a1c test

After my last post have had  2 a1c tests 5 months ago fasting bs 122 a1c 6.4 and hgb a1c 8.0, doc wanted me to go on meds I did not. Tried diet and excersise. Lost 14 pounds . (STILL HAVE A WAYS TO GO ON THE WEIGHT)  most recent blood results were fasting 114, a1c 6.2 hgb a1c (6 months average) 7.7. ,Doctor still wants me on meds.  really want to stay on diet and ex. program. what do you think. PS still get that light headed wobbley feeling once in a while. thanks for the help, new at this

[WaveRider]

OK, let's first do some analysis of your A1c levels and what they equate to on a daily estimated blood sugar level [eAG].

1. Five months ago it was 6.4%. This equates to an eAG of 137 mg/dl
2. Then you say "a1c 8.0". This equates to an eAG of 183 mg/dl.
3. Recent is 6.2%. This equates to an eAG of 131 mg/dl.
Normal A1c is <5% or an eAG of <99 mg/dl. As you can see you still have a ways to go.

You have the correct mindset by using diet and exercise to help lower your blood sugars. I cannot speak for your doctor but can assume that he/she feels your levels are not lowering the way they should.

Constant high blood sugar levels compounded by excessive weight is hard on your kidneys and cardio system. This may be the reason behind doctor suggesting medication. Medication helps to lower your levels along with diet, exercise, and maintaining normal body weight. Normal Lipid panels play an important role too. You may give medication a try to see if it does help. If it does, and you obtain normal A1c values with medication and a healthy lifestyle, then there is no reason to continue the meds. But by all means continue with the healthy lifestyle. Good luck -

[hobss57]

had the light headed wobbly feeling to day at work toke blood pressure 117/77 blood suger 112  ate felt better 2 hours later toke bs 114.

[WaveRider]

OK, let's first do some analysis of your A1c levels and what they equate to on a daily estimated blood sugar level [eAG].

1. Five months ago it was 6.4%. This equates to an eAG of 137 mg/dl
2. Then you say "a1c 8.0". This equates to an eAG of 183 mg/dl.
3. Recent is 6.2%. This equates to an eAG of 131 mg/dl.
Normal A1c is <5% or an eAG of <99 mg/dl. As you can see you still have a ways to go.

You have the correct mindset by using diet and exercise to help lower your blood sugars. I cannot speak for your doctor but can assume that he/she feels your levels are not lowering the way they should.

Constant high blood sugar levels compounded by excessive weight is hard on your kidneys and cardio system. This may be the reason behind doctor suggesting medication. Medication helps to lower your levels along with diet, exercise, and maintaining normal body weight. Normal Lipid panels play an important role too. You may give medication a try to see if it does help. If it does, and you obtain normal A1c values with medication and a healthy lifestyle, then there is no reason to continue the meds. But by all means continue with the healthy lifestyle. Good luck -

[hobss57]

thanks,  why are the a1c 6.2 and the hbga1c 7.7 so far apart. doc says normal range for  hbga1c is 3.9 to 7.4

[WaveRider]

" why are the a1c 6.2 and the hbga1c 7.7 so far apart."

Unsure of what you're asking. Your first post has, "a1c 6.2 hgb a1c (6 months average) 7.7." but doesn't tell how you arrived at 7.7. Also, you don't average A1c's unless you are saying the 7.7% was 6 months after the 6.2%. Needs claification.

You might want to question your doctor why he/she feels an A1c of 7.4% is normal as 7.4% equates to an eAG of 166 mg/dl, unacceptable.

[hobss57]

Each  time he does my blood work  for diabetes he gives me two numbers, a1c three month av. and a hgb a1c six month av., thats why the two numbers, 6.2 being the 3 and 7.7 being the 6. his lab chart says for the six month hgb a1c  3.9-74.4 is normal range. I am confused.

[WaveRider]

Me too! I have never heard of an 6 month average. Is your doctor an Endocrinologist, a diabetes specialist? I'll call my medical contacts 2morrow and get back with you.

[hobss57]

no he is not, thanks for the help

[WaveRider]

Here's where the confusion lay's. The A1c [HbA1c] and hemoglobin [hgb] are two separate tests. To help clarify the confusion, the tests in a nutshell.

The A1c is determined by measuring the percentage of glycated hemoglobin, or HbA1c, in the blood looking back 2-3 months. It would be impossible to come up with a 6 month A1c average looking forward.

Your doctor may perform a hemoglobin test [hgb] if you're experiencing weakness, fatigue, shortness of breath or dizziness. These signs and symptoms may point to anemia or polycythemia vera [bone marrow issues]. He/she can check hemoglobin variability by calculating the 1 month and 2 to 6 month rolling average hemoglobin for each patient.

If still unclear, contact your doctor for clarification.

HTH

[hobss57]

THANKS WaveRider so a 7.7 hgb-a1c isnt that far out of the norm???

[WaveRider]

You are speaking about an A1c of 7.7%  not hgb [hemoglobin], right?

Normal hemoglobin results vary, but in general are:
Male: 13.8 to 17.2 gm/dL
Female: 12.1 to 15.1 gm/dL

If A1c, well, it is far out of the norm when you consider 7.7% on a daily basis equates to 174 mg/dl, close to twice the normal maximum of 99 mg/dl.

The ADA [American Diabetes Association] has "An A1C 5.6% or below is normal. In prediabetes, A1C levels range between 5.7%-6.4%. If the A1C is 6.5% or above, a person has diabetes."  This range is 114 mg/dl - 137 mg/dl, high in my books, considering t2 diabetes begins at 126 mg/dl. Your optimum goal is <5%, if not strive for <5.6%.

Remember, your home glucose test meter is a very good friend. It doesn't lie and tells you the truth. Know your testing times and test often. Know the foods and drinks to avoid, and exercise 30-60 mins daily. And, maintain a healthy normal body weight too.

[hobss57]

Thanks again , lots of work to do. Still not going to take meds ,if I can not in prove more  in three months then I will have to.

[WaveRider]

Good luck. Down the road post back if questions arise. Also, give us an update on how you're doing. It's a challenging battle but it's one that I know you can win.

[nursegirl6572]

I think another 3 months is reasonable, but at that time, if your doc recommends meds, I would follow his lead.

Like waverider said, you can always continue with the lifestyle changes, and d/c the meds down the road if you are well managed with diet and weight manangement.  It's important (for the reasons wr mentioned) not to let this go unchecked for too long.  By unchecked, I mean, above the norm without medications to get you to a more acceptable level.

Please do keep in touch!