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[IP] HbA1c readings



The thing to remember about HbA1c readings is that they reflect the area
under the BG curve for some period of time.  This makes the HbA1c test a
very useful tool to help gauge one's overall BG control.

There are a few nasty wrinkles, however, that can be misleading when
interpreting HbA1c readings:

1. The younger a red blood cell is, the more susceptible it is to
glycosylation. 
As a result, the BG levels of the _recent past_ will affect the HbA1c
reading much more so than those that are further back in time.  This means
that your HbA1c readings are really only indicative of the control you've
had for the last 30 days or so, and the past 2 weeks are much more 'heavily
represented' in the reading.

2. Red blood cells are subject to deglycosylation when BG levels that were
once high are brought down to a more normal range.  This means that your
HbA1c reading may look pretty good even when your BG takes regular
excursions into the 300+ range.  It all depends on _how long_ your BG stays
in that range.  Someone who is bouncing up and down between extreme highs
and extreme lows may still have a reasonably decent HbA1c.

So while HbA1c readings are a useful tool, they can be easily misinterpreted.
What we _really_ need is a continuous glucose sensor!  Then you can _really_
know what's happening, and HbA1c tests will be a thing of the past.

I think MiniMed is working on a continuous sensor, and I heard something a
while ago about a device called a Glucowatch...anyone have an update on this?

DanO
--------
At 02:46 3/10/98 EST, Craig wrote:
>The thing to remember is that the same place that the Aic looks for results is
>the same place that during those lows, your body searches those and every cell
>for glucose to recover naturally. Severe lows actually misrepresent what is
>actually going on in terms of higher blood sugars. Back to the point of do
>lows cancel the highs. I say probably!
>
>Craig

Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/