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Re: [IP] A1C and efficacy of regimen



> In a message dated 98-03-07 00:58:03 EST, Judy writes:
> 
> >  Your child's hemoglobin A1C's will indicate to both you and your
> >  doctor how well the present regimen is working.  
> 
> Not really.  The A1c is only an average of your highs and lows and gives
> absolutely no idea as to how well a regimen is or is not working.  Only by
> looking at the log books (if kept) and seeing that highs are not in fact being
> balanced out by lows will a doctor have any idea if a regimen is working.
> 

I disagree. The hbA1c measures the glucose molecules that stick to 
hemoglobin.  This is a non-linear process, it is not simply an 
average of highs and lows.  A few highs that last awhile cause a lot 
of damage as opposed to a few short peaks. The lows don't really do 
much at all.

A simple formula converts the hbA1c to the sort-of-average your 
talking about.

HbA1c*33.3-86=avg glucose

you will find that this is quite a bit higher than the average you 
see on your meter.  That is because of the sticky effect of the 
glucose molecule.  Basically it is a measure of the glucose stuck to 
the red blood cells that are alive in your body.  Since they are 
replaced completely about every 90 days, this gives an overall 
indication of the level of control.  

Don't mistake my point, I am not advocating big swings in bg.  Simply 
that the HbA1c is a more sophisticated measure of control than simply 
looking at your bg's even if you test a lot.

Michael
email @ redacted
Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/