When it comes to diabetes management, blood sugar control is always the central theme. After all, keeping by keeping our blood sugars in check can help us live a long and healthy life. One of the central themes when it comes to glucose control is maintaining a good A1C.
By now most of us are aware of what an A1C and eAG test are, but why are they so important? What does an A1C actually measure? How about an eAG? Can one make it easier to understand your overall numbers or provide better insight as to what’s going on? All great questions, so lets take a closer look!
What is An A1C?
By now, this is the one you are probably most familiar with. You know, you go into the endo’s office and the first thing they do is sit you down and take a finger stick, only to zoom off into another room to measure the results and report back. As a blood test that provides information about a person’s average levels of blood sugar over a 3 month period, but how does it all work?
Per the National Institute of Health:
The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent.
So what is this hemoglobin that they are talking about? Well, hemoglobin is the protein specifically found in red blood cells and is responsible for transporting oxygen throughout the entire human body. When blood sugar levels are elevated, some glucose attaches to hemoglobin and since red blood cells normally have a lifespan of 120 days, the A1C test is useful because it offers an indication of longer term blood sugar levels.
So how about an eAG?
What Is An eAG?
eAG also know as estimated average glucose is a newer term you may see talked about by your doctor. The American Diabetes Association introduced this term in order to help us translate our A1C tests into numbers that would more closely represent our daily glucose meter readings. How does this all work?
Well, your eAG number is calculated from the result of your A1C test. Like the A1C, the eAG shows what your average blood sugars have been over the previous 2 to 3 months, but instead of a percentage, the eAG is in the same units (mg/dl) as your blood glucose meter.
Below is small reference guild that will help you calculate your estimated average glucose level from your A1C result.
Or if your looking to calculate your very own, after your next doctors visit feel free to do so by using the following formulas:
28.7 x HbA1c – 46.7 = eAG (in mg/dl)
1.59 x HbA1c – 2.59 = eAG (in mmol/L)
So What Do These Numbers Mean?
Well, not to get into all the negative details but the higher the eAG number, the higher your chances of developing negative side effects associated with diabetes as we continually hear. We all know about them, so I will spare you the details but there is a direct correlation between the two, just like with your A1C.
People will have different A1C and eAG targets depending on their diabetes history and their general health. People should discuss their target with their doctor or healthcare team, but studies have shown that people with diabetes can reduce the risk of diabetes complications by keeping A1C levels below 7 percent.
Its important to not stress over your numbers either. We all have those roller-coaster rides. One day we will be sailing along, trending perfectly, then out of nowhere you get awful consistent numbers. Don’t be to hard on yourself, adding stress isn’t going to do anything but hurt you overall and make your blood sugars worse. I use to stress, obsess actually over all my readings when I was first diagnosed with type 1 diabetes and it certainly reflected in my A1C when I could not get it below 8.6% during the first 3 years upon diagnosis.
Try to take a step back, take a breath and follow your guidelines for treating highs provided by your doctor. Once I stopped obsessing about my numbers, both my A1C and eAG came down nicely to my most current reading of 5.9%.
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