  When I receive it, I'll be here for guidance.

Cb - You are doing great.  Your questions show that you are serious about understanding this.  We have all been where you are now.  You will soon be an expert as to how you work.

 

A1C can change very quickly (over a few months).  There are many posts where people were first diagnosed at 12 and within 3-6 months had it down to 7 or below.  When I was first diagnosed, my A1C was 8.5.  Within 3 months I had it down to 5.5 IIRC.

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Moonpie

It's 3:00 a.m. and I am up and wide awake.  I'll be so glad when I get this sleep apnea hours back to normal.   

 

I've been rereading all these messages again.  And I've decided to order the Relion (sp) meter and strips from Walmart today.  Just our of curiosity, do insurance companies pay for glucose meters?  My doctor (soon to be replaced) is allowing me until April 11th to get my weight and A1C levels down a tad. 

 

Can A1C levels go down or up (substantially) within 3-months?  I thought this disease was slow progressing.  Maybe I've missed something.

 

Thank you everyone for being there.

Yes insurance should cover the meter & strips, but you may have to get the D dx not a pre D dx. 

Yes, A!C can show a change in 3 months, becasue it is an aggregate of the precious 3 months..

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