Diabetes Testing and Control

In order to manage my diabetes, I am continually researching, trying to understand what the disease does to the body.  I am fortunate enough that although I have Type II diabetes, I am not taking any insulin medication.  In my case, my pancreas is producing insulin, but my body is not able to make use of it to break down the sugar in my blood stream.  Every time we eat, food is converted to sugars.

Blood Sugar Tests

There are two types of tests.  The first one needs to be done by a diagnostic lab and requires drawing blood.  This test is for A1C. Doctors generally prescribe this test several times a year.   The other type of test is for individuals like myself take using a glucose meter.  I do this up to 3 times a day.

  • A1c Tests

It stands for glycated hemoglobin and is also referred to as HbA1c.  So what is it?  The test measures average blood sugar levels by sampling hemoglobin A1C cells, a red blood cell component. The Accuchek and American Diabetes Association websites, https://www.accu-chek.com/us/glucose-monitoring/a1c-calculator.html# and http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/ describe the process behind the test as follows:

Hemoglobin, a protein that links up with sugars such as glucose, is found inside red blood cells. Its job is to carry oxygen from the lungs to all the cells of the body. Glucose enters your red blood cells and links up (or glycates) with molecules of hemoglobin. The more glucose in your blood, the more hemoglobin gets glycated. When this happens, the cell is considered  “glycated.”

Once a cell has been glycated, it stays that way. And since each A1C cell has a lifespan of about 4 months, your A1C sample will include cells that are a few days, a few weeks and a few months old. As a result, the test covers a span of about 2 to 3 months.

The more sugar in your blood, the higher the percentage of glycated A1C cells you'll have—that percentage is your A1C test result.  The Mayo Clinic (http://www.mayoclinic.org/tests-procedures/a1c-test/details/results/rsc-20167939) states that: For someone who doesn't have diabetes, a normal A1C level is below 5.7 percent. Someone who's had uncontrolled diabetes for a long time might have an A1C level above 8 percent. When the A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate occasions indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes.  My doctor's target for me is under 7.0.  A1c readings are expressed as a percent.

  • Blood Glucose Test

Blood glucose test is intended for home and personal use.  It requires a blood glucose meter.  There are many times of meters available in the market,  I mentioned some of these in my previous blogs. In addition to the meter, there are consumables:  test strips, and lancets.  The test strip is specific to the meter, and the lancet is used to prick a finger to draw blood.  The drawn blood is placed on the test strip which is inserted into the meter during the test process.

Unlike the A1c, which is an average, the Blood Glucose Test measures the amount of blood sugar in the blood at the time of testing.  It is more like a snapshot.  So what is blood glucose?  The National Institure of Health (NIH) MediLine Plus website (https://medlineplus.gov/ency/article/003482-3-2.htm?) states: Glucose is a major source of energy for most cells of the body, including brain cells. Carbohydrates are found in fruit, cereal, bread, pasta, and rice. They are quickly turned into glucose in your body. This raises your blood glucose level.  The test measures the amount of glucose in the blood.  It is expressed as mg/dL (milligram per deciliter) in the US, and in other parts of the world, it is expressed as mmole/liter.

Although the tests are different, there is a relationship between the two tests.   I try to maintain a daily glucose test of between 100 to 130 mg/dl.  This puts in somewhere between 6 and 7 % A1c.  By testing daily, I manage my diabetes by being aware of what I need to do.  Testing helps me determine what food to eat.  For example, if my blood sugar level is high, I avoid carbohydrates such as bread and pasta.  If the sugar level is low, I splurge and eat the carbohydrates I love.

A1C levelEstimated average blood sugar level
5 percent97 mg/dL (5.4 mmol/L)
6 percent126 mg/dL (7 mmol/L)
7 percent154 mg/dL (8.5 mmol/L)
8 percent183 mg/dL (10.2 mmol/L)
9 percent212 mg/dL (11.8 mmol/L)
10 percent240 mg/dL (13.3 mmol/L)
11 percent269 mg/dL (14.9 mmol/L)
12 percent298 mg/dL (16.5 mmol/L)
13 percent326 mg/dL (18.1 mmol/L)
14 percent355 mg/dL (19.7 mmol/

So in the end, and educated patient is one who is able to manage their diabetes.  By educating myself and reading the journals and publications, in addition to talking to doctors and practicioners, I am on my way to managing my diabetes.