A1C test for Diabetes (HbA1c) - What is a Good A1C Test Result? SUGARMD

hello guys today we are going to talk about a1c so what is a one-seed it's commonly asked question and today I'm specifically answering Barbara Williamson's question where she asked in our what is normal blood sugar video and I think I mentioned a1c in that video and she's asking what is really a von C and everybody has in the same question so let's talk about it I am dr. Amit Aryan I am the founder of sugar MDS calm again our primary purpose is to serve you remotely so we can take care of your diabetes using technology not that you have to be tech savvy but we will make it easy for you where you don't have to leave your home and you can still see us and make sure your diabetes under control and reduce the number of medications now let's move on to the topic so why we measure a1c right so a1 sees a test as commonly used is a standardized test so but most people have trouble understanding what they one C is so why do we call it a1 C or hemoglobin a1c in that better term because we are measuring the glucose within your hemoglobin now hemoglobin is a protein in your blood that is subject to carry your oxygen from A to B so your your hemoglobin is getting oxygenated in your lungs and carrying that oxygen to the rest of the body now the same himavan is permeable which means that it is open to the transfusion of glucose into itself so it opens its arms to the glucose so as a result the more glucose you have in your system the more glucose will be in your Hema globin so that's what we are measuring now why do we measure that every three months that's the next question right so that is because your hemoglobin lives for three months so as a result assuming that your hemoglobin are living three months the glucose they accumulate in three months will be tested and then we can tell exactly how much your blood sugars are running based on how much glucose is in the hemoglobin there is a percentage it's reported as a percentage and every percentage corresponds to an average blood sugar it is a perfect test barely but we'll talk about the advantages and disadvantages of this test now so before we dive into details let's talk about what do the results mean but sometimes I tell people okay your a1c is 7% or they'll tell that their a1c is 6% 8% 10% whatever when I ask my patients okay what does that mean to you and they say oh I think it's supposed to be less than seven let's suppose to be like a 6.5 they don't they don't really know what it means right so as an educated patient which is the best patient right so if you know what they won't see is at the end of this video you're gonna be an a1c Pro you're gonna be able to teach everybody about a1c but the bottom line at least you should understand if nothing else from this video that every percentage in Avon C corresponds to an average blood sugar so 6% is on average 120 right so 7% is 150 so every 1% increase or decrease in your blood Sugar's corresponds to a 30 milligram per this little change in your in your overall blood Sugar's so if you're going from 6% to 7% that means that your average blood Sugar's are rising by 30 milligrams per deciliter on average so 6 percent is 127 percent is 1 58% is 180 and then it goes on so if you go to like for example I wanna calculate I went I'm gonna cheat here so if you go look twelve percent that's that's around three 300 so what you can make an easy calculation about that so I hope that's easy to understand and we'll to the next topic now a lot of people are also confused about their a1c goal right there's a lot of things said and done about this Avon see now of course clinicians actually determine the a1c goal the universal goal is less than 7% and the reason there's a universal goal is because they use a1c in studies to determine the risk reduction so for example if your a1c goes down 1% you're actually overall risk of diabetic complications can go down by 30% so as a result they determined that if you use to be below 7% overall for the entire population that is a good target to keep patients with diabetes under control now of course the lower the sugar the better so we want to keep actually young diabetics who just got diagnosed in the first five eight years of diabetes or even 10 years we want to keep them as long as possible less than six point five down to 6 percent that's all ok I have a lot of patients with a1c down to 5.7 5.5 not even in a diabetic range because of the approaches we have and they almost live their life almost free of diabetes right so that is possible so what I say to my patients with the a1c goal is as low as reasonably achievable what does it mean to bring the a1c you have to bring your average blood sugars down right so to do that you have to use sometimes strong medications and some medications can cause very low blood sugars I know if you ever had a low blood sugar but it's not a pleasant experience it is very very difficult to go through that experience now if you're having low blood sugars frequently yes your Avon C will go down right why because your average blood sugar will go down because you're if you're running low frequently your average will be low as well but that's not what we want that's one of the downside of Avon C is that just because your a1c is down doesn't mean that you are doing great you may still be having a lot of electricians it doesn't tell you again Avon C does not tell you anything about fluctuations it only tells you what is your average so we want to avoid low blood sugars but still want to keep the a1c down that is the key that the French is a good diabetes doctor from a bad one that differentiates a good endocrinologist from a bad one so if if you're on medications that cause a lot of low blood sugars and you're suffering from this and your doctor don't care about that that is a problem right so yeah do you need to give them hypoglycemia the low blood sugar see how they how it feels you know so anyways so that's the goal as long as reasonably achievable that if you're going down to 6% and you're having a lot of low blood sugars and we don't have any way of improving that because you have to be on these medications for some reason then I tell them look it's okay to be a 6.5 or it's okay to be 7% rather than having so many low blood sugars correct so I hope we agree on that some people are extremely obsessed about their blood Sugar's they there there's their stock in the a1c or my a1c has to be 6% or whatever however they came up with these ideas they don't even know sometimes what the a1c is but they you want to see that number down to six it's a psychological thing but I try to educate them look it's it's not just about the number it's about your health right so the reason we want to bring the Avon sea down we want to avoid complications but 6.5% also will not give you complications 7% less than 7% we'll probably not going to give you complications so it is better to be safe than trying to pull the numbers too low sometimes there are actually studies where when they tried every medication it's called a cord study if you want to look it up it said major study is super large study so what they did they try to bring a1c down as much as possible and they realize that more people actually died and they attribute that due to too many low blood sugars causing the deaths so as result we want to avoid that problem so the problem with anyone see as you can imagine so since you're having low blood sugars and you are having a bossy down so that is one of the problems you really you know when you start using a Dexcom g6 or freestyle library for example that tells you all the fluctuations because it's a continuous color cause measurement devices tell you everything happening with your blood sugars you'll be so surprised how much your blood sugars are actually fluctuating so as a result we want to make sure that does not happen so I'll give you an example so you may have a 7% a1c right with blood sugars ranging between 130 and 180 that's not actually bad if you're waking up with 180 and your highest during the day is 180 you can still have a 7% and that's a healthy number because you're not really fluctuating too much but you can achieve the same number again seven percent is what 150 on average right so 130 180 you know put them together divided by two that is 7% now if you are having a blood sugar of 50 and 250 every time let's say you're fifty one time 250 next time fifty one time 250 next time and keeps going so you're actually having a lot of very high blood sugars but because of the low blood sugars it negates it out as a result you still have 7% anyone see so just because you go to your primary care doctor and your a1c is 10% and they say oh you're good that doesn't necessarily mean you're good you may still be having a lot of fluctuations and that still needs to be addressed so as a result it's sugar md's we monitor you and we track you remotely so if you are fluctuating that much we don't wait three months if we don't just check your a1c we look at your real numbers we try to get to you continues glucose monitoring devices we you know if you cannot get those we at least monitor your finger sticks remotely so if you are using our app I can see what's going on on my screen without you even knowing so that is the beauty of it so we can intervene and fix those problems before it turns into bigger problems another quick tip for you to know Avon sea may be different from lab to lab so if you're checking your avons in doctors office and then you to to another lab you may actually end up having like let's say one time you check it six point eight next time it can be seven point one and you look like oh well it went up actually it's just a variation in the labs so I recommend to stick with the same lab because Avon C basically helps us the most to see the trend so if you're going down from nine percent down to eight percent seven percent that's a good sign although again it doesn't tell you the whole story but it's still pretty good sign okay alright now what are the disadvantages now sometimes actually not appropriate so again remember we rely on your hemoglobin so if you have an e mia which is mo globin problem right so if you have an iron deficiency b12 deficiency or you have chronic kidney disease and they are giving you arrest report and anything that that messes with your hammer globins you may be having transfusion you know you may be having bleeding's you may be having iron infusions anything that tries to manipulate your anemia your your hemoglobin cells can definitely distort the overall result because you are basically adding then you are transfusing you are adding fresh cells your you know diluting the pool or if you have an anemia your your hemoglobins may actually die faster so as a result doesn't really reflect the three months so some in some diseases they actually live longer and it does you know you can over reflect so if there is a hemoglobin problem if you have talus emia if you have sickle cell disease then the hemoglobin a1c is really not very reliable so that's something that you should know about so what do we do if you cannot use hammer globin a vaccine number one we can use continuous glucose monitoring systems and they are the best so even if you don't have a personal CGM like a Dexcom g6 or freestyle Debray we can do a professional one we can put one on you for a week or two to see how your sugars are really running instead of just a1c also we have other testing such as fructosamine again that aligns the glucose so we rely on Tosa means ability to bind the glucose which gives us a shorter duration around 2-3 weeks timeframe of have your blood Sugar's on average running so that can we can use that we can use glycol mark if you're not on Jordans fire cigar invokana that certain medications that actually makes you urinate the blood sugar glycol mark is a test that relies on the kidneys ability to reabsorb glucose and so forth so we can use glycol mark as an alternative test so we have other ways to find out how your sugars are running and then most importantly if you have nothing else to do you have your finger sticks you can do blood sugar checks and if you are checking frequent enough that can give you a problem okay good enough understanding of how your blood sugars are running as well sometimes pregnant women women with gestational diabetes also are curious if they can't just rely on a1c it is it is still used however remember when you're pregnant your blood volume goes up your hemoglobin changes so it may be a little falsely low but if you know that it's falsely low and he can you can you still have to check your finger sticks you should still be okay you can still look at the hemoglobin as a way of controlling diabetes during pregnancy but again just you have to be careful because the results are not exactly the same as if when you are not pregnant again guys thank you for watching if you liked it please give a thumbs up and subscribe to the channel so we are sending videos a couple of videos every week for your entertainment and education please support us and remember sugar md's is a channel it's a website we basically provide remote diabetes care we have an office in West Palm Beach that if you need to be seen physically we do see patients physically but we recommend actually avoiding to go to the doctor for our purposes because we can actually do everything remotely without the physical limitation and we can stay in touch through texting emailing and so forth so that's a concierge service covered by the insurance just take advantage it see you later [Music]

Channel: SugarMD

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Keywords: a1c hemoglobin test, hemoglobin, a1c test, a1c test explained, a1c test for diabetes, a1c test high, a1c test instructions, a1c test kit how to use, a1c test levels, a1c test video, a1c testing at home, hemoglobin a1c blood test, hemoglobin a1c test machine, hemoglobin a1c test procedure, glycated hemoglobin, glycated hemoglobin (a1c) test, glycated hemoglobin (chemical compound), blood glucose, diabetes mellitus, glucose, health care, hyperglycemia, pathology

Id: mzwnIdOLs6Y

Length: 15min 40sec (940 seconds)

Published: Tue May 05 2020