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[IP] Re: A1C Numbers and How They Compare to Blood Sugars

Jim, I think the the problem here is how one defines success. We 
really know exactly how high BG leads to complications in diabetes. 
The A1C is a convenient method to assess longer term BG control, but 
there is little mechanistic evidence that would link hemoglobin 
glycation to say retinal bleeding or nerve damage.  The A1C also 
provides information about the BG when we don't test, and so we and 
the docs can see "how good we have been".  But as you know, the 
standard deviation in the correlation between A1C and complications 
is very large.

>I'm not sure about that because I haven't studied the glycation process in a
>lot of detail.  But the test is *not* an average.  The test tells - at the
>time of the test - the percentage of RBCs that are glycated.  That is *the*
>measure of diabetes control because of the time element in the glycation
>process, and it is that measurement that is the prognosticator of future
>complications.  The home blood tests that we do every day are less rigorous
>approximating tests that help us estimate our insulin needs - but they are
>not the measure of our success at controlling our diabetes.
>Jim Handsfield
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