The Normal A1. C Level - Diabetes Developments. You want to control your diabetes as much as possible. You wouldn’t be reading this if you didn’t. So you regularly check your A1. C level. This is the best measurement of our blood glucose control that we have now. It tells us what percentage of our hemoglobin — the protein in our red blood cells that carry oxygen — has glucose sticking to it.
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The less glucose that remains in our bloodstream rather than going to work in the cells that need it the better we feel now and the better our health will continue to be. As we are able to control our diabetes better and better, the reasonable goal is to bring our A1. C levels down to normal — the A1. C level that people who don’t have diabetes have. But before we can even set that goal, we have to know what the target is. The trouble with setting that target is that different experts tell us that quite different A1. C levels are “normal.” They tell us that different levels are normal — but I have never heard of actual studies of normal A1.
C levels among people without diabetes — until now. The major laboratories that test our levels often say that the normal range is 4. They base that range on an old standard chemistry text, Tietz Fundamentals of Clinical Chemistry. The Diabetes Control and Complications Trial or DCCT, one of the two largest and most important studies of people with diabetes, said that 6. But the other key study, the United Kingdom Prospective Diabetes Study or UKPDS, which compared conventional and intensive therapy in more than 5,0. Those levels, while unsubstantiated, are close.
But they comes along one of my heroes, Dr. Bernstein, the author of the key text of very low- carb eating for people with diabetes, Dr.
Bernstein’s Diabetes Solution. Bernstein himself developed type 1 diabetes in 1. For my patients. Bernstein says is normal is so at odds with the other experts that at least a year ago I determined to find scientific proof of what a normal A1. C level actually is. It turned out to be a lot more difficult to find than I ever imagined. My personal quest for a normal A1.
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C level and that of my favorite Certified Diabetes Educator drove that search. When I learned in 1. I had diabetes and that my A1.
C level was 1. 4. I was gradually able to bring it way down. Lately I have been doing everything I can think of to try to get my A1. C down to normal. But in 2. 00. 8 my level in nine separate A1.
C tests always ranged from 5. That’s far from normal, according to Dr. Bernstein. My favorite Certified Diabetes Educator is also doing everything she can to get a normal A1. C level. And she doesn’t even have diabetes — which she double- checked by taking a glucose tolerance test — but her most recent A1. C was 5. 4. What could we be doing that is so wrong?
Each of us is thin, eat a very healthy diet, exercise a lot, take care of our teeth and gums, which is a major source of infection. Could we have other infections or stresses that prevent us from getting our A1.
C levels down to “normal”? It turns out that my favorite Certified Diabetes Educator and I have normal A1. C levels after all. I learned this just yesterday when I finally tracked down actual research determining what normal levels are. A friend suggested that I contact the people who run the standardization program for A1. C testing. This organization affiliated with the University of Missouri is the NGSP. Those initial used to stand for the National Glycohemoglobin Standardization Program.
But now that the NGSP is international, they changed the name. So I called Curt Rohlfing, the NGSP data manager and technical writer/research analyst at the University of Missouri. And finally hit pay dirt in my quest for learning what a normal A1. C is. Curt told me that every three or four years his lab at the university studies a group of people who don’t have diabetes to scientifically determine what a normal A1.
C level is. The results from one study to the next are always close, Curt told me. In their most recent study they tested 2. Missouri. I asked how they knew if the people they tested didn’t have diabetes.
They ranged from 4. Curt replied. That’s at plus or minus 3 standard deviations. I am certainly no statistician.
But Curt tells me that it includes about 9. The range is narrower — 4.
This includes about 9. The upper limit is the more important one,” Curt explained further. In fact, levels below 4.
Remember these are the ranges obtained by the people who set the standards for A1. C tests. Sadly, however, not every laboratory or home test kit meets those standards. Maybe the lab that Dr. Bernstein uses doesn’t. Curt suggests that you ask your doctor if the lab running the test uses a method that is certified by the NGSP. The first conclusion of the research for me is that we need to shoot for a normal A1.
C level of no more than 6. However, an A1. C level of 6. That’s why the American Diabetes Associations sets the goal conservatively at 7. Still, a lower A1. C level among people who take those medications is possible without hypos.
Bernstein has amply shown that both in his own life and that of thousands of his patients. And certainly, for those of us who don’t take insulin injections or one of the sulfonylureas we can set our goal even lower. That’s because we have to understand the different between normal and optimal. For example, two- thirds of all American adults are overweight. Thus it has become normal in our culture to be overweight. Likewise, the average American gets little exercise, and that is also normal.
We know that being a chubby couch potato isn’t optimal.“I’m going to aim to be in the lower end of the normal A1. C range,” my favorite CDE tells me, “because that is what I believe is optimal for human health.” And now that I know my A1. C is in the normal range I am still going to do my best to bring it down as much as possible. Are you? This article is based on an earlier version of my article published by Health.
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