BillKaneEMT Posted July 22, 2012 Posted July 22, 2012 Iron deficiency Anemia will throw off the A1C as well sometimes. I realize the blood glucose was at 105 mg/dl but mine is often that high and I keep mine controlled with diet, exercise and metformin (though they halved my metformin dose recently). 110 and below is fine as I understand it. Without knowing the patients oral intake I'd hesitate to tell her she needed drugs. I was taught that an A1C of 4-6% was normal for a non diabetic and that between 6-6.5 could indicate pre-diabetes but that without at least 2 consecutive tests of at least 6.5% a doctor wouldn't diagnose diabetes. For me, I learned I had type 2 following drug test in which I was spilling sugar. At that point I was sitting at 280 mg/dl BGL so they decided I had a problem even before my A1C came back. I was a truck driver then, living an extremely unhealthy lifestyle, sedentary, eating garbage, smoking 3 packs a day and 60 pounds heavier than I am now. Thing is, it was pretty clear to the doctor under the circumstances that I was a type 2 diabetic (entirely due to my bad decisions:-D) and that multiple A1Cs wouldn't be needed in my case prior to me starting metformin. Given the patients stats I'm a little surprised at the diagnosis but of course, I'm no doctor:). I'm gonna run this post past my neighbor, who is a doctor, and see what she says. Also: Another useful – but underused – blood sugar marker is fructosamine. Fructosamine is a compound that results from a reaction between fructose and ammonia or an amine. Like A1c, it’s a measure of average blood sugar concentrations. But instead of measuring the previous 12 weeks like A1c, fructosamine measures the previous 2-3 weeks. And unlike A1c, fructosamine is not affected by the varying length of red blood cell lifespans in different individuals. Fructosamine is especially useful in people who are anemic, or during pregnancy, when hormonal changes cause greater short-term fluctuations in blood glucose levels. That was taken from a very interesting article I read recently. http://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker Enjoy.
Just Plain Ruff Posted July 22, 2012 Posted July 22, 2012 True on the fructosamine. The urgent care doc should not have been so quick to diagnose her as diabetic without a second a1c unless he had seen her one time before and had done a previous a1c. Sent from my SPH-D710 using Tapatalk 2
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