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Mstatz
Total Posts: 12
Registered on: ‎02-29-2012
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What is AC1?

Hi Everyone - I'm new at this as you can tell by my question.  I read the definition of AC1 but not quite understanding the numbers.  What is a good AC1 number? Can you lower it?  And how to do you test/receive an AC1 number?  My doctor has done a lot of blood work but I can't find the AC1.  

 

Thanks - Mary

alan_s
Total Posts: 14,565
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Registered on: ‎10-30-2009

Re: What is AC1?



Mstatz wrote:

Hi Everyone - I'm new at this as you can tell by my question.  I read the definition of AC1 but not quite understanding the numbers.  What is a good AC1 number? Can you lower it?  And how to do you test/receive an AC1 number?  My doctor has done a lot of blood work but I can't find the AC1.  

 

Thanks - Mary


 

It may help if you switch the letters around. The true terminology is HbA1c, or A1c for short.

 

This is the best and clearest explanation I have read for lay people like myself. Click on this and scroll down to Subject: What's HbA1c and what's it mean? and subsequent sections.

 

As to the number to aim for; I aim to be under 6% if I can. I don't always succeed, but I prefer to aim low and just miss than to aim too high.

 

As to how I achieve it, begin here: Test, Review, Adjust

Cheers, Alan, Type 2, d&e metformin 2000mg, Australia.
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey (latest: It Must Be OK - It's Sugar-Free! Wrong!)
Born Under a Wandering Star (Latest: Budapest, Hungary)
Occasional Responder
Mstatz
Total Posts: 12
Registered on: ‎02-29-2012

Re: What is AC1?

wow!  I came to the right place.  Thanks again!

Advisor
ronaka
Total Posts: 950
Registered on: ‎12-24-2011

Re: What is AC1?

Here is a useful link:

 

A1C and eAG

Ron

Not a doctor, only another T2 diabetic with, unfortunately 11 year experience. Be cautious about accepting advice, including mine, on medical conditions from the internet. It can be a good place to get ideas, but validate them with your doctor and other medical professionals first.
alan_s
Total Posts: 14,565
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Registered on: ‎10-30-2009

Re: What is AC1?

[ Edited ]


ronaka wrote:

Here is a useful link:

 

A1C and eAG


 

Useful?

 

One of these days some eminent researcher will explain to me why, after decades of using and finally understanding the value of HbA1c, they are confusing the diabetes public - and their doctors - with the introduction of eAG (mainly in the USA) and the new International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) mmol/mol standard in the rest of the world.

 

To me it is a retrograde step which, among other things, will make it increasingly difficult to relate results to past research papers using A1c.

 

PS. Am I the only one that thinks this makes the eAG rather suspect when applied to type 2 diabetics:

 

How does HbA1c relate to average glucose (AG)?

In the Diabetes Control and Complications Trial or DCCT (New Engl J Med 1993;329:977-986) study of patients with Type 1 diabetes, quarterly HbA1c determinations were the principal measure of glycemic control; study subjects also performed quarterly 24-hour, 7-point capillary-blood glucose profiles. Blood specimens were obtained by subjects in the home setting, pre-meal, 90 minutes post-meal, and at bed-time. In an analysis of the DCCT glucose profile data (Diabetes Care 25:275-278, 2002), mean HbA1c and AG were calculated for each study subject (n= 1439). Results showed a linear relationship between HbA1c and AG (AG(mg/dL) = ( 35.6 x HbA1c ) - 77.3), with a Pearson correlation coefficient (r) of 0.82.

Cheers, Alan, Type 2, d&e metformin 2000mg, Australia.
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey (latest: It Must Be OK - It's Sugar-Free! Wrong!)
Born Under a Wandering Star (Latest: Budapest, Hungary)
Established Advisor
legion681
Total Posts: 600
Registered on: ‎07-05-2011

Re: What is AC1?

Personally, I am totally happy with the simple notion that A1C's result gives you the average bg for the past 3 months. No need for further complication.

Name: Al
Location: Massachusetts South Shore
Diabetes Type: 2
A1C results: 17 (at dx), 8.3 (2 months after dx), 5.2, 5.2, 5.1, 5.2 (<-- latest 10.10.2012)

*** Boston Bruins - 2011 Stanley Cup Champions ***
Super Advisor
powerwalker2
Total Posts: 5,420
Registered on: ‎11-02-2009

Re: What is AC1?

I don't think it hurts to be aware of all the facts and details on something that is so important.  People can do with them what they want.  Some want to do more than others.  I don't see any problem with that.  I would never tell anyone not to post something just because some people might not "get it", or care to.  With diabetes, I think you *do* have to dig and delve a bit, in order to understand everything better.  For those who are interested, of course.  If someone's not interested, then that's okay, too.  Whatever works; whatever's useful.  I personally want to never stop digging for answers.  In the process of digging, we may find some solutions that may be of use.  And from what I've seen, it takes every tool in the toolbox, and then some.  Some tools are more useful than others.  So what.  At least you know they're there if you need them.  Take them or leave them, or pick them up when you're ready.  What could be simpler...

Nancy ~ T2 since '98 ~ 16 yrs ~ D&E 11yrs ~ treadmill, elliptical, bike 15-20 minutes 3x/day (including evening), dumbbells/resistance training, small portions heart-healthy high-fiber/low-fat fuel/carb-counting, 500mg Glucophage XR x4, 2.5mg Glucotrol XL x6, 6000IU Vit. D/day ~ RHR 53 ~ A1cs mainly between 5.9-6.9 av. 6.5
alan_s
Total Posts: 14,565
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Registered on: ‎10-30-2009

Re: What is AC1?



powerwalker2 wrote:

 

 I would never tell anyone not to post something just because some people might not "get it", or care to. 


 

I certainly would not want to give that impression. My disagreement was with the researchers and the notion that the new terms were useful.

Cheers, Alan, Type 2, d&e metformin 2000mg, Australia.
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey (latest: It Must Be OK - It's Sugar-Free! Wrong!)
Born Under a Wandering Star (Latest: Budapest, Hungary)
Trusted Contributor
morrisolder
Total Posts: 10,455
Registered on: ‎11-28-2009

Re: What is AC1?

As long as you note that it might not be precise, I think it is very useful to equate A1c with an estimated Average Glucose, or eAG.  That way people have some sense of what it means to have a 6 or a 7 or whatever A1c, and it their meter is telling them something different, they are put on notice that hey are missing high (or low) numbers at times when they are not testing.

 

I don't see any difference between the imprecision of the correlation and the margin of error of test strips. In both cases, the meter readings and the eAG, we are getting useful information on which we can base choices and improve outcomes.

Morris

Diagnosed Type 2, with an A1c of 11.4 in 2003; averaging a 5.0 A1c since then with diet, exercise and Glipizide XL + meds for blood pressure and cholesterol. 
A bit dated, but scroll down on this page if you want to know more ...


Frequent Advisor
t1wayne
Total Posts: 952
Registered on: ‎10-30-2011

Re: What is AC1?

Well, you've gotten some useful links to do your own research, and you should, but here's the gist.  As already noted, the test is the HbA1c test.  It was a clever idea by some researchers to come up with a way to measure average blood glucose of patients, in order to evaluate their blood sugar control over time.  Blood glucose binds to hemoglobin; the life of the red blood cells that make up hemoglobin is 3 to 4 months.  By testing for the amount of glucose bound to red blood cells at any given point in time, researchers came up with a measure of what the average blood sugar levels were for the past 3 to 4 months.  The target number is generally below 7%; BUT... talk to your doctor to find out what his target is for you.  As for changing it... it is always changing.  Remember, it's an estimation of the average of the past 3-4 months; the "better" your daily control, the "better" your A1c number (theoretically) is.  Of course, as in every scientific endeavor, there are some caveats.  First, more recent research suggests that the A1c "average" is weighted heavily towards the most recent 2 to 4 WEEKs.  Thus, it may not be a valid indicator of how you were doing 2-1/2 months ago.  Second, it's usefulness is limited to the individual: ie, comparing your own A1c today to one taken 6 months ago is a valid comparison, but it's not valid to compare it to mine; you and I will test differently (ie, we may have the exact same true average blood glucose, but different A1c results).  For this reason, its usefulness is limited for researchers looking at one or more populations of diabetics (that's your answer, Alan...).  The eAG link that Ron gave you is an attempt by those researchers to get at a more useful estimation of that number, but that's a whole 'nother story.

 

For your purposes, Mary, the A1c is a test your doctor will order to get an idea of how your BG control is going over time.  You can help by keeping a log of your tests, which is how you should be doing your daily management anyway, and generating an actual average glucose number from that... overall, for morning readings (fasting), post breakfast, and so on (this is what the researchers that created the A1c based there estimations on in the first place.)  Remember, the whole purpose of testing - in whatever form - is to improve BG control.  The more you can keep your BG in the "normal" range (90 to 120 mg/dl, give or take whatever your own doc advises) the less susceptible you'll be to complications from excess BG.  Of course, that too varies by person... some people keep relatively good control and get complications anyway, and others don't do so well at control, but are spared serious complications.  Just like the difference between your and my A1c not being a valid assessment of our relative avg BG, our outcomes will vary, purely by the luck of the draw.  (Well, the researchers will suggest that there are other factors, and no doubt there are).  BUT... whatever your destined to experience, it will go better if you've kept the best control you can.  Good luck, and best wishes, w.

Wayne T1 May 1966
MDI; 46u Lantus Basal