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Re: [IP] A1c question?


Thanks for the info. At the risk of confusing this issue even further, we
might want to consider the advent of home fructosamine testing. The
fructosamine test supposedly "bridges the gap" between the daily BG testing
and the A1c, by specifically correlating with the average BG readings over
the past 2 - 3 weeks.

There's a summary type article from Joslin posted at:


What quickly caught my eye in the Joslin article is their statement:

"In fact, people with wide swings in blood sugars - lots of highs and lows
- - would also have a normal hemoglobin A1c (your target being 8 or below and
ideally below 7), yet their treatment plan would need modification. This is
why daily blood sugar readings are also important."

Further down in the article, they make the same kind of statement about the
fructosamine test. The common theme seems to be that any test which
averages your readings, regardless of the sample interval, is still subject
to some error, introduced by the extreme samples. (Warning - I'm not a math
person, so I can't argue or defend this one any further <vbg>)

Somewhere on the Becton Dickinson site http://www.bd.com  (be patient while
all their little internet gizmo whiz bang thingies load) is information on
the home A1c test which they have available. This is also referenced in the
Joslin article.

>    I've located some more information on this topic that keeps popping
>up.  Although there have been several comments suggesting that once high BG
>increased the A1c, it couldn't be decreased, It seems that the sugar
>coating on the red blood cells can come off if you do lower your BG.  The
>reaction rate for lowering this is much less that that for forming the
>glycated Hb, but it is reversible.  In the website fro Ohio State below it
>says that for this reason, the A1C measurement only is a representative
>value for the past month, not 3 months.  In fact, even this measurement
>will be dominated by your BGs over just the last 2 weeks!  They also found
>some rather large variation among different subjects, that makes comparing
>the A1Cs in different people not very useful.  The variation was 1 to 2 %
>in A1C for the same BG!.   This large variation also makes that formula


It's still good to know there is common agreement that lowering your A1c
reduces the likelihood of complications. How we get to that number is
likely to be debated for a while yet.

Bob Burnett

mailto:email @ redacted

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