Wednesday, December 21, 2011

Tell us about the benefits of NMR and A1C testing...pleazzzzzzz. Thank you!

  Carl Old Sr said...
Tell us about the benefits of NMR and A1C testing...pleazzzzzzz. Thank you!

 NMR lipid profile is a test that measures the number and size of lipoproteins  such as LDL and HDL. This can be useful when trying to evaluate someones LDL cholesterol when they have an elevation of their Triglyceride level over 150mg/dl.
    LDL is made in the liver and is produced is a spectrum of sizes varying from small  to large LDL particles. The smaller size LDL is associated with increased risk of heart disease . Triglyceride elevation which is common in people with Type 2 diabetes is associated with an increase is the small dense LDL particles .
     Apo b test is another way of  this problem. See my blog Dec.14

 
 What are the Benefits of A1c testing ?

      This is a great question.

 Glucose in blood binds to  hemoglobin in  red blood cells  and remains attached for the life of the  cell which is about  3 months.  Higher glucose levels are associated with more glucose attachment . The chart below will give you an idea of how A1c results correlate with mean glucose test results..
  
                                        Mean plasma glucose
A1C (%)
                                         mg/dl               mmol/l
6                                          126                     7.0

7                                          154                      8.6

8                                          183                    10.2
9                                          212                    11.8
10                                        240                    13.4
11                                        269                    14.9

    The A1c test is a predictor of the risk for developing diabetes complications. Two classic studies, the DCCT study in Type 1 Diabetes and  the UKPDS  done with Type 2 Diabetes demonstrated a significant   reduction in eye , nerve and kidney damage by reducing  the A1c  to 7. There was about a 30 % reduction in risk for  a 1 % point drop in A1c. There was also a nonsignificant 16% reduction in cardiovascular risk  by reducing The A1c from 8 to 7 in the UKPDS .
 These two large studies  and another one called the Kumamoto study provided the evidence for establishing an A1c result of < 7 as the recommended target goal
         Thanks again for the good question. Dr. Calder

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Your comments and questions are appreciated. David Calder,MD