HbA1c May Soon Be Top Diabetes Diagnostic Test

Family Practice News ^ | 15 March 2009 | MITCHEL L. ZOLER

[MetaThought]

I definitely should have mentioned that it’s a form of Thiamine, and is very safe.

It does sound exotic, doesn’t it.

[steve86]

I see A1C kits are available OTC now, but it is really difficult to get any blood out of my wife using the usual lancets, and I generally can’t do it. Even with the depth set at nearly the maximum there is only the tiniest trace of a droplet and not even enough for the fancy low requirement meters. I’m afraid the lancet tip is going to hit the bone if it goes any deeper. The forearm is hopeless — no sign of blood whatsoever. What do people do in a case like this? We have tried the usual heating the area, rubbing the area, etc., etc. OTOH, I gush with just a small prick when I have practiced on me. Maybe the answer is to fly up at 12,499 MSL and try for a sample? Perhaps at the bottom of a loop

[Sparky1776]

??????

Me too, I thought it was the test they used for diagnosis!

[varina davis]

Constant diarrhea mostly, for years. On Avandia, the muscle aches and weakness were severe. Junovia caused awful itching. So far, glyburide is the only thing that seems to have no bad reactions.

[varina davis]

I think your doctor has it right.

[Myrddin]

I can sympathize with the difficulty of getting blood samples. I went in for a colonoscopy last week. I hadn't had any food for 36 hours. The only blood vessel the nurse could nail for the IV was on the back of my right hand. The lab sits around 5,000 ft AMSL. Altitude didn't help much either. Doing curls with a large dumb bell seems to provide much better targets, but I haven't had one along when getting blood drawn.

The snow is melting. It's about time for us gray hairs to get the bikes back in service. It's +42F outside right now. Good enough to take the cruiser out for a bit.

[airedale]

So do I.

[SnarlinCubBear]

I was told about that but since I’m on an Atkins type diet, not experiencing it.

I eat NO sweets now and cut out potatos and most bread. I’m learning to love proteins and veggies. And rice.

[Bloody Sam Roberts]

Since the fasting blood suger (or non-fasting for that matter) that your meter gives you, can spike or dip any number of times during the day, a running average over the last 90 days is what the gA1C gives you. I use it as well as the meter but relying on the A1C means I don't have to test many times per day. Once is enough. Several times per week gives me an acurate picture and the A1C gives my doctor a good tool.

Though, knowing she'll ask for my daily number from the meter, it keeps me honest and doesn't allow me to 'game' the system. Without daily meter tests, the A1C can be misleading.

[Myrddin]

I was told about that but since I’m on an Atkins type diet, not experiencing it.

I've had excellent results with Atkins for weight loss in the past. Unfortunately, I fell off the wagon. Beer and baby back ribs. Iced green tea lattes at Starbucks. Not all the time, but just enough to have my weight creep up over time. I really need to resume Atkins. I was much healthier and leaner when I stuck to that approach.

[Pining_4_TX]

The A1C is not as accurate as people think it is. For example, people with anemia have higher A1C levels, and what they need is more iron, not more dieting.

I have a bad feeling about this. Treating the numbers is NOT the same thing as treating the disease. So many people are taking drugs to lower their blood sugar numbers, when there are no long-term studies that show it results in meaningful (that is, other than just lower numbers) reductions in serious complications. (I am speaking of Type 2 diabetes here.)

The data from the major studies cited in defense of all the oral diabetic meds have been seriously misused and massaged to muster even a miniscule amount of benefit.

“If there is no benefit, why tolerate any risk?”
http://abcnews.go.com/Health/Story?id=3232247&page=1

Excellent hard science blog on health matters:
Junkfood Science
http://junkfoodscience.blogspot.com/

[muawiyah]

Sounds like you never really got friendly with the big -pills . The smaller glipicide doesn't have that effect. BTW, that glucophage stuff does cause a change in your bowel behavior and keeps you from absorbing so much starch. I figure eliminating the starch eliminates the diarrhea (should that happen).

[muawiyah]

Sounds like you have a problem inherited from your ancient, distant Northern Scandinavian or Siberian ancestors.

When cold weather arrives your veins sink into your meat.

Just use the back of your hand, maybe both if they want more than two vials of blood.

[Myrddin]

It's winter and my hands were cold. That definitely makes the veins disappear. They did use the back of my right hand with a small butterfly needle for the IV last week. When it's warm, I don't generally have a problem.

Having lived in San Diego and Pocatello, I'm definitely better suited to a cold climate. As long as I'm wearing a medium long sleeve shirt, I'm good down to around +34 without a jacket. I can tolerate riding my motorcycle around in +26F as long as the streets have no ice patches. The summer weather here is bone dry. I handle that just fine. Add a little humidity and I'm soaked to the skin with perspiration.

[Myrddin]

I'm surprised that you can get an A1C as OTC. Isn't the HbA1C internal to the erythrocytes? Don't you have to spin them down, separate and induce hemolysis to release the Hb?

[steve86]

There are at least several OTC A1C products...Metrika, HomeCheck-A1c, Appraise...Some are “developed” at home, others require the sample to be sent in to the lab. At least one (Metrika) claims their process is essentially what’s used in a lab. A quick review of topical forums suggests some of these have more than the usual testing error.

[Myrddin]

I did a little research. Most of the OTC A1C tests vary widely from "lab" results. Some as much as +/- 1%. That's too inaccurate. A waste of money. Even "lab" results can vary significantly. My lab results came from a lab used by my life insurance company to rate potential customers. Hopefully, they choose their facility carefully.

[Myrddin]

The company that created the HomeCheck-A1c claims to have a more consistent result than Metrika. I haven't taken my insurance company lab results to my doctor. He opted to wait for their results instead of sticking me with more tests and bills for duplicate work.

[muawiyah]

Time to pack up the skis and snowshoes and move back home.

[Myrddin]

Time to pack up the skis and snowshoes and move back home.

We're just contemplating packing them up for the warm season. Locally, we have an alpine facility with a good ski lift and lodge. The cross country folks enjoy 25 miles of groomed trails and it's only 10 miles away from downtown Pocatello. Craters of the Moon National Monument allows cross country skis and snow mobiles during the winter. It's a fine area to putter around on a motorcycle in the summer. There is plenty of parking at the designated exhibits. I enjoy climbing into Boy Scout cave in the summer. It's well over +100F on top of the lava, yet the cave has ice on the floor. Digital pictures really bring out the colors of the minerals in the cave walls.

I left San Diego in Dec 2000. Many people consider that a "resort" town. Frankly, I find southeast Idaho has the kind of "vacation" environment that suits my interests. Mountains, rivers, lakes and sand dunes. It's nice to live in the middle of that kind of environment.

BTW, where is "home"?