If you’re diabetic you’re probably familiar with the term hemoglobin A1c. However, if your doctor is concerned you’re “prediabetic” meaning you’re knocking on the door of type 2 diabetes, then this is a lab value you need to understand.
When you are diagnosed with diabetes, it means you have too much blood glucose (sugar) floating around in your system and your body isn’t able to create enough insulin to combat all the sugar you’re consuming. Think of your body like a pool. People with sunscreen (carbs that get broken down into sugar) and sweat (sugar) are getting in the pool making it cloudy. The pool has chloride (your insulin) to fight the sunscreen and sweat so that the pool stays nice and clear despite all the people in and out BUT when all the chlorine storage is depleted (type 1 diabetes) or there are just too many people in the pool and the chlorine demand can’t keep up (type 2 diabetes) and the sweaty, sunscreened people keep getting in the pool the water is not going to clear on it’s on and it’s going continue getting pretty murky. The pool walls are going to get a build-up of all that sunscreen and sweat. Then, the pipes will start to clog. Eventually not allowing any water to filter through.
This is what happens with our blood vessels. Without insulin to breakdown the glucose (sugar), this abnormal environment starts allowing build up in our vessels (with plaque), clogging them from being able to get fresh blood to the area. That’s why diabetics complain of having pain in their feet and can have wounds that don’t heal well; or if severe enough, they may not have much feeling in their feet at all. Those small blood vessels have been blocked due to poorly managed glucose levels (too much build-up on the walls). The well oxygenated blood can no longer flow unimpeded to the area. Pretty scary. This happens all over our body. Our vision starts to change (think small vessels again), our heart has to work harder to push through all that sludge raising our risk of stroke and heart attack. Also, studies are finding each year that you have an elevated hemoglobin A1c your average brain loss is 1%, thus increasing your risk for dementia.
So, back to the original question: what is hemoglobin A1c and why do I need to pay attention?
Your hemoglobin A1c is a lab test done sometimes by a finger stick but usually by blood draw that gives a percentage of your average blood glucose levels over the course of 3 months. A normal A1C level is below 5.7%, a level of 5.7% – 6.4% indicates prediabetes, and a level of 6.5% + indicates diabetes.
What does this look like in numbers on your meter? Fasting, meaning no food or drink when testing: If you’re in the normal range your average glucose is 99 or below. If you’re in the prediabetes range your numbers would be between 100-125 and if you’re diabetic your average would be 126 and greater.
Briefly mentioned in the pool analogy was the difference in type 1 diabetes and type 2. Type 1 diabetes means the body doesn’t produce insulin. That’s why sometimes you hear someone call themselves “insulin dependent.” They have to give themselves doses of insulins to balance out what they eat. Where as type 2 diabetes can often correct with proper diet and exercise. Type 2 diabetics produce insulin but the cells have become resistant to its effect so the body cannot make enough insulin to combat all the glucose. Type 2 diabetics take medications such as Metformin to help bring that glucose down in addition to adding healthy lifestyle changes to hopefully lower that hemoglobin A1c number back to normal.
The body keeps score. Usually long before we are diagnosed as being sick we already start to notice that we are slowing down, feeling sluggish, not sleeping great, compensating with caffeine, and getting winded going upstairs. Now’s the time to start investing in you.
Ask questions. We want to help you be well. If you are feeling some of these effects and aren’t sure what your body is trying to tell you, sign up for our healthcare membership. You’ll get a timely visit with your doctor who will spend TIME with you to sort through your issues. For just $69/month, can you really afford NOT to get in for an evaluation? Give our office a call at 317-300-4091