Wednesday, May 29, 2013

Tips for converting A1c reading to average plasma glucose


 Answer to yesterdays question - 
        An A1c test result of 8  is equivalent to a mean glucose of 183 mg/dl or 10.2 mm/l 

  A1c interpretation tip -
       A 1 point change in your A1c equals a 29 mg/dl or 1.6 mm/l  change in your average glucose.  I
       personally remember the desirable target goal for A1c is 7 which equals 154 Mg /dl ( 8.6 mm/l )
       and the add or subtract  from there. There are calculators that are useful if you happen to have
       it with you at the time. The attached link is to the ADA calculator.
       http://professional.diabetes.org/glucosecalculator.aspx
   I have attached a link to an article with more details on this 
   subject.
   http://care.diabetesjournals.org/content/early/2008/06/07/dc08-0545.f   ull.pdf

  

    What are the Benefits of A1c testing ?  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.. The chart below was copied from the American Diabetes Association Standards of care         A1C (%)                  Average plasma glucose
                                          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
       12                                 298                    16.5
          
    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
Have fun , Be smart and know your numbers
David calder,MD
Question - What is the difference between whole blood and plasma glucose test results ?

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Your comments and questions are appreciated. David Calder,MD