HbA1C Tests for Diabetes

[connda]

I'm just curious as to why hospitals put so much emphasis on fasting blood sugar (FBS) tests over using the HbA1C tests as the HbA1C test shows a three month average of glucose bound the hemoglobin.  I'd think this would be more accurate.

It is sort of like blood pressure tests.  In the past in the US my primary care physician prescribed high blood pressure meds for me bases on two in-office BP readings.  I ended up buying a home BP unit and measured my BP daily at different times of the day.  On average, I was completely normal.  I sort of didn't buy that I had high BP primarily because I was literally an athlete (skiing) at the time and as is phenomenally good shape.

So applying the same concept to quarterly FBS tests, how would a single FBS be the "gold standard" for diagnosis diabetes when it is looking at a single data point over a 90 day period instead of using the HbA1C tests that uses the sugar bound to your hemoglobin with the intention that hemoglobin remains in your body for about 3 months, therefore provides a running three month average of your blood sugar.

[scubascuba3]

If they are solely using FBS then they should be ignored, second opinions should be the norm here

[TravelerEastWest]

I have had type two for around 30 years and have read  books and watched videos and spoken to doctors - both tests serve a purpose and are good to know.

 

If you have a very high fasting glucose level that is a red flag.

 

A very high HBa1c is also bad.

 

Note you can have a normal Hba1c and still be quite sick - example: lots of highs and lows which make a nice average - it happens...

 

Modern medicine uses both not just one if only one they are saving money...

 

Also a single glucose test if done over time (I forget how many hours) with glucose given to you as a test is accurate. What are you thinking of?

Edited October 3, 2023 by TravelerEastWest

[retarius]

I find diabetes care and measurement is markedly different in different places I have lived. My physician uses both FBS and HbA1C. FBS he does in office with a stick, and HbA!C is done quarterly. As you point out the measure different things. To be honest if your HbA1C is ok then a random FBS measurement is meaningless. I test my FBS first thing each morning and it seem to vary quite dramatically for no apparent reason. I show the FBS results to my physician each month. 

Diabetes is not a static disease though and progress as you age. Also other parameters of health change along with blood sugar parameters. For example my high cholesterol has vanished as has my high blood sugar although I still take Triplix for triglycerides and 25 or 12.5 mg atenolol for blood pressure (my BP is actually a bit low now, but atenolol is cardioprotective). 

[Sheryl]

FBS is certainly not the "gold standard".  Hb1Ac is. FBS readings nto only fluctuate from day to day, they rise in response to stress. There is a sort of equivalent to the "white coat syndrome" some people have with their blood pressure - just being at the hospital undergoing a blood draw can elevate your reading a bit (by say 10 or even 20 points).

 

My FBS is always elevated. My HB1Ac is always normal. For decades now.

 

FBS is a bit cheaper. Also, the contents of hospital check up packages tend to be decided on more from a marketing perspective than a health one.

 

 

[tandor]

7 hours ago, connda said:

I'm just curious as to why hospitals put so much emphasis on fasting blood sugar (FBS) tests over using the HbA1C tests as the HbA1C test shows a three month average of glucose bound the hemoglobin.  I'd think this would be more accurate.

It is sort of like blood pressure tests.  In the past in the US my primary care physician prescribed high blood pressure meds for me bases on two in-office BP readings.  I ended up buying a home BP unit and measured my BP daily at different times of the day.  On average, I was completely normal.  I sort of didn't buy that I had high BP primarily because I was literally an athlete (skiing) at the time and as is phenomenally good shape.

So applying the same concept to quarterly FBS tests, how would a single FBS be the "gold standard" for diagnosis diabetes when it is looking at a single data point over a 90 day period instead of using the HbA1C tests that uses the sugar bound to your hemoglobin with the intention that hemoglobin remains in your body for about 3 months, therefore provides a running three month average of your blood sugar.

your GP should request both..FastingBloodGlucose and an HbA1C profile if you are classed as a Diabetic I or II. (Insulin dependent or not)..there are many factors to consider first.

If not you should do a Glucose Challenge & Tolerance Test to establish your ability to handle glucose, then go from there after you have been on medication for three months.

Edited October 3, 2023 by tandor
xtra

[Antiparovian]

Am a retired (10 years) Physician in my day Diabetes Mellitus was defined as Fasting Blood Glucose mor than or equal to 7.0 mmol/l on 2 separate occasions more than 48 hours apart. Or random blood glucose more than or equal to 11 mmol/l with same time criteria. OR a presentation with Diabetic Keto Acidosis. HbA1c is a cheap and easy test that could be done in clinic with rapid result.

[CartagenaWarlock]

My doctor orders Hba1c and ask me to do the finger prick test. I bought a cheap chinese smartwatch that uses IR based sensor to measure blood glucose. I used it in conjunction with finger prick method and collected more than 100 data points over a month for one specific subject - Me. While the accuracy of such non-invasive measurement is still in question, i found the non invasive measurement is highly correlated with finger prick data to the tune of 0.92 for R (squared). The F statistics is also meaningful in rejecting the null hypothesis - there is no correlation. I heard recently Huawei has launched their smartwatch with IR sensor for blood glucose monitoring. 

[sikishrory]

My experience was the opposite.

The hospital put all the emphasis on the a1c.

 

[PPMMUU]

limited resources

[jas007]

Type II Diabetes?

 

Recently, I got it into my head that I might have Pre-Diabetes, so, I made an appointment at Bumrungrad for a screening.  The appointment was a month away, so I spent the interim watching YouTube videos by doctors explaining how Type II diabetes can be reversed with a proper diet. And I actually tried the diet.  No sugar, no grains, no or few carbohydrates, no fructose, no processed foods, no seed oils of any kind, some green leafy vegetables, etc. And the occasional water fast or an intermittent fasting regimen to help reset the gut microbiome. I could eat meat, certain types of fish, eggs, some cheeses. A “caveman diet.”  The basic idea is that our human genomes have yet to adapt to the typical diet these days. Too much sugar, too many carbohydrates, and so on.  Our genes evolved over millions and millions of years, and only recently, in the grand scheme of things, did humans become dependent upon modern agriculture and highly processed foods. Even the widespread use of sugar is a recent development. And the end result isn’t pretty for many people. Obesity, metabolic syndrome, diabetes, heart disease, etc.

 

Anyway, all my worrying was for nothing.  My HBA1C was 4.8. All the other tests were also great.  One surprise, though, was my weight.  I actually lost 10 kilos or so.  

[scubascuba3]

3 hours ago, jas007 said:

Type II Diabetes?

 

Recently, I got it into my head that I might have Pre-Diabetes, so, I made an appointment at Bumrungrad for a screening.  The appointment was a month away, so I spent the interim watching YouTube videos by doctors explaining how Type II diabetes can be reversed with a proper diet. And I actually tried the diet.  No sugar, no grains, no or few carbohydrates, no fructose, no processed foods, no seed oils of any kind, some green leafy vegetables, etc. And the occasional water fast or an intermittent fasting regimen to help reset the gut microbiome. I could eat meat, certain types of fish, eggs, some cheeses. A “caveman diet.”  The basic idea is that our human genomes have yet to adapt to the typical diet these days. Too much sugar, too many carbohydrates, and so on.  Our genes evolved over millions and millions of years, and only recently, in the grand scheme of things, did humans become dependent upon modern agriculture and highly processed foods. Even the widespread use of sugar is a recent development. And the end result isn’t pretty for many people. Obesity, metabolic syndrome, diabetes, heart disease, etc.

 

Anyway, all my worrying was for nothing.  My HBA1C was 4.8. All the other tests were also great.  One surprise, though, was my weight.  I actually lost 10 kilos or so.  

don't need some weird diet, just cutting out western junk food diet would have worked

[jas007]

3 hours ago, scubascuba3 said:

don't need some weird diet, just cutting out western junk food diet would have worked

Cutting out Western junk food?  To hear some doctors tell it, it’s almost all junk food. And that’s the problem. With the exception of fresh meats and organic vegetables, just about all the food you’ll find in a typical grocery store is junk. Too much sugar, too much high fructose corn syrup, too much highly refined wheat or other grains. Seeds oils that no one should eat.. It’s  a long list. In addition, they add all sorts of other chemicals to the food as preservatives, thickeners, coloring, etc.  Of course, you can pretty much assume much of the restaurant food also might not be so healthy.  
 

It’s crazy.  Everywhere you go you see food you’re not supposed to be eating.

[scubascuba3]

24 minutes ago, jas007 said:

Cutting out Western junk food?  To hear some doctors tell it, it’s almost all junk food. And that’s the problem. With the exception of fresh meats and organic vegetables, just about all the food you’ll find in a typical grocery store is junk. Too much sugar, too much high fructose corn syrup, too much highly refined wheat or other grains. Seeds oils that no one should eat.. It’s  a long list. In addition, they add all sorts of other chemicals to the food as preservatives, thickeners, coloring, etc.  Of course, you can pretty much assume much of the restaurant food also might not be so healthy.  
 

It’s crazy.  Everywhere you go you see food you’re not supposed to be eating.

Potatoes, rice, vegetables, fruit, even bread helps people lose weight. That's what i eat majority of the time, for me it's simple, people make it complicated

[riclag]

23 minutes ago, jas007 said:

Cutting out Western junk food?  To hear some doctors tell it, it’s almost all junk food. And that’s the problem. With the exception of fresh meats and organic vegetables, just about all the food you’ll find in a typical grocery store is junk. Too much sugar, too much high fructose corn syrup, too much highly refined wheat or other grains. Seeds oils that no one should eat.. It’s  a long list. In addition, they add all sorts of other chemicals to the food as preservatives, thickeners, coloring, etc.  Of course, you can pretty much assume much of the restaurant food also might not be so healthy.  
 

It’s crazy.  Everywhere you go you see food you’re not supposed to be eating.

So true!

My ex father in law ( American)had Diabetes!

His daughters always beat him down

when they found his Stash of sweets!

I loved that guy!

[BigStar]

1 hour ago, riclag said:

His daughters always beat him down

when they found his Stash of sweets!

I loved that guy!

 

Once good friend of mine same, but open stash. Bags of Hershey's Kisses and Reese's Peanut Butter Cups kept beside the recliner for continual snacking throughout the day, alternating with meds from a big basket. Millions paid out from gov't health insurance for docs, meds, and surgeries kept her alive until age 72.

 

Lived that short and happy life promoted by our Life Coaches here, but died in her chair, not with a smile during a bonk. 

 

Love more those who'll depart earlier.

Edited November 25, 2023 by BigStar

[BigStar]

44 minutes ago, scubascuba3 said:

for me it's simple, people make it complicated

 

Calorie restriction is indeed simple. That's why so few people are overweight, and there's no obesity problem in the States.

[scubascuba3]

2 minutes ago, BigStar said:

 

Calorie restriction is indeed simple. That's why so few people are overweight, and there's no obesity problem in the States.

I don't restrict calories, must be awful monitoring calories in vs calories out

[BigStar]

6 minutes ago, scubascuba3 said:

I don't restrict calories, must be awful monitoring calories in vs calories out

 

Yes, if you notice yourself gaining weight, you simply eat less. Otherwise, you burn off those useless carbs via exercise.

Edited November 25, 2023 by BigStar

[scubascuba3]

8 minutes ago, BigStar said:

 

Yes, if you notice yourself gaining weight, you simply eat less. Otherwise, you burn off those useless carbs via exercise.

for me it's not so much about eating less, if i go up 1 or 2kg It's most likely caused by a little extra junk and beer, doesn't take much over a month or two

[BigStar]

4 hours ago, scubascuba3 said:

for me it's not so much about eating less, if i go up 1 or 2kg It's most likely caused by a little extra junk and beer, doesn't take much over a month or two

 

Right, eating less won't make you go up 1 or 2 kg. So actually you'd eaten more, the "extra" junk and beer, then you stop eating the more, thereby eating less.

[mstevens]

17 hours ago, jas007 said:

Anyway, all my worrying was for nothing.  My HBA1C was 4.8. All the other tests were also great.  One surprise, though, was my weight.  I actually lost 10 kilos or so.  

 

Congrats on your new diet and your A1C results. 4.8 is GREAT!

[scubascuba3]

6 hours ago, BigStar said:

 

Right, eating less won't make you go up 1 or 2 kg. So actually you'd eaten more, the "extra" junk and beer, then you stop eating the more, thereby eating less.

Eating less junk, the other food is business as usual, specifically target certain foods 

[jas007]

Well, everyone is different, I guess, so whatever works for you.

 

I’m not sure where everyone is from, but in America right now, there’s a terrible obesity problem.  A large percentage of young adults wouldn’t even qualify to enlist in the military. They’re too obese. As for the population at large,, the numbers are even worse.  They’re mostly obese or morbidly obese, diabetic or pre diabetic. Blame the typical American diet. And the drug companies, doctors and hospitals are making $$$$  treating these people.  And yet there is very little focus on the root cause of the problem.  Most of the medical establishment would just as soon prescribe insulin or pills.  They tell their patients to eat less and exercise more.  
 

Anyway, good information is out there, for anyone needing help. 

[TravelerEastWest]

22 minutes ago, jas007 said:

Well, everyone is different, I guess, so whatever works for you.

 

I’m not sure where everyone is from, but in America right now, there’s a terrible obesity problem.  A large percentage of young adults wouldn’t even qualify to enlist in the military. They’re too obese. As for the population at large,, the numbers are even worse.  They’re mostly obese or morbidly obese, diabetic or pre diabetic. Blame the typical American diet. And the drug companies, doctors and hospitals are making $$$$  treating these people.  And yet there is very little focus on the root cause of the problem.  Most of the medical establishment would just as soon prescribe insulin or pills.  They tell their patients to eat less and exercise more.  
 

Anyway, good information is out there, for anyone needing help. 

You are correct 100%.

 

A good diet and exercise and getting enough sleep/keeping stress down will be the best things that you can do...!

[scubascuba3]

4 hours ago, jas007 said:

Well, everyone is different, I guess, so whatever works for you.

 

I’m not sure where everyone is from, but in America right now, there’s a terrible obesity problem.  A large percentage of young adults wouldn’t even qualify to enlist in the military. They’re too obese. As for the population at large,, the numbers are even worse.  They’re mostly obese or morbidly obese, diabetic or pre diabetic. Blame the typical American diet. And the drug companies, doctors and hospitals are making $$$$  treating these people.  And yet there is very little focus on the root cause of the problem.  Most of the medical establishment would just as soon prescribe insulin or pills.  They tell their patients to eat less and exercise more.  
 

Anyway, good information is out there, for anyone needing help. 

Yep the fatty western diet is to blame but yet they focus just on sugar

[BigStar]

4 hours ago, TravelerEastWest said:

You are correct 100%.

 

A good diet and exercise and getting enough sleep/keeping stress down will be the best things that you can do...!

 

Keeping stress down is ironically one of the major Principles that our ANF Health & Longevity Experts use to justify not dieting and exercising: they find it stressful--incredibly, a lot more stressful than running after docs, meds, surgeries, hospitals, paying all those medical bills, and worrying about health insurance.

 

Yet exercise is known as a great psychological stress reliever. Physical stress thru exercise is a good thing right down to the cellular level, contributes to strength, mobility, health and longevity. A good diet takes away a lot of metabolic stress, meaning better health etc. Preemptive strike: no one's talking about overdoing it.

 

    --P. D. Mangan

 

 

[jas007]

1 hour ago, scubascuba3 said:

Yep the fatty western diet is to blame but yet they focus just on sugar

You should take a look at some of the functional medicine and diabetes doctors on YouTube. Look into how sugar, glucose, and carbohydrates are metabolized. What you’ll find is that a “fatty” diet isn’t the problem at all.  The problem is sugar, highly refined grains, carbohydrates , and processed food. They have everyone brainwashed , though, into thinking animal fat and meats are the problem.  The FDA even has a “food pyramid” that I’m sure most people in America have seen.  Everyone is supposed to eat lots of carbs, but eat meat and dairy products sparingly. Nothing could be further from the truth.  They have it backwards, and many doctors are now realizing that fact. 
 

So people did what they were told, ate lots of carbs and sugary foods, and America is now a country filled with obese people.

 

 

 

 

 

 

 

[scubascuba3]

10 minutes ago, jas007 said:

You should take a look at some of the functional medicine and diabetes doctors on YouTube. Look into how sugar, glucose, and carbohydrates are metabolized. What you’ll find is that a “fatty” diet isn’t the problem at all.  The problem is sugar, highly refined grains, carbohydrates , and processed food. They have everyone brainwashed , though, into thinking animal fat and meats are the problem.  The FDA even has a “food pyramid” that I’m sure most people in America have seen.  Everyone is supposed to eat lots of carbs, but eat meat and dairy products sparingly. Nothing could be further from the truth.  They have it backwards, and many doctors are now realizing that fact. 
 

So people did what they were told, ate lots of carbs and sugary foods, and America is now a country filled with obese people.

 

 

 

 

 

 

 

next you'll be telling me to watch alfred berg on youtube

[bbi1]

On 10/3/2023 at 11:42 AM, TravelerEastWest said:

I have had type two for around 30 years and have read  books and watched videos and spoken to doctors - both tests serve a purpose and are good to know.

 

If you have a very high fasting glucose level that is a red flag.

 

A very high HBa1c is also bad.

 

Note you can have a normal Hba1c and still be quite sick - example: lots of highs and lows which make a nice average - it happens...

 

Modern medicine uses both not just one if only one they are saving money...

 

Also a single glucose test if done over time (I forget how many hours) with glucose given to you as a test is accurate. What are you thinking of?

If you want to reverse diabetes & other preventable diseases you should cut out all added sugars, carbs, alcohol, fast & junk foods, processed foods, processed meats.

 

Watch the following Drs on Youtube who don't follow the herd of other Drs out there & big pharma, but actually did their own research.

 

Dr. Pradip Jamnadas (Indian Cardiologist based in the US)

https://www.youtube.com/@pradipjamnadasmd and also https://www.youtube.com/@thegalenfoundation/videos

 

Dr. Sten Ekberg

https://www.youtube.com/@drekberg/videos

 

Dr. Jason Fung

https://www.youtube.com/@drjasonfung/videos

 

Dr. Robert H. Lustig

https://www.youtube.com/results?search_query=Dr.+Robert+H.+Lustig

Edited November 26, 2023 by bbi1