June 14, 2009

blood-zThe big story this week was a recommendation by an international body of experts, including the American Diabetes Association, to use a test called hemoglobin A1C, often abbreviated HbA1C, or even simply A1C, to diagnose diabetes.

A1C is based on the fact that sugar molecules lurking about in the blood will attach to hemoglobin, the oxygen carrying molecule found in red blood cells. Red blood cells survive for a couple of months, so testing how much sugar is attached to them provides an average of blood sugar over that time period. The average is very important as all of us have spikes and valleys in our blood sugar daily.

This test will now replace two older tests: fasting plasma glucose, where people needed to have their blood drawn before eating anything that day (hopefully first thing in the morning!) or the oral glucose tolerance test, where they drank several ounces of a very sugary liquid and then had blood drawn periodically afterward to see how high the blood glucose went and how quickly it came back down afterward. Both tests had their down sides.

A1C can be drawn at any time of the day and whether or not someone has eaten. The level considered to indicate diabetes is given as a percent, and the number is 6.5. So if your A1C is 6.5% or higher that means you very likely have diabetes. As Rick says, it may take some time before everyone is using A1C and the other tests are abandoned, but you can certainly ask for this test rather than the other ones if you're being evaluated for diabetes.

Other stories this week included A Randomized Trial of Therapies for Type 2 Diabetes and Coronary Artery Disease, The Safety of Metoclopramide Use in the First Trimester of Pregnancy, and Genetically Elevated Lipoprotein(a) and Increased Risk of Myocardial Infarction. Until next week, follow us on Twitter! And to quote Rick, Y'all live well.

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Anonymous June 20, 2009 at 8:55 pm

Hey Elizabeth Tracey.I come from Chinese.I like your program very much.Thanks to my poor listening,i can't get all the information that you and Rick talked about.So i wonder if there is a script of the podcast.Thanks!

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