Why the A1C test trumps resting blood glucose numbers

Over the years, many diabetics including others potentially faced with insulin resistance living in a “pre-diabetic” state have been independently using home blood sugar testing methods to monitor daily blood glucose levels. These tests can generally include urine samples as well as simply pricking your finger. While these may be useful tools in managing your blood sugar on a day-to-day basis they only deliver a snapshot of a much larger picture.
These results in addition to a fasting blood glucose test are only accurate the moment they are administered. Doctors and medical experts have learned that blood sugar levels can vary wildly depending on the time a day, a person’s activity level as well as hormone changes. For example, a high fasting blood glucose test result doesn’t necessarily define or correspond to overall blood sugar levels, and vice versa.
That said, a normal fasting blood sugar test may not completely eliminate the possibility of type 2 diabetes (Theobald, 2014).

How does the A1C test work?
The A1C test measures the amount of glucose attached to hemoglobin in the blood, sometimes called glycated hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen to the body. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. What makes the test effective is the lifespan of the hemoglobin cells. Blood glucose levels may fluctuate between normal and high from week to week during that 3 month range but hemoglobin keeps a “record” in the form of A1C in the blood to produce an average number given that the cells live approximately 90 days. Thus, the A1C test provides the average person’s blood glucose score over the past 3 months (Manfred, 2014). This gives a doctor a good idea of how effective blood sugar has been controlled over time. And because A1C tests do not require fasting, results may perhaps appraise a person’s level of insulin function and sensitivity.
The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. For instance, someone who is not diabetic will have about 5% of their hemoglobin glycated (or the percentage of glucose attached to it). A normal A1C level is below 5.7%; 5.7%-6.5% would be considered a pre-diabetic state; anything over 6.5% would indicate diabetes. To gauge overall glucose control, diabetics should perform an A1C test biannually (Borg and Kuenen, 2008). It’s important to note that some people may produce false results if they are severely anemic, in kidney failure or have a form of liver disease.

Tips to reduce A1C:
1. Get active and move more.
Exercise can help improve your blood sugar control, boost your overall fitness, and reduce your risk of heart disease and stroke. Attempt to achieve 30-40 minutes of both aerobic exercise and resistance training in totality 4 – 5 times a week. These do not have to be organized activities. Take the dog for a walk or play a leisure sport with a buddy. Simple resistance tubing can be comfortably used in your home to perform strength exercises.
2. Maintain a responsible balanced diet with reasonable portions.
You may load up on non-starchy vegetables including broccoli, cauliflower, asparagus and other flowering greens. Be mindful of serving sizes of fruits that contain higher concentration of sugar, saturated fats and starchy carbohydrates such as breads and potatoes. Try to avoid sugary drinks and fried foods. Most importantly, try not to skip meals. It may be prudent to connect with a certified nutritionist to provide further education and guidance.
3. Adhere to your treatment plan.
Diabetes treatment is very individualized. Follow doctor’s orders! Any changes that are made within your protocol should be under the instruction and supervision of your doctor.
4. Check your sugar as directed.
Monitoring your blood sugar on your own may still be required even though you are receiving the A1C test every 6 months. Keeping a journal will allow you to detect and record how daily activities and diet may impact your blood sugar levels (Dodell, 2014).

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