When you were diagnosed with diabetes (or prediabetes), did your doctor do a fingerstick blood test in his office, or give you a fasting plasma glucose test? Or did he make the diagnosis based on your HbA1c level? Although some doctors are already using HbA1c test results as a diagnostic tool, you may be surprised to know that there are currently no official guidelines for doing so. However, that may be about to change.
The HbA1c test — a measure of blood glucose levels over 2–3 months that is usually used to assess how well a person is managing his diabetes — may soon be used officially to diagnose Type 2 diabetes as well. Earlier this month, the American Diabetes Association announced that a group of several leading diabetes organizations will publish guidelines in the next six months on using the HbA1c test as a diagnostic tool. Such a consensus statement is necessary because right now there is no agreement on what HbA1c level would constitute a diagnosis of diabetes.
Most people who don’t have diabetes have an HbA1c level of 6% or less, and those with a higher HbA1c level may have diabetes. In the future, the HbA1c test will probably be used along with other tests to make a diagnosis.
The tests currently in use for diagnosis are the fasting plasma glucose test and the less common oral glucose tolerance test. However, these tests can be inaccurate if a person has eaten recently or is sick. Advantages of the HbA1c test are that it can be given at any time and, because it reflects blood glucose levels over a longer period, it is not unduly influenced by events on the day of the test.
Do you think that using HbA1c as a diagnostic tool is a smart move? Do you remember what your HbA1c was when you were diagnosed? Let us know with a comment here.
At diagnosis 10.4
Posted by Gail | Feb 20, 2009 at 5:28 pm3 mo later 6.5
Over the many months it moved down to 5.5 and has been slowly creeping back up so that 2 mo ago it was 6.4 w/ workouts 25 out of the 30 days in Dec, meds as ordered, and dietary control.
Next month I expect it to be up over 6.5 and MD plans to add Actos
Now testing 2-3 times daily to find out what is going on in between. I know it is slow in returning to normal after a meal
Sure I think it can and should be used, however since a quick fingerstick bloodtest gives direct results I think they should use both…
Posted by Erik | Feb 21, 2009 at 7:23 amSure I think it can and should be used, however since a quick fingerstick bloodtest gives direct results I think they should use both…
Posted by Erik | Feb 21, 2009 at 7:24 amI think using the HbA1c as a diagnostic tool is a smart move since it shows glucose levels over a long period of time. This should help avoid decisions based on fingerstick or whole blood readings that can vary greatly.
Posted by Joan | Feb 25, 2009 at 1:18 pmThe HbA1c test shows how well your diabetes has been taken care of for the past 3 months. Why use the C-peptide test which identifies the function of the pancreas better by showing how much insulin is produced and whether it is a useful amount of insulin?
Posted by Paula | Feb 25, 2009 at 1:49 pmI think HbA1c would be very useful to DX diabetes as it gives a reading of the previous 2-3 months. As everyone who tests there glucose on a regular basis knows, the blood levels of glucose are extremely variable. Stress, nerves, exercise level, illness are a few of the things that may cause a variation of one’s glucose levels independent of what and how much you might have eaten.The HbA1c gives an average without the spikes and lows of the regular glucose levels.
Posted by Ruth | Feb 25, 2009 at 2:08 pmI think this is a good thing do to. My hba1c were almost 10 before i was diagnosed. I was eating good most of the time so the other test came back ok. I was just eating alot of white rice.
Posted by psantana | Feb 25, 2009 at 2:28 pmWhen I was diagnosed with type II seven or eight years ago, it was from a HbA1c test as part of a yearly checkup. I’ve been under the impression that HbA1c was standard.
Posted by Edward | Feb 25, 2009 at 3:05 pmAt Diagnosis: 7.1
3 months later: 6.9
1 year later: 6.1 to 6.2
I thing the A1C is an excellent tool. In my case, my fasting blood glucose readings were in the caution area for a couple of years: over 100 but always below 110. Each time Dr. would say, “We need to keep an eye on this.” Had he checked my A1C, I’m sure it would have been plenty above 6.0 since at the 7.1 reading my fasting glucose was still only 106. I’m only glad another physician finally did check A1C and then order the GTT.
Posted by gailfreimann | Feb 25, 2009 at 3:22 pmWhat’s GTT?
Posted by theresia | Feb 25, 2009 at 4:10 pmAt Dx 8.9
three months later 6.1
three months more 6.1
When BG was over 200, doc ran A1c, I never took an ‘official’ GTT, but he did do extensive BG tests and A1c every three months for monitoring.
I think it’s an excellent idea, my BG changed dramatically in a year’s time, the A1c was a good indicator.
Posted by luvariddle | Feb 25, 2009 at 4:58 pmDiagnosed 11/15/07 - A1c 11.3
By April 2008 - A1c 6.0
In Sept 2008 - A1c 5.7
I’m now on a 6 month schedule with my Doc since my BG is under control.
My Doc suspected that I had “a problem” after treating me for my second severe skin infection (boil) within 2 months. He ordered a complete blood test it confirmed his suspicions. My serum glucose was 285.
Now I treat the A1c test results as confirmation of my self test records.
Posted by philsyes | Feb 25, 2009 at 5:21 pmI think that the A1C test does a good job in finding out what you blood sugars have been for the last 2 or 3 months. I have had type 2 diabetis fot 35 years and my last A1C testwas 5.4.My doctor is considering changing my insulin to one of the newer fast acting insulin along with the Lantus.At the present time I use the R insulin before each meal anf the Lantus in the morning and before bedtime.I check my blood sugar before going to bed and is it is to high I take a small amount of the R before going to bed.
Posted by jheidrick | Feb 25, 2009 at 5:54 pmRespectfully….jheidrick
I do believe the HbA1c test is a good diagnostic tool for diabetes. This is what the doctor at the Mayo Clinic used when I had a physical there recently.
Posted by Tony G | Feb 25, 2009 at 10:04 pmI think it is inexcusable for any doctor to definitively diagnose Diabetes without having done a A1C. This measures over time. I understand that a finger stick in the doctor’s office can be indicative of a potential problem,but that is only a moment in time. Giving someone a diagnosis of Diabetes 2 changes one’s life forever. This happened to me and it was a very scary moment because no referral to a dietician, etc. was done. I was left to cope on my own. When an A1C was later done, my level was 6.0% and has remained so. I think pre-diabetic was better in my own particular case. That still means that I need to watch my diet and increase my exercise, but is not quite as scary as the diagnosis of Diabetes 2, without further information.
Posted by geriola | Feb 26, 2009 at 2:43 amMy A1C at diagnose was 8.2. Now my Doctor takes it every 3 months and I maintain a 6.9.
Posted by spuppymom | Feb 26, 2009 at 10:42 amI have been a Type 2 diabetic for over 12 years now and have seen the same doctor over that time period. Since day one, my doctor has always used the HbA1c test as the number 1 measurement for determining how I am doing and what medication he is going to prescribe to me.
After reading your comments, I feel fortunate to have a doctor with his understanding of this terrible disease.
Posted by bkasten | Feb 26, 2009 at 4:01 pmActually, while I agree that it can be helpful, I don’t think that it and a fingerstick should be the only criteria to diagnose type 2 in perhaps most cases.
My husband’s A1c has never been above 6.0, but his fasting BG’s are often <126, and it’s not uncommon for his PP readings to be >180. And, he “flunked” the 2hrOGT. Sort of a mixed bag.
When diagnosed, my BG (random) was >400, and my A1c was >10.0. No doubt there.
Posted by marcie | Feb 27, 2009 at 3:06 pmI recently had my yearly physical and my blood glucose was 117. Prior blood tests showed blood glucose of 100 or less. My doctor ordered an A1c. I received the results today at 6.2. Doctor said it was slightly high. I don’t think I have diabetes. I do think that the test is an excellent tool and should be used in addition to the other tests for diabetes to help make the diagnosis.
Posted by Paula June 15th 2009
Posted by Paula Beaulieu | Jun 15, 2009 at 8:55 pmHBA1C 8.0
A1C molar 64
wot do i need to do to reduce them
Posted by nic | Oct 28, 2009 at 1:05 pmHello Nic,
Thank you for your comment. For information about getting your blood glucose into target range, check out “Managing Your Blood Glucose Ups and Downs.”
Sincerely,
Posted by Diane Fennell | Oct 28, 2009 at 2:24 pmDiane Fennell
Web Editor