June 23, 2009

A1C Measure Replaces Glucose to Diagnose Diabetes and High Risk

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For years the way to diagnose diabetes has been to draw a blood sample and check the glucose count, either fasting or random (any time of day). Two high levels on two different days and the diagnosis of diabetes was made. Glucose tolerance tests went by the wayside years ago other than for diagnosing gestational diabetes.

A dramatic recommendation from an International Expert Committee to use A1C (the long term measure of glucose control) instead of glucose measures to diagnose diabetes was recently announced at the American Diabetes Association meeting (June 2009).

The A1C line in the sand:

Diabetes: Greater than or equal to 6.5% defines diabetes. (See FAQ How is Diabetes Diagnosed?)

High risk for diabetes: Between 6.0 or less than 6.5%. (See FAQ What is meant by pre-diabetes?)

Why the change? When these experts scoured the research they determined that A1C provides a better read on how long the body has been exposed to elevated glucose levels. (Keep in mind glucose doesn’t rise overnight – this is a multiyear process with overweight and insulin resistance being the instigators. (Read Stop Type 2 in Its Tracks to learn more. In fact, numerous studies have shown that people with mildly elevated glucose levels for several years have already developed signs of diabetic eye disease (retinopathy). Other reasons? A1C is a simpler test and generally more convenient for you and your healthcare provider to complete. The committee recommended that this A1C be performed in a lab vs. a home test or quick test done in your provider’s office.

As for the term pre-diabetes? The term may be put to rest but the jury’s final decision has not yet been made.

Bottomline: If you suspect diabetes - have symptoms? family history? overweight? – get your A1C checked. If you have diabetes, take it seriously and manage it aggressively from day one. At high risk? Knock off a few pound by trimming your fat grams and becoming more active. Yes, easier said than done, but more effective than “going on a diet.”
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