Comments on: HbA1c for dx

By: roy_1600

roy_1600 — Sat, 18 Oct 2003 18:29:07 +0000

Hi Jan:
Happy New Year…I may not be able to respond too well for the next
week…having surgery tomorrow for carpal tunnel no less!!!
I love when either non-health care providers or health care providers who are
not well informed, tell patients this junk!!!! It just says that this lady
may be in reasonable enough control that her A1C is normal for the moment,
but that doesn’t mean she should stop doing what’s right for her, and her MHO
case manager is leaving her company open for MAJOR litigation! I’d love to
be the hungry lawyer who takes on the case.
Please let her know that she should rely on the instructions of her endo and
her CDE Nurse educator in decision making of this kind. This lady may have
had a 251 mg/dL result and may have still had a normal A1C…a serum
fructosamine level tells us how glucose control has been over the last 2-3
weeks (non-diabetic results 1.5 - 2.7 mmol/L; diabetic >2.0-5.0 mmol/L)- this
would have been a better tattle-tale, where a glycated hemoglobin (Hg A1C)

looks over a 3 - 4 month period and how saturated the red blood cells have
become with glucose…sort of like force-feeding glucose to those RBCs.
When we start seeing glucose levels greater than 126 mg/dL after 8 hour
fasting, or a fasting greater than 110 actually…someone may be carbohydrate
intolerant and need workup.
When we start seeing greater than 140 mg/dL 1 hour after eating, then it’s
how many abnormals we see. An A1C of 6.5 or greater is pushing the
upperlimits of "normal" but 6.5 would mean she’s in a diabetic state and
needs to start taking things back for herself…and quick…Joan :))

By: antoinette_5

antoinette_5 — Fri, 17 Oct 2003 13:18:24 +0000

Here is a guide I got from Pace but all labs do vary.

Joan,
I got this from another site. Can you verify these #’s? MHO is that she was
doing things right and should have kept it up. She went off for a year and had a
251 BG and is back being a diabetic! This is a clipped post. What HbA1c is used
for dx?
Jan

By: kristan_180

kristan_180 — Fri, 17 Oct 2003 03:13:54 +0000

There is not enough info there to make an informed comment. Was this
person diagnosed as a diabetic? What type? Was the person on any
medication? It strikes me that to suggest you can return to bad habits
after any diagnosis that suggests diabetes is bad advice. As far as
the accepted limit for A1c, it varies from lab to lab, and the reasons
for a lab choosing a number vary widely. Therefore, the limit number
is suspect in any event.

David

jan hughey wrote:

By: mitzi_100

mitzi_100 — Thu, 16 Oct 2003 16:45:06 +0000

The Doc does not know what she is talking about. Once a diabetic always a
diabetic. By this doctors rule I am not a diabetic since my a1c is 6.4,
HOWEVER if I do not take my insulin, monitor my diet, and TEST, I will be in
deep trouble. I wonder how much damage she did in the year out of control.

Joan,
I got this from another site. Can you verify these #’s? MHO is that she
was doing things right and should have kept it up. She went off for a year
and had a 251 BG and is back being a diabetic! This is a clipped post. What
HbA1c is used for dx?
Jan